51 jobs found in Madison, WI

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

Outpatient 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. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Coder I, Professional This is a full time day shift position for SSM Health Cancer Care located at 1104 John Nolen Dr. in Madison, WI. The schedule is 8:00 a.m. to 4:30 p.m. Monday through Friday for a total of 40 hours per week. Ideal applicants will be ROCC certified (Radiation Oncology Certified Coder), have knowledge of ICD10 and CPT. Experience with pre-authorization and reviewing documentation to confirm it supports the coding is also helpful. Job Summary: Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures. Job Responsibilities and Requirements: Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps. Identifies all billable services. Reviews all applicable data sources, including but not limited to, electronic health record, inpatient admit, discharge and...

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...

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...

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...

SPECIALTY SCOPE FOR THIS CODER II POSITION TO INCLUDE BUT NOT LIMITED TO: Upper Extremity: - Shoulders: Total/Hemi Arthroplasty, Arthroscopy, Rotator cuff repair, Biceps tenodesis, Acromioplasty, Distal claviculectomy, Superior Labrum Anterior to Posterior tear (SLAP) repair - Elbows: Cubital tunnel release, Bursectomy, Arthroplasty - Wrist: Carpal tunnel release, Carpectomy, TFCC debridement/repair, 4-corner fusion, De Quervain (1st dorsal compartment) - Hands: Trigger fingers, Ganglions, Mallet fingers, Carpometacarpal (CMC) arthroplasty, , Dupuytren's (Palmar fascial fibromatosis), Amputations Lower Extremity: - Hips: Dislocation reductions, Total/partial Arthroplasty, Femoral fracture treatments, Arthroscopy - Pelvis: Fracture repairs - Femur: ORIF neck fractures, Trochanteric repairs, shaft fracture repairs - Knees: Dislocation repairs/reductions, Total/hemi arthroplasty, Meniscal repairs, Ligamentous reconstructions and repairs,...

Job Description About the Role: 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...

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER Are you a detail-oriented leader with a passion for accuracy and process improvement? Join our team as a Medical Coding Supervisor , where you'll play a key role in ensuring high-quality coding practices, supporting provider education, and leading a dedicated team that drives the success of our revenue cycle operations. The Medical Coding Supervisor oversees the operations and personnel within the Medical Coding department. Key responsibilities include reviewing provider-assigned codes for accuracy and compliance, auditing insurance claims, and addressing coding-related denials. This role provides coding education to providers, supports documentation standards, and may assist with related research initiatives. The supervisor manages team functions such as hiring, onboarding, training, performance evaluation, and ensuring adequate staffing. Additional duties include developing departmental policies, leading...

It's more than a career, it's a calling WI-Turville Bay Worker Type: Regular Job Highlights: This is a full time day shift Coder I, Professional position for SSM Health Cancer Care located at 1104 John Nolen Dr. in Madison, WI. The schedule is 8:00 a.m. to 4:30 p.m. Monday through Friday for a total of 40 hours per week. Ideal applicants will be ROCC certified (Radiation Oncology Certified Coder), have knowledge of ICD10 and CPT. Experience with pre-authorization and reviewing documentation to confirm it supports the coding is also helpful. Job Summary: Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps. Identifies...

Become a part of our caring community and help us put health first The Inpatient Medical Coding Auditor 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. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

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...

Job Description About the Role: Join our innovative healthcare information management team as a Lead Inpatient Medical Coder. This pivotal position is essential in connecting clinical data with technology, driving the development of advanced AI solutions for medical coding and billing. You will leverage your expertise to significantly influence our product development initiatives. Requirements and Qualifications: At least 3 years of extensive experience in inpatient medical coding within a hospital setting. Expertise in accurately identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and their modifiers from patient records. Comprehensive knowledge of the evidence requirements for precise coding. Hands-on experience with grouper software for MS-DRG and APR-DRG assignment. Excellent communication skills for effective collaboration with the billing department on coding-related matters. Up-to-date with the latest ICD-10-CM,...

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER This is a hybrid position which will have a combination of remote and onsite work on a weekly basis. Applicants must be a resident of Wisconsin and have the ability to work onsite as scheduled. 1.0 FTE / 40 hours per week. The Medical Billing Specialist is responsible for all Fee-for-Service (FFS) patient accounts. This includes timely billing of non-covered services, services covered by other health insurance, co-payments and deductibles. They are also responsible for the collection and posting of all payments related to patient accounts. Additionally, they provide assistance to members with billing inquiries, complaints and compliments; and performs credentialing certification for GHC-SCW providers for billing purposes. The Medical Billing Specialist is responsible for enrollment of uninsured individuals in the Community Care Program and students in the Madison College Student Health Services. The...

