15 jobs found in Toledo, OH

Medical Billing Specialist The Medical Billing Specialist is responsible for the timely and accurate preparation of claims within their access for submission to Medicare, Medicaid and Third party carriers. Preparation of claims include, but are not limited to, researching, learning, maintaining and applying new and changing regulations as mandated by Federal and Third Party Payors to maximize reimbursement and ensure compliance. Providing education to other hospital personnel of regulations & requirements and the impact it has on reimbursement and billing. The Medical Billing Specialists are responsible for comprehensive follow-up with payers on timely reimbursements for accounts. The Medical Billing Specialist lives the Mission, Vision, Values and Philosophy of the department and Saint Francis Healthcare System. Constantly works with and maintains restricted or confidential information from many sources within the medical center. Any and all jobs as assigned by Assistant...

Coding Position This level 2 coding position provides support to the Enterprise Coding Department for coding of physician's fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA. Function/Duties of Position Coding Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS). Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry. Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU. Monitor activity for compliance with federal and/or state...

Coding Specialist III Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). JOB SUMMARY: The Coding Specialist III will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the needs of hospital data retrieval for billing and reimbursement. Coding Specialist III validate MSDRG and/or APC calculations in order to accurately capture the diagnoses/procedures documented in the clinical record. Coding Specialist III performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and...

Job Description Job Description Hours: Monday - Friday 9am - 1:45 pm Must be certified General Summary: The Pathology Medical Coder is responsible for accurately translating pathology services into standardized medical codes for billing, reporting, and compliance. This role requires in-depth knowledge of coding systems such as ICD-10, CPT, and HCPCS, along with the ability to understand medical terminology and pathology reports. The ideal candidate must ensure that all coding meets regulatory requirements and is performed in compliance with healthcare policies and procedures. Additionally, the coder will be responsible for working all eCW claims for denials and errors, ensuring timely resolution and adherence to billing guidelines. Principal Duties & Responsibilities: Example of Essential Duties: Review pathology reports and assign the appropriate ICD-10, CPT, and HCPCS codes for all diagnostic and procedural information. Demographic...

Certified Inpatient Coder Full time Inpatient Coder position responsible for coding inpatient discharges, review medical record documentation to abstract data and assign accurate ICD-10 diagnosis(es) and procedure codes (PCS). Works closely with the CDI Team for clinical documentation to support code assignment. Loyola Medicine, part of Trinity Health, is a nationally ranked academic health system located in Chicago's western suburbs. We're seeking a Certified Inpatient Coder to join our Revenue Excellence team and help support accurate, ethical coding and reimbursement. This is a remote position offering a flexible work schedule, empowering you to balance your professional and personal life while making a meaningful impact. What You'll Do: Review inpatient medical records to assign accurate diagnoses and procedure codes. Apply MS-DRG, APR-DRG, POA, SOI, ROM, HAC, and PSI indicators. Use encoder software and stay compliant with guidelines from CDC, CMS, AHA, and AHIMA....

ICD-10 Coding Specialist You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be willing to travel to NYC twice a year for required meetings. Position Purpose: The focus of this position is to establish processes to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review. Analyze moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance. Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. Provide...

Medical Risk Adjustment Specialist (Coder) At Greenbrook Medical, we believe seniors deserve more from the healthcare systemmore time, more care, more coordination, and more heart. We provide high-touch, relationship-based primary care to seniors, built around one simple idea: deliver the kind of care we'd want for our own parents. Founded by two brothers inspired by their father's pioneering work in Medicare Advantage, Greenbrook is deeply personal and proudly modern. We quarterback our patients through their healthcare journey, making sure they're never alone in a complex system. Our business model is designed around patient outcomes, not volumeso we only succeed when our patients thrive. With roots in Tampa Bay and a partnership with Tampa General Hospital, we're growing thoughtfully to bring our model to more communities. Our team is the heart of it all: mission-driven, values-oriented, and relentlessly committed to taking the best care of our patients. Greenbrook Medical...

Medical Claims Specialist This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. Job Duties/Responsibilities Maintains a thorough understanding and education of federal and state regulations and payer specific policies and...

