54 jobs found in Springfield, IL

Serco is seeking a Medical Coding Auditing Specialist to support the Defense Health Agency (DHA) Medical Coding Program Branch. You will conduct routine audits across DHA Markets’ facilities, helping ensure ICD/PCS coding accuracy and compliance with CMS/NCD guidelines. The role involves collaboration on annual audit plans and targeted reviews, with potential CONUS/OCONUS travel, and onsite engagements as needed. #J-18808-Ljbffr

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

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...

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. 1,500 Sign on Bonus 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,...

EVERSANA INTOUCH® is a global, full‑service marketing agency network serving the life sciences industry, and is the first – and only – agency network to be part of a fully integrated commercialization platform through EVERSANA®. We provide next‑generation creative and media services, enterprise solutions and data analytics services for clients. We get fired up when people talk about getting—and staying—healthy. That’s where we find our inspiration: in the very human experiences of patients, doctors, and even each other. Then, we collaborate on ways to make caring for one’s health more achievable, connecting patients and physicians with the information and tools they need. We embrace diversity in backgrounds and experiences. Improving patient lives around the world is a priority, and we need people from all backgrounds and swaths of life to help build the future of the healthcare and the life sciences industry. We believe our people make all the difference in cultivating an...

10 Sarah Bush Lincoln Health Center seeks a Coding Auditor - Professional to ensure proper coding for clinic services. This full-time role involves assisting coders, conducting audits, and maintaining high accuracy in documentation. Ideal candidates will have a high school diploma and relevant certifications like CPC and CEMA. The position offers remote or hybrid work opportunities within specific states. Benefits include tuition reimbursement and comprehensive health coverage. #J-18808-Ljbffr

Coding Auditor - Professional Department: Physician coding Hours: Full-Time (40 hours per week) Location: Remote or onsite. Must reside in one of the following states: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas. Pay: Starts at \$23.87/hour, based on experience. Estimated compensation range \$23.87 - \$37.00. Responsibilities Assist coders with coding questions. Conduct collection and reporting of provider and coder audit results and education. Work with coders and providers to ensure appropriate documentation for clinic services. Report results to Coding Supervisor – Professional. Demonstrate ability to code all types of encounters. Maintain 95% accuracy in diagnoses and procedures coding. Ensure data quality and optimum reimbursement under federal and state payment systems. Identify and refer trend patterns of coding and...

Coder Auditor-Professionals are responsible for auditing coding assignments with providers and coders, training coding professional staff, and pro‑fee based coding which includes the assignment of ICD‑CM, CPT, HCPCS codes, E&M assignment, modifiers, and charge posting. They interact with medical staff, nursing, ancillary departments, provider offices, and outside organizations. At this time, we are only able to consider applicants who reside in the following states: Alabama, Arkansas, Arizona, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, North Carolina, New Mexico, Ohio, Oklahoma, South Carolina, Tennessee, Texas. Responsibilities Assists coders with coding questions. Conducts the collection and reporting of provider and coder audit results and education. Works with coders and providers to ensure appropriate documentation for clinic services. Reports results to Coding Supervisor - Professional. Demonstrates ability to code all...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

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:...

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. (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-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

Southern Illinois Hospital Services Inc. is seeking a professional coder to review provider documentation and assign ICD-10-CM, CPT/HCPCS codes in line with official guidelines. You will research and address coding edits and focus on complex outpatient hospital-based and provider-based services. The role requires a High School Diploma and 3 years of procedural coding experience for CCS-P/CCA/CPC, with RHIA/RHIT/CCS preferred for hospital coding; RHIA/RHIT/CCS/CCS-P/CCA/CPC for provider-based #J-18808-Ljbffr

Sarah Bush Lincoln is seeking coders for a hospital setting to assign ICD-CM/PCS, CPT and HCPCS codes, and determine MS-DRGs and APCs. The full-time role resides in Medical Record Management with remote work options for Illinois and on-site as needed. You will collaborate with physicians and staff to document coding needs, train new staff, and ensure high-quality coding for compliant reimbursements. HS diploma and credentials (CCA/CPC/RHIT/RHIA/CCS-H) are required. #J-18808-Ljbffr

Become a part of our caring community 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. Where you Come In 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 of...