Current Madison College employees must apply to the internal career site by logging into Workday Job Posting Date: January 29, 2025 Application Deadline: Salary Information: Salary depends upon workload. Department: School of Health Science_OTA, MA, MC, OptTech, TM&Rad_PT Faculty Job Description: Madison College is recruiting a pool of highly motivated and qualified candidates to teach part time courses for the Medical Coding Specialist program. Applications will be accepted on a continuous basis for the 2025-2026 academic school year. If you possess the aspiration to help others succeed, this is an opportunity for you to positively impact the community and lives of our students. Madison College is a first-choice institution that offers exceptional educational opportunities to our students providing high-demand skills for professional and academic growth. Madison College's dedication to promoting equity, inclusion and diversity is reflected in our...

Job Posting This is a remote position. Job Details: Assign diagnosis and procedure codes to reflect the condition(s) and treatment provided to the patient based on the documentation within the record for both inpatient and outpatient stays. The code assignment is utilized to determine reimbursement for the facility and physician, quality measures, hospital statistics, and medical research. Skills and Experience Required: Knowledge of the contents of the medical record Demonstrates working knowledge of ICD-10-CM, ICD-10 PCS and CPT 4. Passing Score of 80% or higher on the coding test to be considered. Working knowledge of Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) Previous outpatient and/or inpatient coding experience 1 year minimum Must be a member of the AHIMA in good standing

Job Description Job Description Description: Illuminus is seeking a full-time Health Information Coder to join our team. The Coder is responsible for extracting relevant clinical details from patient records to assign accurate diagnostic codes (ICD-10CM) while ensuring compliance with all state and federal regulations and coding guidelines. This position will work onsite generally Monday - Friday from 8:00am - 4:30pm onsite at our office located at 2970 Chapel Valley Road in Fitchburg, Wisconsin. Responsibilities Maintains and actively promotes effective communication with all individuals. Maintains a positive image of the entity in the community keeping in alignment with our mission, vision, and values. Maintains working knowledge of laws, regulations, and industry guidelines that impact compliant coding while practicing ethical judgment in assigning and sequencing codes for proper reimbursement. Researches and analyzes health records to verify clinical...

Medical Coding Supervisor Are you a detail-oriented leader with a passion for accuracy and process improvement? Join our team as a Medical Coding Supervisor, where you'll play a key role in ensuring high-quality coding practices, supporting provider education, and leading a dedicated team that drives the success of our revenue cycle operations. The Medical Coding Supervisor oversees the operations and personnel within the Medical Coding department. Key responsibilities include reviewing provider-assigned codes for accuracy and compliance, auditing insurance claims, and addressing coding-related denials. This role provides coding education to providers, supports documentation standards, and may assist with related research initiatives. The supervisor manages team functions such as hiring, onboarding, training, performance evaluation, and ensuring adequate staffing. Additional duties include developing departmental policies, leading staff meetings, addressing inquiries or...

Vascular Surgery Coder The job family is General Coding. Travel is not required. Clearance is not required. The Vascular Surgery Coder must be proficient in surgical coding for all Trauma Surgery type cases. E/M experience is also required for associated providers. The coder will review clinical documentation and diagnostic results to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager, the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and...

Job Posting This is a remote position. Job Details: Assign diagnosis and procedure codes to reflect the condition(s) and treatment provided to the patient based on the documentation within the record for both inpatient and outpatient stays. The code assignment is utilized to determine reimbursement for the facility and physician, quality measures, hospital statistics, and medical research. Skills and Experience Required: Knowledge of the contents of the medical record Demonstrates working knowledge of ICD-10-CM, ICD-10 PCS and CPT 4. Passing Score of 80% or higher on the coding test to be considered. Working knowledge of Ambulatory Payment Classifications (APC) and Diagnostic Related Groups (DRG) Previous outpatient and/or inpatient coding experience 1 year minimum Must be a member of the AHIMA in good standing

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER Are you a detail-oriented leader with a passion for accuracy and process improvement? Join our team as a Medical Coding Supervisor , where you'll play a key role in ensuring high-quality coding practices, supporting provider education, and leading a dedicated team that drives the success of our revenue cycle operations. The Medical Coding Supervisor oversees the operations and personnel within the Medical Coding department. Key responsibilities include reviewing provider‑assigned codes for accuracy and compliance, auditing insurance claims, and addressing coding‑related denials. This role provides coding education to providers, supports documentation standards, and may assist with related research initiatives. The supervisor manages team functions such as hiring, onboarding, training, performance evaluation, and ensuring adequate staffing. Additional duties include developing departmental policies, leading...

A leading health data exchange company is seeking experienced outpatient coders to join their remote team. Candidates should have at least 3 years of coding experience, strong knowledge of medical terminology, and AHIMA or AAPC certification. Responsibilities include reviewing medical records, assigning accurate codes, and maintaining high coding accuracy. Enjoy benefits such as medical coverage, paid time off, and opportunities for continuing education. This role is perfect for detail-oriented individuals looking to make an impact in healthcare. #J-18808-Ljbffr

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 for...