15 plan coder jobs found

Billing Compliance Curriculum Development Specialist Dana-Farber Cancer Institute Boston, MA Full Time The Billing Compliance Curriculum Development Specialist is responsible for the design, development, implementation, and evaluation of enterprise-wide billing compliance education programs at Dana-Farber Cancer Institute (DFCI). This role serves as a subject-matter expert in professional and technical billing compliance, with a strong emphasis on oncology services, regulatory requirements, and risk-based education strategies. The position partners closely with Billing Compliance leadership, Revenue Cycle, HIM, Clinical Operations, and Compliance to ensure education is standardized, scalable, evidence-based, and aligned with CMS, OIG, NCCI, payer guidance, and institutional risk priorities. Located in Boston and the surrounding communities, Dana-Farber Cancer Institute is a leader in life changing breakthroughs in cancer research and patient care. We are united...

This position has the primary function of coordinating and supporting the Deputy Chief Compliance Officer with administrative, analytical, and program coordination activities. This position will provide support related to compliance auditing activities and programs, assisting with developing and coordinating the Compliance Audit Plan, supporting proactive and reactive audits of professional fee billings in clinic and facility settings, including federally qualified health centers. Proactively support audit activities related to billing and coding risks to the SOM, identifying and calculating potential overpayments based on audit results, participating in the repayment process if necessary, reviewing research billing compliance issues and assisting the Deputy Chief Compliance Officer in designing and managing a comprehensive billing/auditing program.  The position supports compliance-related activities by gathering information, coordinating documentation reviews, monitoring...

Senior Billing Compliance Hospital Reviewer  Dana-Farber Cancer Institute  Boston, MA  Full Time Reporting to the Director of Billing Compliance, the Senior Billing Compliance Reviewer will be responsible for the identification and performance of Billing Compliance inpatient and ambulatory activities. The Senior Reviewer will provide oversight related to reviewing the accuracy and appropriateness of ICD-10-PCS procedure coding and assessing DRG assignment. The Senior Reviewer will assist in the development and execution of the annual Billing Compliance work plan. They will monitor federal and state regulatory requirements and industry developments and work to determine applicability and risk to both technical and operational aspects of the organization. Metrics will be developed and reported quarterly. The Senior Reviewer will be expected to pursue successful completion of multiple tasks collaborating effectively with many departments across the institute, Mass...

A Day in the Life of a Coder III The Coder III uses independent judgment to review medical records documentation to abstract demographic data and assign diagnoses, procedures, and modifiers for statistical classification and reimbursement purposes. Utilizes software applications and electronic  coding  references to perform  coding  related tasks. Why Work at Cheyenne Regional? Employer Sponsored Medical, Dental, and Vision Plans 403(b) and 457(b) retirement options with 4% employer match Life Insurance Short Term and Long-Term Disability Insurance Employer Sponsored Wellness Program Employee Assistance Program ANCC Magnet Hospital 21 PTO days per year (increases with tenure) Tuition Reimbursement Program Dedicated Loan Forgiveness Advisory Service Here is What You Will Be Doing: Selects appropriate assignments for   coding /abstracting from work queues. Uses   3M Encoder , various software applications, electronic and printed...

A Day in the Life of a CRMG Coder II Under general supervision, reviews medical record documentation to abstract demographic data and assign diagnoses, procedures, and modifiers for statistical classification and reimbursement purposes. Performs various  coding  assignments under the direction of  Coding  Management. Utilizes software applications and electronic  coding  references to perform  coding  related tasks. Why Work at Cheyenne Regional? Employer Sponsored Medical, Dental, and Vision Plans 403(b) and 457(b) retirement options with 4% employer match Life Insurance Short Term and Long-Term Disability Insurance Employer Sponsored Wellness Program Employee Assistance Program ANCC Magnet Hospital 21 PTO days per year (increases with tenure) Tuition Reimbursement Program Dedicated Loan Forgiveness Advisory Service Here is What You Will Be Doing: Interprets clinical information documented within medical records. Assigns...

Director, Billing Compliance  Dana-Farber Cancer Institute  Boston, MA  Full Time  Overview Reporting to the VP, Chief Compliance Officer with a dotted line reporting relationship to the VP, Revenue Performance Management, the Director of Billing Compliance is a strategic leader and subject matter expert responsible for ensuring the integrity, accuracy, and compliance of billing practices across the organization. The Director provides constructive oversight and mentorship to the Billing Compliance team. This role leads the development and execution of a robust billing compliance program focused on hospital technical and professional fee billing in compliance with internal policies and state, federal and local rules. The Director serves as a key 'second line of defense' in support of accurate and compliant operational processes. The Director works as a cross functional leader, partnering with clinical, administrative, and financial teams and participating in...

Billing Compliance Reviewer  Dana-Farber Cancer Institute  Boston, MA  Full Time Overview Reporting to the Director of Billing Compliance, the Billing Compliance Reviewer plans and executes risk-based audits, analyzes documentation and coding for medical necessity and regulatory adherence, and recommends corrective actions to mitigate compliance risk. The role evaluates the accuracy and integrity of hospital and professional billing practices to ensure compliance with federal and state regulations, payer requirements, national coding guidelines, and internal policies. The Billing Compliance Reviewer is responsible for developing clear findings, collaborating with clinical and administrative stakeholders to resolve issues, and supporting continuous improvement in charge capture, documentation, and coding processes. This role works collaboratively with Coding, HIS, Billing and other internal and external teams to evaluate complex billing issues and initiate...

SUMMARY/OBJECTIVE: The Revenue Cycle Management Manager is responsible for all duties listed below. The position requires coordination with clients, executive staff and RCM staff for the revenue cycle management performance reporting.   ESSENTIAL FUNCTIONS: Core duties and responsibilities include the following. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned. 1. LEAD AND SUPERVISE REVENUE CYCLE STAFF Provide day‑to‑day leadership, coaching, and performance oversight for billing, coding, collections, and reimbursement teams. Ensure staff adhere to organizational policies, regulatory requirements, and best practices across the full revenue cycle. 2. Monitor and Report Staff Productivity Develop, track, and analyze productivity metrics for all revenue cycle functions. Prepare regular performance dashboards and present findings AND SUGGESTIONS for improvement to...