26 jobs found in Boise, ID

What You'll Be Doing You'll contact payers for medical claims status, followup denials, or partial payments You'll obtain payer requirements for timely adjudication of claims You'll file claims with appropriate documentation attached You'll pursue, maintain, and communicate medical coverage/guideline changes/updates to our internal team and/or customers You'll process all incoming and outgoing correspondence as assigned You'll verify, adjust, and update Accounts Receivable (A/R) according to correspondence received from insurance company You'll help facilitate communication on error and denial trends You'll initiate the review/appeals process on disputed claims You'll maintain partnerships with Candid's Strategy & Operations team regarding customer accounts and claim trends You'll maintain HIPAA guidelines Who You Are You have at least 2 years of experience in revenue cycle management (for medical billing or within healthcare/healthtech) You have...

About Otsuka At Otsuka, we challenge limits to help others do the same. Our commitment to exceeding expectations drives us to address complex medical needs, empowering patients to transcend their conditions and achieve their daily goals. About the Role Our Omnichannel Center of Excellence is focused on fostering innovation and delivering capabilities that enhance our impact on patients and providers. We prioritize customer centricity, patient empathy, and expertise in disease education and treatment access. We are seeking a Medical Omnichannel Data Scientist with expertise in artificial intelligence, machine learning, and data integration. This role involves conceptualizing, prototyping, and developing advanced analytics models to support data-driven decision-making. The ideal candidate will collaborate closely with stakeholders to leverage analytics and machine learning techniques, enhancing communication strategies and ensuring personalized interactions with...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures,...

Outpatient Coders Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this...

Hcc (Hierarchical Condition Category) Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code...

Inpatient Hospital Medical Coder An inpatient hospital medical coder is a healthcare professional responsible for reviewing and analyzing patient medical records from hospital stays and assigning standardized codes for diagnoses and procedures. These codes are primarily based on ICD-10-CM (International Classification of Diseases) and PCS (Procedure Coding System) standards. Responsibilities: Review clinical documentation to assign accurate ICD-10-CM and ICD-10-PCS codes. Communicate with physicians to clarify diagnoses and procedures through the query process. Utilize electronic encoder applications to assign codes in compliance with practice policies and regulatory guidelines. Maintain a minimum accuracy rate of 98% while meeting internal productivity standards. Achieve productivity expectations: Inpatient 1624 encounters per day or 23 encounters per hour. Complete reports and perform additional duties as requested by management from the hospital side of forms (not...

In Person Medical Coder (CPC) (Boise) Emerald Administration - Boise, ID 83704 Overview Position Type: Full-time Job Shift: Daytime Education Level: CPC Description We are looking for a Medical Coder to support our Business Office! You must either be a CPC or be able to obtain your full CPC within 6 months of start date. Purpose This position will support our Business Office with inpatient, outpatient, Medicare and Medicare Advantage coding services. If you are looking to challenge your coding skills, this is a great opportunity for you! Schedule Monday through Friday from 8am-5pm. Who We Are Our vision is that every Idaho community is healthy and thriving through our commitment to outstanding care and the education of tomorrow's healthcare leaders. Benefit Information We offer a well-rounded benefits package to include everything you would expect. Multiple health and dental plans some as low as $0/pay period! No cost to employee life insurance, long...

Join Datavant, a leading data platform company revolutionizing health data exchange. Our mission ensures that every healthcare decision is guided by the right data at the right time and in the right format. As the world's foremost health data network, our platform enables secure, accessible, and actionable data, empowering healthcare stakeholders including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing, values-driven team, you'll contribute to innovative technology solutions that address some of healthcare's most challenging issues. Our diverse team brings various professional, educational, and life experiences together to achieve our ambitious goals for the healthcare sector. What You'll Be Doing: Conduct audits of coded medical charts according to the client's guidelines as assigned by the quality supervisor. Navigate multiple client guidelines with ease. Maintain a 95% quality average at the...

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: This role involves comprehensive medical record reviews to extract vital medical and demographic data, accurately interpret and apply diagnoses and procedures using ICD coding systems, and contribute to reducing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES: Thoroughly review and interpret medical records, physician treatment plans, outcomes, and other relevant information to assign appropriate ICD codes for diagnoses and procedures. (65%) Abstract necessary data elements to fulfill statistical requests from the hospital, health system, and medical staff, ensuring all coded and abstracted information is accurately input into the designated system. (15%) Manage medical information efficiently and support cash flow by monitoring and addressing the unbilled coding report. (10%) Stay updated on ICD guidelines by participating in training, reviewing coding clinics,...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...