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). You will ensure coding accuracy, complete documentation, and adherence to state, federal, and company guidelines across medical, behavioral health, and transportation providers. The CPC will audit CPT/HCPCS, discuss findings with Medical Directors, identify billing errors and opportunities for savings, and maintain thorough records while staying current on coding #J-18808-Ljbffr

CVS Health is seeking a Medical Records Auditor to audit and abstract medical records for CMS risk adjustment, ensuring accurate ICD coding and documentation compliance. You will support coding judgments with industry standards and maintain strict timelines across provider and vendor records. The role requires 1 year of related experience and CPC/CCS-P credentials, with AA/AS or equivalent preferred and CPC/CCS-P training completion viewed favorably. #J-18808-Ljbffr

Overview Review provider documentation and assign ICD-10-CM, CPT/HCPCS codes as appropriate based on official coding guidelines. Research and take action on any coding/claim edits. Focus on complex outpatient hospital based (Observation, Emergency Department, Wound, Ambulatory Surgery) and provider based complex procedural services (surgery, procedures, wound). Responsibilities Follow all coding policies, procedures and standard operating procedures. Use encoding software and reference materials to assign appropriate codes. Provide provider-driven coding: review and accept or revise code selection based on documentation and guidelines. Provide non–provider driven coding: review documentation and assign codes based on guidelines. Review coding edits and resolve them accurately so encounters can be sent to claims. Send clear, respectful communications to providers in inbox or queries when additional information is needed. Identify and communicate to Coding Lead/Supervisor/Manager any...

Sarah Bush Lincoln is seeking a Coder Technical Charging to manage emergency department charge coding and documentation. The role involves assigning CPT/charge codes, interfacing with ED staff, and ensuring compliant, accurate billing across the department. Qualifications include a High School Diploma, CPC within 1 year of hire, and graduation from an accredited LPN program. This is a full-time on-site/remote Illinois position with compensation based on experience. #J-18808-Ljbffr

10 Sarah Bush Lincoln Health Center in Illinois seeks a Hospital Coder to join the Medical Record Management team. Coders are responsible for technical coding including ICD‑CM/PCS, CPT, and HCPCS codes, modifiers, and MS‑DRG assignments. Remote work is available with full-time hours (40 hours/week). Starting pay is $22.72 per hour, with pay based on experience and opportunity for progression based on performance. #J-18808-Ljbffr

Remote Profee Interventional Cardiology/Electrophysiology/IR Coder Must Know the following: E/M for both clinic and inpatient services Diagnostics/Procedures including the following: Stress tests Holters Vascular / Coronary Interventions Echo's Nuclear stress test Pet test Interrogations_ Pacemakers/Defibrillators Angiography Electrophysiology (Ablations, Device Insertions, Change / Removal) Cardiac catheterizations (PTCA, PCI, IVUS) 3M CAC, HDM, TouchWorks helpful Comfortability using Excel spreadsheets and following complex workflows; attention to detail #LI-LM1 #LI-Remote

AbbVie is seeking a Senior Auditor in Internal Audit to lead compliance-focused audits across U.S. and international locations. You will perform audits, analyze data from SAP and payroll systems, and present findings to leadership while upholding AbbVie’s Code of Conduct and audit standards. The role requires at least 3 years in a client-facing capacity, knowledge of FCPA or healthcare, and willingness to travel 15–35%. Office-based collaboration at AbbVie locations is expected. #J-18808-Ljbffr

Baylor Scott & White Health is seeking a Coding Auditor 1 to join our health information management team. The role performs coding quality audits, provides feedback to coders, and uses ICD-10-CM/PCS, HCPCS, CPT and other coding references to ensure accurate coding and classification, including MS-DRG, APR-DRG and APC. You will collaborate with Clinical Documentation Specialists, complete production coding when needed, and help improve documentation quality while upholding HIPAA and regulatory #J-18808-Ljbffr

Memorial Health System in Springfield, IL is seeking a Billing Specialist to analyze, investigate, and resolve complex medical claims and related billing information, ensuring accuracy and compliance with managed care guidelines and MMC policies. The role requires attention to detail, strong problem solving and communication skills, and the ability to work with internal departments and external payors to secure timely reimbursements. #J-18808-Ljbffr

Position Summary: Analyzes, investigates, and resolves claims/billing information and/or errors associated with the more complex inpatient/outpatient medical insurance claims. Ensures compliance with managed care guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values. USD $18.34/Hr. Max USD $28.42/Hr. Overview Position Summary: Analyzes, investigates, and resolves claims/billing information and/or errors associated with the more complex inpatient/outpatient medical insurance claims. Ensures compliance with managed care guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values. Qualifications Education: Education equivalent to graduation from high school or GED is required. Experience...