26 jobs found in Cleveland, OH

Profee Auditor The Profee Auditor is responsible for assigning ICD-10 and/or CPT/HCPCS codes as appropriate and abstracts pertinent information from patient records. Minimum Requirements: Must hold at least one of the following certifications: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H (COC) and have a preferred minimum of 2 years relevant coding experience Must be at least 18 years of age Must have experience in Profee Auditing Benefits At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: Competitive pay & weekly paychecks Health, dental, vision, and life insurance 401(k) savings plan Awards and recognition programs *Benefit eligibility is dependent on employment status. About Amergis Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our...

Medical Coder Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve. The Medical Coder reviews and assigns diagnostic and procedure codes to patient records for reimbursement and data purposes, in keeping with state and federal regulations. This position must integrate company values into daily practice. Essential Functions Include: Assigns codes using the International Classification of Disease-10th Revision-Clinical Modification (ICD-10-CM). Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations. Maintains a 95% threshold for coding accuracy. Receives and reviews patient charts and documents for accuracy. Identifies discrepancies and follows up with the provider on any documentation that is insufficient or unclear. Queries...

Regional Medical Associate Director-Central Join the team transforming care for people with immune challenges, rare diseases, cancers, and neurological conditions. In Specialty Care, you'll help deliver breakthrough treatments that bring hope to patients with some of the highest unmet needs. The US Rare Disease, Regional Medical Associate Director (RMAD)-Central, will be responsible for cross-portfolio support including proactive engagement of select HCPs across multiple specialties. The RMAD will support pipeline initiatives, with a focus on enhancing awareness of disease states associated with late-stage pipeline assets (including alpha-1 antitrypsin deficiency-AATD) among HCPs across a breadth of accounts. We're an R&D-driven, AI-powered biopharma company committed to improving people's lives and delivering compelling growth. Our deep understanding of the immune system and innovative pipeline enables us to invent medicines and vaccines that treat and protect millions...

Physician Coder: Multi-Specialty/RHC Physician Coder: Multi-Specialty/RHC is responsible for reviewing and accurately coding all professional services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid, and third-party payer guidelines to ensure receipt of accurate reimbursement. Physician Coder: Multi-Specialty/RHC is expected to adhere to MedKoder's internal coding policies and expectations set forth by department management. Physician Coder: Multi-Specialty/RHC must prioritize daily duties, multitask, communicate effectively, and make the decisions necessary to complete all assigned tasks and accomplish their goals. We are currently looking for candidates with recent coding experience specializing in the following areas: Rural Health Clinic (RHC) Family Medicine and multi-specialties Ideally candidates also have experience in Radiology (CT, US, MRI) and/or Urology procedures Responsibilities:...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Ovation Healthcare At Ovation Healthcare, we've been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior. We're looking for talented, motivated professionals with a desire to help independent hospitals...

Coding Specialist I Your job is more than a job The Coding Specialist I will be responsible applying the appropriate ICD-10-CM/PCS and CPT (charging) diagnostic and procedural codes for outpatient and/or inpatient encounters, ancillary encounters ambulatory/ provider-based clinics. Your Everyday Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APCs, CPT/HCPCs assignment and all required modifiers. Validates charges by comparing charges with health record documentation as necessary. Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding. Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems. Tracks issues (i.e. missing...

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world. As an Interventional Radiology Coder, you will be dedicated to either hospital inpatient or hospital outpatient coding. In this role, you will code and abstract highly complex clinical information from high-acuity inpatient charts or outpatient surgery and observation charts for reimbursement, research and compliance with federal regulations and other agencies, utilizing established coding principles and protocols. This position will help expand our in-house outpatient surgery coding team, including the ability to code and charge for interventional radiology procedures. Inpatient: Identify, review, and assign...

Job Title: Regional Medical Associate Director-Central Location: Remote/Field About the Job Join the team transforming care for people with immune challenges, rare diseases, cancers, and neurological conditions. In Specialty Care, you'll help deliver breakthrough treatments that bring hope to patients with some of the highest unmet needs. The US Rare Disease, Regional Medical Associate Director (RMAD)-Central, will be responsible for cross-portfolio support including proactive engagement of select HCPs across multiple specialties. The RMAD will support pipeline initiatives, with a focus on enhancing awareness of disease states associated with late-stage pipeline assets (including alpha-1 antitrypsin deficiency-AATD) among HCPs across a breadth of accounts. About Sanofi: We're an R&D-driven, AI-powered biopharma company committed to improving people's lives and delivering compelling growth. Our deep understanding of the immune system - and innovative pipeline...

