186 jobs found in Pawtucket, RI

Billing Specialist As a Billing Specialist, you will manage the end-to-end medical billing process for multiple hospitals, facilities, and clients. Your role will involve entering and verifying patient and insurance information, coding procedures accurately, and submitting claims for professional services (Pro Fee). You will follow up on unpaid or denied claims, resolve discrepancies, and ensure compliance with payer requirements. Additionally, you'll collaborate with internal teams and external partners to maintain accurate records and support the acquisition transition. This position requires strong attention to detail, familiarity with medical billing systems, and the ability to work efficiently in a fast-paced environment. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates...

Coder Central Billing Office Working under the supervision of the Central Billing Department Supervisors, you will be accessible to physicians, staff, and patients regarding billing questions. You will assure that all billing functions are completed in a timely fashion and develop billing goals. Responsible for accurately coding providers outpatient and inpatient visits based on the documentation provided and abstracting accurate and complete patient care data to ensure optimum and timely reimbursement. Applies knowledge of specialized information specific to coding and medical terminology according to all coding guidelines. Required Qualifications and Skills: Minimum of 1-2 years of medical billing experience in either charge payment or follow-up work Minimum of 1-2 year of coding experience for primary care medical and surgical specialties or secured CPC CCS-P coding certifications Excellent written and oral communication skills with attention to detail Excellent...

Job Description Job Description Medical Biller Location: Pawtucket, RI 02861 Pay: $23–$25/hour Type: Contract-to-Hire (CTH) or Direct Hire (DH) Start Date: Within 3 weeks Schedule: Monday–Friday, 8:00 AM – 5:00 PM Dress Code: Business Casual About the Role We are seeking experienced Medical Billers to join our growing team. This position requires strong knowledge of hospital billing, insurance denials, and proficiency in Epic. If you are detail-oriented and thrive in a collaborative environment, we want to hear from you. Key Responsibilities Data Verification: Review and verify billing data for accuracy Accounts Receivable: Track payments and follow up on overdue accounts Discrepancy Resolution: Address billing inquiries and resolve discrepancies promptly Insurance Claims: Prepare and submit claims to carriers, ensuring compliance Payment Processing: Post and reconcile payments Compliance: Stay current on billing regulations and insurance...

JOB DESCRIPTION As a Billing Specialist, you will manage the end-to-end medical billing process for multiple hospitals, facilities, and clients. Your role will involve entering and verifying patient and insurance information, coding procedures accurately, and submitting claims for professional services (Pro Fee). You will follow up on unpaid or denied claims, resolve discrepancies, and ensure compliance with payer requirements. Additionally, you’ll collaborate with internal teams and external partners to maintain accurate records and support the acquisition transition. This position requires strong attention to detail, familiarity with medical billing systems, and the ability to work efficiently in a fast-paced environment. REQUIRED SKILLS AND EXPERIENCE Medical Billing or Pro Fee billing Experience Familiarity with claims processing or CPC certification Minimum 2–3 years in medical billing Onsite Requirement: Must work onsite in Pawtucket, RI, 5 days per week...

Medical Coding Coordinator 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...

Coder II Position Specialty scope for this coder II position includes but is 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, Arthroscopy Tibia/Fibula:...

Inpatient Medical Coding Auditor As an Inpatient Medical Coding Auditor, you will make an impact by auditing consultant inpatient. You will be a valued member of the Cognizant team and work collaboratively with stakeholders and teams. In this role, you will: Review ICD-10 inpatient patient records for accuracy and compliance Review physician documentation to verify diagnosis and procedures Communicate with physicians to obtain or clarify diagnosis and/or procedures via the query process Assign accurate ICD-10-CM and ICD-10-PCS codes utilizing an electronic encoder application, 3M, in accordance with practice policy and regulatory guidelines Complete reports as requested Provide ICD-10-CM and ICD-10-PCS education and mentoring to Company's clients in coding, billing and compliance Perform Peer Reviews of Company Health Information Management coding auditors and coders Assure that services provided to Clients of Company are current and up-to-date with industry standards...

Senior Medical Coder The Senior Medical Coder plays a critical role in supporting clinical trials by ensuring the accurate, consistent, and timely coding of medical terms using standardized dictionaries (e.g., MedDRA, WHO Drug). This individual brings advanced knowledge of medical terminology, clinical trial processes, regulatory requirements, and coding best practices. The Senior Medical Coder serves as a subject matter expert and collaborates cross-functionally with clinical operations, data management, safety/pharmacovigilance, biostatistics, and medical writing teams to maintain high-quality data that meet global regulatory standards. Medical Coding Perform complex medical coding for adverse events, medical history, procedures, and concomitant medications using MedDRA and WHODrug dictionaries. Review and validate coding performed by other coders to ensure consistency and accuracy. Identify ambiguous or unclear terms and query clinical sites or data management for...