Job Description Job Description Certified Medical Coder (Remote Production Role) Our mission to change wound care and improve the lives of others isn’t easy, but it’s worth it! One in ten residents in a skilled nursing facility will develop a skin condition requiring expert medical care. We believe that every person deserves the very best wound care. Building and leading wound care teams is how we do it! Our wound care providers bring education and encouragement to the people who take care of our patients 24/7. When they get better at their jobs, our patient’s wounds heal faster and that is our goal! Main Responsibilities (may include but are not limited to): Meet minimum production goals while maintaining accuracy requirements Review provider medical coding of services rendered for medical claim submission Review and respond to medical coding inquiries submitted...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (60%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

Job Description: The HIM Hospital Inpatient & Same Day Surgery Coding Analyst deciphers and interprets provider documentation in the health record and assigns diagnostic information using ICD-10-CM/PCS and CPT codes for a complex range of acute care services for Intermountain Health. The caregiver provides specific coding expertise in the various fields of NCCI edits, Drugs and Biologicals, Revenue Codes, Current Procedural Terminology (CPT) codes, ICD-10 & CPT codes, DRGs, anatomy and physiology, pharmacology. The analyst also performs audits, provides feedback, and advanced training to clinical teams and physicians on ICD-10 and CPT coding best practices. Essential Functions Reviews and analyzes inpatient medical records for completeness, accuracy, and compliance for Same Day Surgery, Observation and Inpatient acute services at Intermountain Health. Performs coding at an advanced level of complexity for inpatient hospitals including governmental and/or...

A prominent pharmaceutical company is on the lookout for an Associate Director of Scientific Communications. This key role focuses on driving the scientific communications strategy and ensuring the creation of top-notch medical content. The ideal candidate will possess an advanced scientific degree and substantial experience in medical affairs within the pharmaceutical sector. Key responsibilities include: Managing the development of high-quality medical communications. Ensuring scientific accuracy and compliance with regulatory standards. Collaborating with cross-functional teams to align communication strategies. If you are driven by a passion for science and a commitment to enhancing medical knowledge, we encourage you to apply for this exciting opportunity. A competitive salary ranging from $164,530 to $245,985, along with comprehensive benefits, is offered.

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

This is a remote based position. Applicants can be located nationwide Back Medical Coder #2621 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who has Profee Outpatient Coding experience. We need someone who is responsible for assignment of accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Tell us about your experience with Profee Outpatient Coding. Are you a team player and a self-motivator? What is your experience with conducting business in a way that is credit to a company? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD codes for diagnoses and procedures. (65%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This position involves comprehensive medical record review to extract essential medical and demographic data. You will interpret and apply diagnoses and procedures using the ICD and CPT coding systems, contributing to the reduction of average accounts receivable days. ESSENTIAL RESPONSIBILITIES Thoroughly reviews and interprets medical information, physician treatment plans, outcomes, and determines the correct ICD-10 CM/CPT codes for diagnoses and procedures. (60%) Abstracts vital data elements to meet statistical requests from the hospital, health system, and medical staff, ensuring accurate entry of all coded/abstracted information into the designated systems. (15%) Manages medical information effectively and optimizes cash flow concerning the unbilled coding report. (10%) Stays updated with the latest changes and updates in ICD-10 CM/CPT guidelines through training...

At St. Luke's, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke's is truly a great place to work. What You Can Expect: Under general supervision, the Outpatient Coder is responsible for reviewing applicable documentation and assigning appropriate procedure and diagnosis codes. Reviews notations, diagnosis, or procedure information in medical record to assign or validate appropriate diagnosis and procedure codes, ensuring accuracy and appropriateness of codes. Applies basic knowledge of coding to solve unique or new cases resulting in the assignment and sequencing of diagnosis and procedure codes. Ensures documentation supports the...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate...

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The Medical Coding Auditor is responsible for researching and resolving grievances and appeals within the commercial line of business, applying advanced adjudication expertise, clinical...

Senior Inpatient HIM Coder We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts. Requirements and Qualifications: A minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment. Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. In-depth understanding of supporting evidence requirements for accurate coding. Practical experience using grouper software for MS-DRG and APR-DRG assignment. Strong communication skills to interact effectively with the billing department...

Inpatient Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The...