Job Title: Regional Medical Associate Director-Central Location: Remote/Field About the Job Join the team transforming care for people with immune challenges, rare diseases, cancers, and neurological conditions. In Specialty Care, you'll help deliver breakthrough treatments that bring hope to patients with some of the highest unmet needs. The US Rare Disease, Regional Medical Associate Director (RMAD)-Central, will be responsible for cross-portfolio support including proactive engagement of select HCPs across multiple specialties. The RMAD will support pipeline initiatives, with a focus on enhancing awareness of disease states associated with late-stage pipeline assets (including alpha-1 antitrypsin deficiency-AATD) among HCPs across a breadth of accounts. About Sanofi: We're an R&D-driven, AI-powered biopharma company committed to improving people's lives and delivering compelling growth. Our deep understanding of the immune system - and innovative pipeline -...

Coding Specialist III Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). The Coding Specialist III can maintain up to two concurrent client assignments that are short-term in nature. For each client, the Coding Specialist III reviews documentation to code diagnoses and procedures for inpatient hospital-based claims and data needs. For both professional and technical claims and data needs, the Coding Specialist III reviews clinical documentation to code diagnoses, EM level, and surgical CPT codes. Additionally, this role also validates MS-DRG and APC calculations, abstracts clinical...

"Our mission, vision, and values are inspired directly from Scripture and guide our work at every level of Catholic Charities." If you are a compassionate and dedicated person looking for an opportunity to make a difference in society, we encourage you to apply. Catholic Charities isn't just an organization that provides help to those in need in our communities-it's a place where employees are encouraged to live purpose driven lives, professionally and personally. Join our team as we provide help and create hope for those in need. At Catholic Charities, we serve everyone, regardless of belief or background, and we employ qualified individuals who commit to our mission with the goal of transforming lives for the better. One need not be Catholic to join our workforce nor to access our services. Billing Specialist- Temporary Catholic Charities is seeking a dynamic individual to assist our Billing team! This assignment will be temporary through the end of 2024. This individual...

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world. As a Professional Fee Coder III, you will be responsible for monitoring, reviewing, and accurately applying coding principles to clinical documentation received from ambulatory areas to support reimbursement, research, and regulatory compliance. In this role, you will assign appropriate diagnosis codes, CPT codes, and modifiers based on the medical record while ensuring adherence to federal coding guidelines. You will also identify and resolve billing discrepancies to ensure timely and accurate claim submission. This position supports Cleveland Clinic's mission and vision by helping submit clean claims for the services...

Position Type: Administration and Professionals Date Posted: 2025-01-06 Location: Administration or As Assigned INTRODUCTION: CONTEXT AND MISSION The Cleveland Metropolitan School District (CMSD) serves approximately 37,000 students in 100+ schools. Over the past several years, the Greater Cleveland community has united behind the collective goal of ensuring every child in Cleveland attends a high-quality school and every neighborhood has a multitude of great schools from which families can choose. The Cleveland Plan defines CMSD's approach to the reinvention of public education and holds our community accountable for the success of Cleveland's schoolchildren. The Cleveland Plan is supported by Ohio House Bill 525, which provides much-needed flexibility and autonomy for the district and its schools. Our schools have autonomy over human and financial resources in exchange for accountability for performance. The principal has primary responsibility and...

At STERIS, we help our Customers create a healthier and safer world by providing innovative healthcare and life science product and service solutions around the globe. Position Summary The mission of the STERIS Quality & Regulatory Compliance function is to implement repeatable and sustainable processes to ensure on-going compliance with domestic and international regulations and standards. This includes evaluating the relevance to all STERIS facilities and products and implementing efficient and effective processes to ensure adherence to applicable regulations and standards. This is a hybrid role based in STERIS' Corporate Offices in Mentor, Ohio. In order to support the business needs working a minimum of 3 days a week in the Mentor office is expected. 20% domestic and international travel required What you'll do as an Lead, Quality & Regulatory Compliance Auditor Lead internal quality audits to assess compliance of a facility's quality...