Job Description Job Description PRINCIPAL DUTIES AND RESPONSIBILITIES: Reads and interprets health record documentation to identify all diagnoses and procedures that affect the inpatient/outpatient stay/visit. Assign CPT, ICD-10, HCPCS II, and modifiers based on documentation and payer requirements. Independently resolve coding rejections and denials using discretion and analytical ability to apply broad guidelines to specific coding situations. Responsible for maintaining current knowledge of coding, compliance, and reimbursement procedures. Review payer policy updates and coding manuals. Maintain coding certification by keeping track of Continue Education Units (CEUs) Completes work assignments within an acceptable time frame. KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED: Coding certification required by either AAPC or AHIMA 2-3 years of experience in medical professional coding in a physician's office, hospital, or clinic. Knowledge of...

Senior Provider Reimbursement Professional - Certified Medical Coder Become a part of our caring community and help us put health first. The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview: Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department's strategy. Makes decisions on...

Allegheny Health Network Job Posting 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 updates in daily work (5%) Performs other duties as...

About Otsuka We defy limitation, so that others can too. In going above and beyond-under any circumstances-for patients, families, providers, and for each other. It's this deep-rooted dedication that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the limitations of their disease and achieve more than they thought was possible each day. About the Role The Omnichannel Center of Excellence is dedicated to driving innovation, building, and delivering capabilities that enhance Otsuka's opportunity to make an impact in the lives of those we serve. We achieve this through our relentless focus on customer centricity, patient empathy, expertise in enabling pathways for disease education and awareness of management options, and our unwavering commitment to supporting access to treatment. We are looking for an Omnichannel Data Scientist , Medical Omnichannel with strong expertise in artificial intelligence, encompassing...

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...

Job Description Job Description SUMMARY: Under the general direction of the Manager of Revenue Cycle, performs a variety of functions related to patient accounts to ensure the financial stability of the organization. This is a full-time, 40 hours/week position (Monday-Friday), at our Providence location: 110 Elm St., Providence, RI. PRINCIPLE DUTIES AND RESPONSIBILITIES: Applies the Brown Physicians Inc. values of patient care priority, dignity, collaboration, integrity and quality in support of the Brown Physicians Inc. mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Is responsible for knowing and acting in accordance with the Brown Physicians Inc. Compliance Program and Code of Conduct. Practices the Brown Physicians Inc. Customer Service Standards. Maintain current knowledge of federal and state regulations regarding medical billing practices. Act as a resource to practice...

Job Description Job Description SUMMARY: Under the general direction of the Manager of Revenue Cycle, performs a variety of functions related to patient account charge entry. These financial transactions are to ensure stability of the organization’s accounts receivable. This is a full-time, 40 hours/week position (Monday-Friday), located on-site at our Providence office PRINCIPAL DUTIES AND RESPONSIBILITIES: Applies the Brown Physicians Inc. values of patient care priority, dignity, collaboration, integrity and quality in support of the Brown Physicians Inc. mission to deliver compassionate, high-quality patient care, research excellence and outstanding physician education. Is responsible for knowing and acting in accordance with the Brown Physicians Inc. Compliance Program and Code of Conduct. Practices the Brown Physicians Inc. Customer Service Standards. Maintain current knowledge of federal and state regulations regarding medical billing practices. Act...

Medical Billing Specialist Neolytix is a boutique Consulting and Management Services Organization that works with small & medium-sized healthcare providers across the United States. Our portfolio of services caters to micro verticals and is built on the expertise we have developed in enabling these practices. At Neolytix, you will learn to hone your Consultative skills, develop drive & leadership, balance work with family time and importantly have fun! Medical Billing Specialist is responsible for posting medical charges, payments, and journal entries to patient accounts in a timely and accurate manner. Responsibilities include: Work directly with the insurance company, healthcare provider, and the patient to get a claim processed and paid. Verifying correct insurance filing information on behalf of the client and the patient. Verifying receipt of all patient registration data from the client and notifying the client of potential coding problems. Prepare, review,...

Baylor Scott & White Health Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our core values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Eligibility on day 1 for all benefits, Dollar-for-dollar 401(k) match, up to 5%, Debt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more, Immediate access to time off benefits....

