84 jobs found in Raleigh, NC

Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor - DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes and expertise in...

Specialty Coder II (REMOTE) BayCare is currently in search of our newest team member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details: Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: Full time (non-exempt) Shift: 8:00AM - 4:30PM Days: Monday through Friday This Specialty Coder II opportunity is a full-time remote position. This team member must reside in the state of Florida, Georgia, North Carolina, or South Carolina. Responsibilities: The Specialty Coder II is a Certified Professional Coder who assigns diagnosis and procedural codes using ICD-10 CM and CPT-4 coding systems. The Specialty Coder audits physician documentation to assign appropriate CPT codes, diagnosis codes, and modifiers related to anesthesia coding and billing as well as...

This Jobot Job is hosted by: Brendan Thomas Are you a fit? Easy Apply now by clicking the "Apply" button and sending us your resume. Salary: $150,000 - $360,000 per year A bit about us: We're seeking a Senior Family Law Attorney who wants to focus on practicing law-without the distractions. No admin headaches. No office politics. No micromanagement. Just meaningful, strategic family law work for clients who truly need your expertise. When you're not billing, you're off the clock. We mean it. This is a fully remote position, with occasional in-person court appearances in the San Francisco Bay Area. The rest of the time, you're free to work from wherever you feel most productive-your home office, a sunny patio, or your favorite coffee shop. Why join us? Why This Role is Different Zero admin, zero drama: Dedicated paralegals, legal assistants, and billing specialists handle the rest so you can focus on the law. No facetime culture: We value results, not hours spent at a...

The Sr. Compliance Auditor is responsible for implementation of the Corporate Compliance Plan and ensures WakeMed is billing in accordance with federal and state regulations on facility documentation, coding, and billing. The Sr. Auditor works under Auditor, Compliance, Physician, Audit, Billing, Healthcare, Health

A healthcare services provider in the United States is looking for a Nurse Auditor 2 to perform clinical audits and ensure medical documentation accuracy. The role involves interpreting coding, validating records, and exercising clinical judgment. Applicants must hold a current U.S. RN license and have clinical experience with PDGM and PPV. This remote position requires independent decision-making and strong communication skills, alongside a commitment to healthcare excellence. Occasional travel for training may be necessary. #J-18808-Ljbffr

Join our compassionate team dedicated to prioritizing health! The Lead Medical Coding Specialist plays a crucial role by extracting essential clinical information from diverse medical records and accurately assigning procedural terminology and medical codes such as ICD-10-CM and CPT to patient records. In this leadership position, you will take charge of advanced, specialized administrative and operational tasks, requiring proactive initiative and sound judgment. You will ensure correct diagnosis-related group (DRG) assignments and analyze, input, and manipulate essential databases. Also, you will respond to internal inquiries regarding medical information and determine daily priorities for an administrative work group while overseeing the progress of work activities along with external vendors. This role operates under minimal supervision and broad guidelines. Utilize your expertise to make a difference! WORK STYLE: This is a remote position with occasional travel to...

Associate Director, Medical Science Liaison At Insmed, every moment and every patient counts and so does every person who joins in. As a global biopharmaceutical company dedicated to transforming the lives of patients with serious and rare diseases, you'll be part of a community that prioritizes the human experience, celebrates curiosity, and values every person's contributions to meaningful progress. That commitment has earned us recognition as Science magazine's No. 1 Top Employer for five consecutive years, certification as a Great Place to Work in the U.S., and a place on The Sunday Times Best Places to Work list in the UK. For patients, for each other, and for the future of science, we're in. Are you? About the Role: We're looking for an Associate Director, Medical Science Liaison on the US Medical Affairs team to help us expand what's possible for patients with serious diseases. Reporting to the Regional Director, US Field Medical, you'll develop and maintain...

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 accuracy...

Company: Allegheny Health Network Job Description: GENERAL OVERVIEW: Join our innovative team as a Medical Coding Auditor Instructor, where you'll play a vital role in ensuring the accuracy and compliance of coding, billing, and medical documentation. Conduct thorough audits on medical records regarding DRGs, APCs, CPTs, and HCPCS Level II codes. Your expertise will be key in optimizing reimbursement strategies and enhancing data quality while adhering to all regulatory standards. ESSENTIAL RESPONSIBILITIES: Lead comprehensive audits and evaluate documentation, coding, and billing practices across various AHN entities. Develop and implement focused training programs to address any deficiencies identified during audits, ensuring compliance with regulatory standards. Collaborate closely with management on external audit findings and engage in strategic discussions to resolve issues. (20%) Create detailed audit reports to highlight the impacts of coding,...

Join our passionate team dedicated to enhancing health outcomes! The Senior Medical Coding Supervisor plays a crucial role in extracting essential clinical information from diverse medical records and accurately assigning procedural terminology and medical codes, including ICD-10-CM and CPT, to patient files. In this vital leadership position, you will oversee advanced administrative and operational tasks that require initiative and sound decision-making. Your expertise will be pivotal in ensuring accurate diagnosis-related group (DRG) assignments while analyzing, inputting, and managing critical databases. You will also address internal inquiries regarding medical information, prioritize daily tasks for the administrative team, and supervise work progress alongside external vendors, all while working independently within established guidelines. Make a significant impact with your skills! WORK STYLE: This is a remote role with occasional travel to Humana's facilities...