Coding Specialist I Your job is more than a job The Coding Specialist I will be responsible applying the appropriate ICD-10-CM/PCS and CPT (charging) diagnostic and procedural codes for outpatient and/or inpatient encounters, ancillary encounters ambulatory/ provider-based clinics. Your Everyday Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APCs, CPT/HCPCs assignment and all required modifiers. Validates charges by comparing charges with health record documentation as necessary. Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding. Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems. Tracks issues (i.e. missing...

Professional Medical Coder II - Remote Position, Must Reside in South Carolina $5,000 Sign-on Bonus Coding Full Time AM Shift 8 a.m. to 5 p.m Sign-On Bonus: 5,000 Consistently named best hospital, Lexington Medical Center anchors an expansive health care network that includes nearly 600 physicians and advanced practice providers at nearly 80 locations across the Midlands of South Carolina, making it the region's third largest employer. From general medicine and orthopaedics to oncology, cardiology and neurosurgery, these dedicated professionals combine the highest quality care with advanced medicine and state-of-the-art technology to help patients achieve the best possible outcomes. Its postgraduate medical education programs include family medicine and transitional year residencies. Job Summary Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

A global tire manufacturing company seeks a Quality Assurance Auditor to oversee compliance audits and enhance the Quality Management System. This full-time role requires a Bachelors degree in Engineering and at least 3 years of relevant experience, focusing on standards like IATF 16949 and ISO 17025. The candidate should possess strong problem-solving skills and fluency in English and Turkish, with a proactive approach to resolving non-conformities and improving quality standards. #J-18808-Ljbffr

Position Summary MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. Position Summary: This job posting encompasses all available Physician coding roles, including Physician Coder I, Physician Coder II, and Physician Senior Coder positions. Applicants will be considered for the appropriate role based on current organizational needs, manager discretion, years of relevant experience, passing a coding assessment and how well they meet the qualifications outlined for each position. Accurately and efficiently accesses wide range specialty physician billing and Health Information Systems to secure and gather all necessary records to accurately code and bill professional physician and/or physician extender (mid-level) services. MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. At Orlando Health, we are ordinary people with extraordinary...

Job Title: Registered Nurse (Rn) We are seeking a Registered Nurse (RN) to review and evaluate medical necessity, appropriateness, quality, and compliance of services rendered by providers. This role involves claims analysis, provider audits, fraud detection, and regulatory enforcement to ensure compliance with state and federal regulations. Key Responsibilities: Analyze claims data, medical records, and provider documentation to identify discrepancies, fraud, or non-compliance. Conduct retrospective case reviews, on-site provider audits, and recipient interviews. Review billing practices for upcoding, duplicate billing, and unbundling of services using ICD-10, CPT, and HCPCS manuals. Prepare reports, case findings, and recommend sanctions when violations are identified. Coordinate and participate in teleconferences, hearings, and legal proceedings with the Office of General Counsel and other agencies. Respond to provider complaints and compliance inquiries via...

A non-profit social service agency is seeking a full-time Medical Billing Representative in Akron, Ohio. You will handle intake admissions, work on claim denials, and ensure proper reimbursement. Candidates should have a High School Diploma, at least 2 years of experience in billing, and strong computer skills. The role offers excellent benefits, including medical coverage and paid time off, all in a supportive and non-smoking work environment. #J-18808-Ljbffr

divh2Coding Specialist/h2pThis is a PRN (pro re nata/as needed) position. Hours are not guaranteed and will vary based on the needs of the organization. Scheduling is at the discretion of management and may change. PRN employees are not eligible for benefits unless required by applicable law./ppstrongWhy youll want to work at nimble!/strong/ppInterested in becoming a part of a dynamic Coding team? This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building!/ppstrongWho we are:/strong/ppNimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline their revenue...

Outpatient Coder Analyst, Medical Records Inpatient Full-Time Days Summa Health System is recognized as one of the region's top employers by a number of third party organizations, including NorthCoast 99. Exceptional candidates gravitate to Summa because of its culture, passion for delivering excellent service to our patients and families commitment to our philosophy of servant leadership, collegial working relationships at every level of the organization and competitive pay and benefits. Summary: Assign codes (ICD-10) for diagnoses and procedures (CPT) on outpatient accounts based on chart documentation according to national coding guidelines, Summa policies and local review agencies. Calculates appropriate DRG based on codes assigned. Formal Education/Experience Required: a. RHIT (or eligible) or CCS or COC or CPC with a 60% or better score on the pre-employment outpatient coding test. OR b. CCA with one (1) year coding experience in an acute care setting with a...