3 credentialed coder jobs found

Primary Purpose of the Position: The Revenue Cycle Medical Coding Supervisor provides daily operational supervision of assigned coding staff and coding inventory. The Supervisor assigns work, monitors throughput and quality, performs and coordinates quality reviews, supports training and onboarding, resolves complex coding issues, and promptly escalates backlog, documentation, compliance, vendor, and system risks to the Coding Manager. The role may also perform complex coding to support operational needs while maintaining appropriate separation between production work and independent quality review. Required Knowledge and Experience: Active CPC through AAPC or CCS through AHIMA; specialty coding credentials are desirable. Minimum five years of professional medical coding experience preferred, including complex surgical or multi-specialty coding; prior lead or supervisory experience preferred. Advanced knowledge of medical terminology, anatomy and physiology,...

Primary Purpose of the Position: The Revenue Cycle Coding Manager provides strategic and operational leadership for professional coding and charge capture. The Manager is accountable for coding quality, productivity, inventory, compliance remediation, workforce planning, vendor performance, physician and division engagement, and coding-related revenue integrity. The position establishes clear standards, analyzes trends, and develops corrective action plans to support accurate, timely, and compliant claim submission.   Essential Duties of the Position May Include the Following: Leads day-to-day and long-range coding operations, including staffing, workload allocation, coverage planning, production priorities, and escalation management. Owns the coding operating model and clearly defines responsibilities among the Coding Manager, Coding Supervisor, internal coders, and external coding vendors. Establishes, monitors, and reports key performance indicators for...

Your Role The Risk Adjustment Compliance Specialist, Principal is responsible for ensuring organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare Advantage lines of business. This role involves auditing, monitoring, and evaluating risk adjustment processes, identifying areas of non-compliance, and recommending corrective actions. The Principal collaborates with internal teams and external partners to maintain the integrity of risk adjustment data and supports the development and implementation of compliance programs. Responsibilities Your Work In this role, you will:  Conduct regular audits and reviews of risk adjustment data submissions to ensure compliance with regulatory requirements (e.g., CMS, OIG, HHS). Monitor changes in risk adjustment guidelines, policies, and regulations, and communicate updates to relevant stakeholders. Analyze risk adjustment...