3 coder jobs found

Certified Claims Call Center Processor I at AllCare Health with the Claims department in Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options. Summary of the Position The Certified Claims Call Center Processor I serves as a primary point of contact for provider offices and their authorized representatives, responding to inbound calls and electronic inquiries regarding professional and facility claims processing and adjudication. This role combines customer service and certified claims processing responsibilities by independently resolving provider inquiries, researching claim issues, and adjudicating professional claims in accordance with company policy, contract language, coding guidelines, and applicable regulatory requirements....

Claims Processing Supervisor AllCare Health | Claims Department We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Claims Processing Supervisor ensures that internal and external departmental performance requirements are consistently met. This role oversees the day-to-day activities of the Claims Processing team, assigns work and coordinates efficient workflows to meet contractual and operational requirements, and serves as a hands-on resource for staff regarding training, questions, and claims processing best practices. Essential Duties Provides one-on-one support and initial training for new hires and facilitates monthly mandatory training sessions for Claims Processing staff. Establishes and maintains a professional, supportive, and provider...

Coding Auditor AllCare Health | Quality Department | Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members. This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes. Essential Duties Ensures the accuracy and...