14 jobs found in Syracuse, NY

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Job Summary: Under the general guidance of the Ambulatory Billing Manager, the Ambulatory biller/coder is responsible for monitoring, auditing, and identifying negative trends in hospital billing. Provides support to staff in the respective areas as needed. Responsible to add, remove, and prioritize diagnosis codes received from clinical departments, physicians, and Financial Service staff to ensure claims are billed and/or resubmitted with appropriate coding. Responsible to assist ambulatory departments with coding issues and/or questions to ensure claims are billed compliantly and accurately based on medical record documentation. Minimum Qualifications: Associates degree and two (2) years relevant patient financial/insurance services experience in a healthcare related setting or equivalent combination of education and relevant experience. Strong communication skills, analytical, and interpersonal skills necessary. CBCS, CPC, CCA, or equivalent coding certification....

Annual Salary: $65k-$85k (varies depending on years of experience) An established orthopedic and spine surgery practice is seeking an experienced Medical Biller with a strong background in out-of-network billing and spine-related claims. This role is responsible for managing the full revenue cycle with a focus on accurate claims submission, payment resolution, and reimbursement optimization. Key Responsibilities Manage end-to-end medical billing and accounts receivable for orthopedic and spine surgical cases. Submit and track out-of-network claims to commercial payers. Handle the Independent Dispute Resolution (IDR) process including documentation preparation, submissions, and follow-up. Review, correct, and resubmit denied or underpaid claims in a timely manner. Post payments, reconcile explanations of benefits (EOBs), and identify discrepancies. Follow up aggressively on unpaid or delayed claims to ensure maximum reimbursement. Communicate with insurance carriers regarding...

Coding Specialist Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. Pay Range: $28.70 - $41.70 Scheduled Weekly Hours: 40 Position Overview Assigns codes accurately to diagnoses and procedures within the medical record to comply with federal and state regulations. Sequences...

Job Summary: Position Summary: Under the direction of the Compliance Officer the main duties for this position include: analysis of professional coding and billing data, review of applicable regulations or guidelines and professional coding and billing audits. Duties/Responsibilities: Analysis of coding and billing data, identification of trends and aberrations. Performance of routine and investigatory audits evaluating compliance with applicable laws, regulations, coding, and billing guidelines. Interpretation of coding, billing, and regulatory standards. Preparation and completion of audit reports including recommendations, education and corrective action. Knowledge, Skills and Abilities: Strong computer skills specifically Microsoft word and Microsoft excel applications. Strong analytical, problem-solving and time management skills. Expertise in report writing and oral communications. Ability to interpret regulations, payment and reimbursement systems, billing and coding...

Coder Quality Auditor The Coder Quality Auditor conducts monthly and quarterly quality assessments of individual codes. Provides guidance and education to coding associates and leaders on established coding guidelines and procedures. Performs additional quality assurance follow-up reviews to assess comprehension of education and training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting professional coding standards and following CMS/AMA guidelines. Candidate should possess the ability to code and a clear understanding of the coding principles and guidelines for multiple specialties. Job Responsibilities: Quality Review - Monitors and audits inpatient and outpatient accounts across the system, looking at physician coding for both inpatient and outpatient accounts. Performs initial baselines as well as quarterly performance quality assurance reviews to assess coders'...

Medical Coding Auditor UNM Medical Group, Inc. is hiring for a Medical Coding Auditor to join our Compliance Team. This opportunity is a remote, full-time, day shift opening located in Albuquerque, New Mexico. This position requires extensive knowledge and experience with E/M coding. $2,000 Sign-on Bonus Minimum $56,173 - Midpoint $70,217* Salary is determined based on years of total relevant experience. Salary is based on 1.0 FTE (full time equivalent) or 40 hours per week. Less than 40 hours/week will be prorated and adjusted to the appropriate FTE. Summary: Under indirect supervision, audits medical charts and records for compliance with federal coding regulations and guidelines. Uses knowledge of UNM Medical group billing systems procedures to provide a review of evaluation and management codes, medical diagnoses and clinical procedures ensuring that accurate medical billing conforms with legal and regulatory requirements. Trains, instructs and provides technical support...

Role Overview: We are seeking a detail-oriented Certified Medical Coder and Billing Specialist to review medical bills for individuals with injuries sustained from motor vehicle accidents. Join our dynamic team to ensure accurate coding and effective communication with customers and attorneys. Key Responsibilities: Review medical bills related to motor vehicle accident injuries. Conduct thorough reviews of medical documentation to ensure correct coding is applied. Utilize resources such as eBooks and 3M software to support your assessments. Interpret and apply fee schedule guidelines during your analysis. Document review outcomes clearly and professionally for customer understanding. Participate in conference calls with customers and attorneys as necessary. Assist with special projects and additional duties as assigned. Qualifications and Experience: 3-5 years of medical billing experience, particularly with PIP fee schedules. Strong communication...