Medical Coder Compliance Spec Perform coding quality audits on outpatient records to assure appropriateness, accuracy, and compliance for CPT/HCPCs, ICD-10-CM code assignments, and modifier assignment in accordance with Center of Medicare and Medicaid Service (CMS) Guidelines, AMA and AHA Official ICD-10-CM Coding Guidelines. Provide ongoing feedback to managers and coders. Develop and implement educational programs regarding elements of the coding compliance program and act as a subject matter expert for the outpatient coding department. Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society....

Note: Please only apply to the specific job posting for which you have experience in the specialty. Duplicate applications will not be considered. Job Summary We are seeking a detail-oriented and knowledgeable Medical Biller and Coder for Dermatology Department to join our healthcare team. The ideal candidate will be responsible for managing the billing process, ensuring accuracy in medical coding, and facilitating timely payments from insurance companies and patients. A strong understanding of medical terminology, coding systems, and collections is essential for success in this role. Responsibilities Process medical billing claims accurately and efficiently using appropriate coding systems such as ICD-10 and ICD-9. Review patient records to ensure all necessary information is included for billing purposes. Verify insurance coverage and benefits prior to submitting claims to ensure proper reimbursement. Follow up on unpaid claims and conduct medical collections as necessary....

A healthcare organization in Ann Arbor is seeking a detail-oriented Medical Biller and Coder to manage billing processes for the Dermatology Department. The role requires strong knowledge of medical terminology and coding systems like ICD-10 and ICD-9. Responsibilities include processing medical claims accurately, verifying insurance coverage, and maintaining accurate billing records. Candidates should have proven experience in billing or coding and possess excellent organizational skills. Join our dedicated team to contribute to efficient healthcare services. #J-18808-Ljbffr

Job Summary We are seeking a detail‑oriented and knowledgeable Medical Biller and Coder for the Dermatology Department to join our healthcare team. The ideal candidate will manage the billing process, ensure accuracy in medical coding, and facilitate timely payments from insurance companies and patients. A strong understanding of medical terminology, coding systems, and collections is essential for success in this role. Responsibilities Process medical billing claims accurately and efficiently using appropriate coding systems such as ICD‑10 and ICD‑9 Review patient records to ensure all necessary information is included for billing purposes Verify insurance coverage and benefits prior to submitting claims to ensure proper reimbursement Follow up on unpaid claims and conduct medical collections as necessary Maintain accurate records of all billing transactions and communications with insurance companies and patients Collaborate with healthcare providers to resolve any...

Job Summary Review and check certain inpatient records to make sure the coding is correct and follows rules for ICD-10 codes. This includes checking the DRG groups, Present on Admission indicators, Severity of Illness, Risk of Mortality, Hospital-Acquired Conditions, and Patient Safety Indicators according to guidelines set by the Centers for Medicare & Medicaid Services and the American Hospital Association. Provide ongoing feedback and training to the staff in the Coding unit. Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society. Responsibilities* General...

At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai's human health care (hhc) mission. We're a growing pharmaceutical company that is breaking through in neurology and oncology, with a strong emphasis on research and development. Our history includes the development of many innovative medicines, notably the discovery of the world's most widely-used treatment for Alzheimer's disease. As we continue to expand, we are seeking highly-motivated individuals who want to work in a fast-paced environment and make a difference. If this is your profile, we want to hear from you. The Associate Director/Director, MSLs is responsible for the leadership, direction and management of MSLs in the region and works collaboratively with the Medical Affairs Senior management with strategic and tactical planning, working collaboratively with Medical Affairs and Clinical Development teams for support of clinical...

Job Description Job Description We are seeking a full time  Medical Biller on site and in person for a fast pace multi-specialty full Service Medical Billing Company. Successful candidates must have a solid working knowledge of insurance plans with the ability to accurately reconcile physician charges, carrier payments and rejections. Strong professional communication and analytical skills are required. 2 years experience at least within a Medical Billing Environment. Salary commensurate with experience and certification. Limited positions available. Company Description Fast paced multi-specialty billing office. Must be organized and a team player. Experience with teams application, Carrier websites and hospitals website's Company Description Fast paced multi-specialty billing office. Must be organized and a team player. Experience with teams application, Carrier websites and hospitals website's