About Us 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. Benefits 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: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

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,...

Join Datavant, a pioneering data platform company transforming health data exchange. Our mission is to ensure that every healthcare decision is guided by accurate data at the right moment and in the most useful format. As a leading health data network, our platform offers secure, accessible, and actionable data, empowering various healthcare stakeholders, including life sciences firms, government agencies, and care providers. By becoming part of Datavant's high-performing and values-driven team, you'll play a vital role in creating innovative technology solutions that tackle significant challenges in healthcare. We celebrate a diverse team bringing together a wealth of professional, educational, and personal experiences to achieve our ambitious goals in the healthcare sector. Key Responsibilities: Conduct thorough audits of coded medical charts according to specific client guidelines as directed by the quality supervisor. Efficiently navigate and apply various client...

Datavant is the data collaboration platform trusted for healthcare. Our mission is to make the world’s health data secure, accessible, and actionable, offering essential data solutions for a diverse array of healthcare entities, including providers, health plans, researchers, and life sciences companies. Whether fulfilling a single patient's request for their medical records or energizing the AI revolution in healthcare, our team at Datavant is dedicated to reshaping the future of health data connectivity and utilization. By joining Datavant, you will be part of a dynamic and collaborative team that is passionate about creating meaningful change in the healthcare landscape. As an Inpatient Coding Auditor, your expertise will be crucial in addressing various consulting and educational needs pertaining to coding quality, compliance assessments, external payer reviews, and coding education. This fully remote role offers you the flexibility to contribute to healthcare...

Certified Professional Coder (CPC) Independent Contractor Remote Who We Are Constellation Quality Health is a non-profit health care quality consultancy and QIO-like Entity certified by Centers for Medicare and Medicaid Services (CMS) founded by physicians in 1983. Headquartered in North Carolina's Research Triangle, we offer an array of quality improvement, clinical review, audit, technical, and consulting services and solutions to improve care delivery, system performance, and patient outcomes. What You'll Do The Certified Professional Coder (CPC) is responsible for reviewing and comparing provider service documentation to billed claims in order to determine compliance with clinical policies, state and federal regulations. We expect you to: Perform reviews in a manner consistent with contract requirements for timeliness and accuracy. Our requirement for this role: Associate or bachelor's degree required in a human services field or five (5) years...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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 this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Join Our Progressive Health Information Management Team! About the Opportunity: Are you looking to elevate your career in a dynamic environment? We are on the hunt for a Lead Inpatient Medical Coding Specialist to play a vital role in our innovative healthcare information management team. In this impactful position, you will bridge the intersection of clinical data and cutting-edge technology, contributing significantly to the development of AI-driven solutions for medical coding and billing. Your extensive experience will shape our product development initiatives as we collaborate to redefine healthcare’s future. Key Qualifications: A minimum of 3 years of relevant experience in inpatient medical coding within a hospital setting. Demonstrated proficiency in accurately identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. Strong understanding of the evidence requirements necessary for precise...

BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details: Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) Status: Full-time (non-exempt) Shift: 7:00 AM to 3:30 PM Days: Monday through Friday The Medical Records Outpatient Coder II will work remotely on a full-time basis. Responsibilities: The Medical Records Coder II assigns diagnosis and procedural codes using ICD-10-CM, ICD-10-PCS, and CPT-4 coding systems and monitors bill hold reports. Assists Manager/Director with mentoring/training of Coder I team members and clinical practice students from various colleges. Performs other duties as assigned. Why BayCare? Our network consists of 16...

As an Associate Director, Field Medical Affairs, you will play a pivotal role as a field-based professional within Respiratory to support the clinical and business objectives across the product life cycle. We deliver strategic and operational support by establishing, developing and maintaining scientific exchange with medical specialists, health care professionals, and payers, aligned with our strategic objectives. We provide clinical and health economic information that enhances the value and appropriate use of Regeneron products. You will work with clinical research sites and investigators, and support of research activities as directed by the Global Medical Functional head. Responsibilities of this role are to ensure accurate exchange and distribution of clinical and scientific information relevant to in-line and pipeline products in a timely, ethical and customer-focused manner. Territory: North Carolina/South Carolina A typical day may include -Engage in scientific...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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 high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or AAPC Coding Certification...

Become a vital part of Datavant, the leading platform for secure, accessible, and actionable health data. Our mission is to enhance health data collaboration for healthcare providers, health plans, researchers, and life sciences organizations. Join us in transforming individual patient requests and advancing AI in healthcare! As a member of our team, you'll contribute to meaningful change in the healthcare landscape from the comfort of your own home. This fully remote position offers flexibility while allowing you to impact the future of healthcare. Key Responsibilities: Utilize ICD-10-CM and ICD-10-PCS codes to assign diagnostic and procedural codes accurately. Abstract and sequence medical codes from patient records, ensuring compliance and precision in documentation. Oversee and provide feedback on the work of Level 1 & 2 Coders when applicable. Identify opportunities for documentation improvement and collaborate with relevant stakeholders to...

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...