Job Description Job Description We are a well established and rapidly growing third-party revenue cycle management/medical billing company located in Smithfield, RI and are seeking a full-time medical billing specialist to join our team. This position offers flexible daytime work hours and partial remote work opportunities.  Two years of medical billing experience in accounts receivable (insurance) follow up is required . The culture at Grey Ledge Medical is focused on providing the highest quality service to our clients, while creating a positive and friendly work environment for all. We offer comparable salary and benefits for all of our positions. Please reply back to this post with your resume. Thank you. Job Type: Full-time Benefits:   Flexible schedule   Ability to Commute:   Smithfield, RI 02917 (Required)   Ability to Relocate:   Smithfield, RI 02917: Relocate before starting work (Required)   Work Location: In person

Job Description Job Description Description: CCAP Mission Statement - To empower all people and communities, challenged by poverty as well as social and cultural barriers, through advocacy, education, and access to high quality health and human services. JOB SUMMARY: This position is responsible for posting all third-party insurance payments, process all denials appropriately and follow up on all unpaid claims. Work with patients and external collections company to provide account resolution. Work with the Billing Manager to maintain A/R. WORK SCHEDULE DEMANDS: This is a full-time position, 40 hours a week. Requirements: REQUIRED QUALIFICATIONS: 1-3 years of experience in third-party billing Medical Billing Certification, preferred Must possess all basic billing knowledge and understanding of third-party reimbursement Knowledge of physician referral protocols and conventions Working knowledge and strategic understanding of medical billing and reimbursement...

Mobile Medical Equipment Supervisor If you are wondering what makes TRIMEDX different, it's that all of our associates share in a common purpose of serving clients, patients, communities, and each other with equal measures of care and performance. Everyone is focused on serving the customer and we do that by collaborating and supporting each other. Associates look forward to coming to work each day. Every associate matters and makes a difference. It is truly a culture like no other. We hope you will join our team! Supporting Milford Regional Medical Center, our Mobile Medical Equipment Team are true frontline heroes. They are proud of their commitment to providing top notch patient care by ensuring medical equipment is sanitary and available when needed. No better time than right now to make an impact in the lives of patients and their families. We are committed to bettering the human condition and are passionate about making a difference. If this aligns with your life's mission...

Medical Billing Specialist - Liability Claims - Norwood, MA Hybrid work - This position is open to remote work once the person is trained onsite for 4 weeks, but you must live in the local area to our Norwood office. Pay: $22 - $24/hr - Full-time Hours: 8:30am - 5pm (M-F) ESSENTIAL FUNCTIONS Investigates, negotiates, bills and follows up for payment regarding first and third-party claims involving any and all coverages, liability, and legal issues. Identifies viable payers, obtains IBs, UBs, HCFAs, correspondence, and medical records when necessary. Maintains the highest level of privacy in accordance with HIPAA requirements and laws. Works inventory by route while maintaining an acceptable level of aged accounts receivable. Contacts patients, payers, hospitals, attorneys, employers, and any other parties involved to collect the necessary information and ensure reimbursement for our client. Recovers maximum dollars for the hospital through coordination of benefits in a...

A leading staffing agency in Norwood, MA is looking for a Medical Billing Specialist for liability claims. This role requires at least four years of industry experience, with a strong knowledge of commercial insurance and claims processing systems. The successful candidate will negotiate and process claims while adhering to HIPAA standards. The position offers a hybrid work model after initial onsite training. Join a dynamic team focused on maximizing reimbursement for clients. #J-18808-Ljbffr

Benefits Bonus based on performance Health insurance Paid time off This full-time opening is available for immediate hire. Company is a reputable, third-party medical billing company providing billing and consulting services to clients of various provider specialties. Please submit your resume ONLY if you believe you match the job requirements outlined below. Resumes that do not match will not be retained. Insurance A/R Coordinator Qualified applicants should possess a minimum of 2 years of experience in the medical billing field with a focus on physician services. Experience with multiple provider specialties is very much preferred. Knowledge of the Epic and CareTracker billing system are a PLUS, but very detailed hands-on industry experience is most important. Billing / Revenue Management Exposure Patient Registration Insurance Eligibility Verification Service Coding Charge Entry Claim Submission Errors Insurance Payment Processing Patient Payment Processing...

We are transforming precision medicine. Variantyx is a technology-driven precision medicine company providing state-of-the-art diagnostic solutions for rare genetic disorders and reproductive genetics markets, and treatment optimization in oncology. Our proprietary whole genome analysis platform allows us to better understand a person’s genetic makeup, leading to unmatched diagnostic capabilities and improved personalized treatment recommendations. Role Description : Variantyx, Inc. is looking for an experienced Medical Billing Specialist to help complete our daily billing tasks to include patient billing, claim rejections, appeal submission and follow-up. In this high visibility role reporting to the Director of Market Access and Reimbursement you will be responsible for developing and executing companywide RCM initiatives and overseeing day-to-day RCM activities to directly contribute to overall company growth and profitability. Strong organizational, data entry,...