Overview Job Summary: Responsible for developing, improving and continuing the process billing of medical claims for specialty pharmacy facilities. Needs to communicate financial and clinical information to appropriate stakeholders (internal and external) to ensure payment for services. Travel : Limited travel may be required. Travel to healthcare providers and to various business and management conferences required. Travel to Facilities for periodic training and review. Scope of Responsibilities: Works under minimal supervision.  Follows standard procedures to accomplish assigned tasks.  Establish, manage, and communicate the process of billing medical claims for specialty facilities. Responsibilities Job Duties: Manages the existing process of medical billing in the specialty pharmacy space to ensure prompt submission and reconciliation of claims from specialty facilities. Collaborate with leadership to enhance and grow the medical billing process...

Certified Professional Coder / Bill Review Expert Responsibilities: Review medical bills related to MVA injuries sustained for NJ and or NY covered insureds Conduct reviews of medical bills and supporting documentation to ensure proper codes assigned Assign proper codes as needed based on review outcome Use various resources, IE: eBooks, 3M software to support reviews Interpret fee schedule guidelines and apply those guidelines in daily reviews Document review outcomes for customer in a professional easy to understand manner Participate in conference calls as needed with customer and/or attorneys Assist with various special projects and other duties as assigned Qualifications and Experience: 3-5 years of medical billing experience specifically NJ / NY PIP fee schedules Strong communicate skills, must be able to explain outcome of review, both written and verbally Extensive knowledge of coding /documentation requirements Thorough knowledge of CPT, HCPCs, ICD-10 CPC/AAPC...

Position Overview Responsible for the accurate and compliant coding of inpatient, outpatient, and professional OB/GYN encounters. This position serves as a key liaison between coding, clinical, and compliance departments ensuring that all documentation and coding practices meet regulatory and payer requirements. The role also includes providing ongoing education to OB/GYN providers and clinical staff on documentation quality, coding updates, and best practices to optimize compliance and reimbursement. Tasks and Responsibilities Coding and Documentation Review: Assign accurate ICD-10-CM, CPT, and HCPCS codes for all OB/GYN-related inpatient and outpatient encounters, including deliveries, surgeries, procedures, and E/M services. Apply knowledge of global obstetric coding, cesarean and vaginal deliveries, postpartum care, and gynecologic surgeries (e.g., hysterectomy, laparoscopic procedures). Review provider documentation to ensure completeness and accuracy...

INTRODUCTION Company Overview: This position is available with Upstate HomeCare, a BioMatrix company. BioMatrix is a nationwide, independently-owned infusion pharmacy with decades of experience supporting patients on specialty medication. Our compassionate care team helps patients navigate the often-challenging healthcare environment. We treat our patients like family and get them started on therapy quickly. We work closely with them as well as their family and their healthcare providers throughout the patient journey, staying focused on optimal clinical outcomes. At BioMatrix the heart of our Inclusion, Diversity, Equity, & Access (IDEA) philosophy is the commitment to cultivate a welcoming space where everyone's contributions are acknowledged and celebrated. Our goal is to draw in, develop, engage, and retain talented, high-performing individuals from diverse backgrounds and viewpoints. We believe that both respecting and embracing diversity enriches the experiences...

Job Summary: Under the direction of the Director of Medical Staff Services, the Associate Director provides strategic and operational oversight of the Medical Staff onboarding process and assists in supporting the activities of the organized medical staff, including its committees. This role encompasses administrative and medico-legal responsibilities related to medical staff governance and serves as a liaison between senior hospital leadership and the medical staff to foster effective communication and collaboration. The Associate Director assists in ensuring medical staff compliance with all applicable accreditation and regulatory standards, including those set forth by DNV NIAHO, NCQA, CMS, the New York State Department of Health, and internal hospital and departmental policies. Responsibilities include administrative support for clinical competency evaluations, regulatory documentation, and medical staff functions. The Associate Director attends medical staff meetings as...

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. Description Medical Coder and Auditor Family Care Practice Full-Time Monday - Friday Flexible Schedule (hybrid schedule after required onsite training period) $22.00 -$28.00 per hour (depending on experience) Medical Coder and Auditor Benefits: Generous paid time-off that increases with years of service 8 paid holidays per year Closed on major holidays Annual performance review, performance-based merit increase Health, dental and vision benefits available with coverage effective the first of the month following date of hire Full complement of voluntary benefits $1,000 annual employer HSA contribution for employees enrolled in CNYFC...