6 coder 4 jobs found

Nemours is seeking a Sr. CDM Specialist  in Orlando, FL This position is responsible for: assistance in maintenance of Charge Description Master (CDM) within Nemours hospital revenue producing departments. Works with the CDM/HB Manager to ensure an accurate CDM and Coding process resulting in clean and compliant claims. Acts as liaison and problem solver for CDM issues with Administration, insurance companies, charge capture departments, Health Information Management, Utilization Management, Recovery Auditors, Managed Care, Corporate Compliances, and Central billing Office (CBO).  Responsibilities: Responsible for the coordination of ongoing CDM consistency within revenue producing departments. Includes maintaining accurate descriptions, coding, in-activations, and revenue code assignments.      Demonstrate and incorporate a working knowledge of the hospital's billing and coding software applications as related to coding and billing of...

Whether you are looking to expand your current knowledge or looking to share your extensive skills with us, this could be the start of something amazing. We are a small, close knit team that works together to accomplish tasks daily. Qualifications: Knowledge in Surgery Billing and Coding Coding Certification- CASCC or COC preferred Experience with Microsoft 365 products Minimum 3 years experience in surgical billing Knowledge in all aspects of RCM Insurance credentialling- preferred Job Requirements: Coding and Charge Capture Insurance Claims Billing Resolution of rejections Coding reviews of denials Appeal assistance Coding reviews of documentation in question by the coding team Management of payor chart audits Insurance overpayment reviews Issuance of disputes as needed Ability to assist in aging follow on unpaid claims Address physician documentation matters Month end closing Utilization of reports Knowledge of and adherence to...

CPC Expertise in medical record review to abstract information required to support accurate coding. Ability to identify documentation deficiencies and properly query providers for proper code capture. Expertise in assigning accurate CPT, HCPCS Level II, and ICD-10-CM medical codes for diagnoses and procedures. Proficiency across a wide range of services, including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine. A sound knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture. CPB Proven knowledge of how to submit claims compliant with government regulations and private payer policies. Ability to follow up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. In-depth knowledge of...

Phoenix Behavioral Healthcare, LLC is seeking a highly skilled Executive   Director of Revenue Cycle Management (RCM) to oversee and optimize the full revenue cycle across multiple behavioral health facilities, clinics, laboratories, and E&M service lines. This onsite leadership role manages all aspects of RCM operations—including intake, UR/UM alignment, coding, billing, claims submission, collections, clinical documentation improvement, denial management, appeals, and compliance oversight. Key Responsibilities: Lead, manage, and optimize end-to-end revenue cycle operations for all Phoenix facilities Oversee billing and coding for inpatient, outpatient, lab, and professional services (UB-04 & CMS-1500) Direct UR/UM workflow integration to improve documentation quality and turnaround times Manage and mentor a full RCM support team (billers, coders, auditors, documentation trainers, compliance) Develop standardized...

The Certified Professional Medical Auditor is responsible for performing comprehensive audits of medical records, coding, and billing to ensure accuracy, compliance with federal and state regulations, and alignment with payer policies. This role helps protect the organization from financial risk, supports accurate reimbursement, and promotes high standards of documentation and clinical integrity. Key Responsibilities Perform prospective and retrospective audits of medical records, coding, and billing across assigned service lines (e.g., outpatient, inpatient, behavioral health, SUD/MH, lab). Verify that documentation supports ICD‑10‑CM, CPT, and HCPCS coding; identify under‑coding, over‑coding, unbundling, and other compliance risks. Review claims for adherence to Medicare/Medicaid, commercial payer, and regulatory guidelines; ensure compliance with NCCI edits and payer‑specific policies. Prepare clear, detailed audit reports summarizing findings,...

Position:   Experienced OT/PT/SLP   Medical Biller (Remote W2 employee) Location:   Florida, Maryland, Virginia, or Idaho residents only Start Date:   January 12, 2026 Classification:   Non-Exempt, Hourly Hours:   Up to 40 hours per week Important Details You Must Review Carefully Before Applying: This is a fully remote position but showing as hybrid to attract people in the Florida region You must reside in one of the following states to be considered: Florida, Maryland, Virginia, Idaho You must be aware that the compensation is hourly between $18-$26 per hour. If you are seeking highest compensation - please don't apply. The role does not include traditional benefits. No paid time off, no retirement plan, no traditional benefits. We do offer health benefits via an HRA for full-time employees with up to $400 per month contribution. You must have extensive medical billing experience preferably in Speech Therapy private practice sector. This role...