69 jobs found in Waterville, ME

Job Summary Assigns diagnosis and procedure codes to ensure quality documentation and accurate reimbursement for services provided. Job Description Assists with reconciling patient lists/census/discharge reports to track that complete and accurate documentation and charges are obtained for each service rendered. Reports back to providers and/or administrators regarding missing information. Reviews visit documentation from 1-2 outpatient and/or ancillary areas to identify appropriate diagnostic and procedural codes (examples: lab, non interventional radiology, PT/OT, Mental Health outpatient treatment primary care, specialty care). Uses coding guidelines and clinics to accurately assign and sequence appropriate codes for 1-2 outpatient and/or ancillary patient areas in clinical information systems, including the assignment of appropriate modifiers as necessary. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. S...

MaineGeneral Medical Center in Waterville, ME seeks a medical coder to assign diagnosis and procedure codes to ensure documentation quality and accurate reimbursement for services provided. You will reconcile patient lists and discharge reports, review outpatient and ancillary visit documentation, apply coding guidelines, and seek clarification from providers to ensure complete, compliant coding across clinical information systems. #J-18808-Ljbffr

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

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 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...

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU), ensuring coding accuracy and compliance with CPT/HCPCS rules across medical, behavioral health, transportation, and related services. The role requires 3+ years of coding experience, CPC certification, strong written and verbal communication, and the ability to review records, interpret guidelines, and support investigators. #J-18808-Ljbffr

Fully Remote Lake Park Building Full time R183439 Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ's and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately...

Datavant is seeking experienced inpatient coders to join our team in a fully remote role with a flexible schedule. You will assign ICD-10-CM/PCS codes, abstract patient records, and ensure accuracy and productivity benchmarks.Ideal candidates have at least 3 years of inpatient coding, CCS/RHIT/RHIA preferred, and strong written and verbal communication skills. AHIMA/AAPC credentials are a plus. We offer training and mentorship as part of a collaborative environment.J-18808-Ljbffr

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 ForWe'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 you to help...

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...

Humana is seeking an experienced Outpatient Behavioral Health Coding Auditor to handle disputes on the Disputes Team. The role emphasizes accuracy, timeliness, and compliance in CPT/HCPCS coding decisions. The position is remote with occasional travel to Humana offices. You will work with coding professionals across departments to ensure high-quality dispute outcomes and adherence to HIPAA and industry standards. #J-18808-Ljbffr

Become a part of our caring community 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 Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor 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 Behavioral Health coding disputes and expertise in CPT/HCPCS...

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...

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: Benefits may vary based upon position type and/or level. Job...

Baylor Scott & White Health is seeking a DRC Coding Auditor to partner with a multidisciplinary team to resolve complex coding-related denials for Hospital and Professional Billing. The role requires advanced knowledge of inpatient and outpatient coding, CMS rules, payer policies, and documentation support to drive successful appeals. You will work with Clinical Validation RNs and other revenueCycle teams to improve coding accuracy, reduce denials, and enhance overall revenue cycle performance, #J-18808-Ljbffr

About the role As a Medical Coding Quality Auditor, you will play a critical role in ensuring coding accuracy, compliance, and quality across healthcare records. You will collaborate with coding professionals and physicians to support accurate clinical documentation, regulatory compliance, and operational excellence while maintaining high quality and productivity standards in a remote work environment. In this role, you will: Review medical documentation to accurately assign diagnosis and procedure codes. Communicate with physicians and other healthcare providers to obtain or clarify diagnoses and procedures through the coding query process. Assign accurate codes using electronic encoder applications in accordance with company policies, coding guidelines, and regulatory requirements. Perform peer reviews and quality audits of Health Information Management coding auditors and coders. Prepare and complete reports, audit findings, and other deliverables as requested. Monitor...

About the role As a Emergency Deparment Coder, you will make an impact by ensuring the accuracy, quality, and compliance of medical coding practices across multiple healthcare settings. You will be a valued member of the Health Information Management team and work collaboratively with coding professionals, physicians, and operational stakeholders to support regulatory compliance and revenue cycle excellence. In this role, you will: Review clinical documentation and accurately assign diagnosis and procedure codes for outpatient surgery, observation, emergency department, and outpatient diagnostic encounters. Communicate with physicians and clinical staff to obtain clarification on diagnoses and procedures through the coding query process. Utilize electronic encoder applications and coding tools to assign accurate codes in accordance with company policies and regulatory guidelines. Perform peer reviews and quality audits of coding professionals to ensure coding accuracy,...

Cognizant is looking for an Emergency Department Coder to ensure accurate, compliant medical coding across outpatient settings. You will collaborate with physicians, coders, and operational teams to support regulatory compliance and revenue cycle excellence. You will review notes, assign ICD-10-CM, CPT, and HCPCS codes for ED, observation, and outpatient encounters, and perform audits to uphold a 98% accuracy rate while meeting productivity standards. #J-18808-Ljbffr

State of Maine's Department of Professional and Financial Regulation is seeking a professional to license and examine mortgage lenders, sales finance companies, payroll processors, money transmitters, and consumer credit agencies to ensure compliance with state laws. You'll review credit files, evaluate logs, and write investigation summaries. This non-supervisory role operates under limited supervision and requires strong analytical, communication, and data analysis skills as you help protect #J-18808-Ljbffr

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

To enhance coding accuracy and compliance, the full-time Certified Coding Compliance Auditor will conduct internal and external audits, review medical records for coding quality, and provide education and training while working remotely.Key responsibilities:Perform concurrent, prospective, and retrospective coding audits and provide feedback and mentoring to staffDirectly code medical records for various specialties and ensure compliance with coding guidelines and regulationsDevelop educational materials and training programs to address deficiencies identified in auditsRequired qualifications:Ten years of medical coding experience required; 15 years preferredCertified Professional Coder (CPC) xmvmafu or Certified Outpatient Coder (COC) certificationAssociate or Bachelors degree preferredCurrent knowledge of hospital outpatient coding and professional codingStrong proficiency with Microsoft Office and analytical abilities

DIAGNOSTIC CODERDEPARTMENT :Health InformationPVH employment application required.All job offers contingent upon background check and completion of pre-employment physical.This is an as needed position utilized to cover gaps in coverage including vacations, leaves of absence, and other instances of unfilled shifts.While remote work is an option, the applicant should be located within Maine and able to be in person in Lincoln, ME when requested.JOB FUNCTIONSRemote work option is available1.Review and process records.2.Assign codes.3.Checks for record completeness and distributes record deficiencies appropriately.4.Sends records to scanning at completion.5.Answers telephone promptly.6.Retrieves information requested.7.Provides customer service support to all visitors of the department as appropriate.8.Completes statistical reports as advised by the Department Director.9.Works with PFS on Insurance follow-up.10.Completes other duties assigned.Quality ImprovementActively participates...