Ambulatory risk adjustment coder jobs

Full Time

CorroHealth Remote

JOB SUMMARY: CDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures. This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES: Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended...

AB

Senior Coder, Risk Adjustment

Alan B. Miller Medical Center Reno, NV

Senior Coder Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Job Summary: The Senior Coder is responsible for documentation and coding review of medical records where services are...

UP

Coding Auditor - University Health Network

UNIVERSITY PHYSICIANS ASSOC INC. Knoxville, TN

Job Type Full-time Description University Health Network is seeking a Full-Time Coding Auditor. This role requires normal business hours Monday-Friday and is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. UHN Auditor provides superior customer experience by educating internally and externally of errors and opportunities for improvement discovered during routine auditing. This individual will work closely with management to implement benchmarks, establish acceptable thresholds, and effective quality assurance programs. The UHN Auditor performs duties in a professional manner while exercising good judgment and ethical standards, interacts effectively and builds respectful working relationships across the organization, and demonstrates integrity by adhering to high standards of personal and professional conduct. This...

PH

Senior Coder, Risk Adjustment

Prominence Health Reno, NV

Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent...

MP

Clinical Documentation Improvement Nurse Coder (Certified)

Martins Point Health Care Portland, ME

Join Martin's Point Health Care - an innovative, not-for-profit health care organization offering care and coverage to the people of Maine and beyond. As a joined force of "people caring for people," Martin's Point employees are on a mission to transform our health care system while creating a healthier community. Martin's Point employees enjoy an organizational culture of trust and respect, where our values - taking care of ourselves and others, continuous learning, helping each other, and having fun - are brought to life every day. Join us and find out for yourself why Martin's Point has been certified as a "Great Place to Work" since 2015. Position Summary The Clinical Documentation Improvement (CDI) Nurse Coder supports accurate and complete clinical documentation that reflects the severity of illness, quality of care, and services provided to patients. This role reviews medical records, collaborates with providers, and applies clinical expertise and coding knowledge to ensure...

NC

Outpatient Surgery Coder

Nemours Children's Hospital Orlando Orlando, FL

Outpatient Surgical And Observation Coder Outpatient surgical and observation coder! Role responsibilities include assessing documentation for each service rendered in the hospital's place of service, in order to accurately code principal diagnoses (i.e. preponderance of care sequence), secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines impacting Florida's enhanced ambulatory grouping. This includes excellent working knowledge of revenue charge capture and the impact to hospital billing (i.e. soft vs. hard coded charges), working knowledge of revenue codes, relevant grouper function and financial impact; assessment and entry of surgical charges (i.e. supplies, implants), and pharmacy charges (i.e. contrast, patient supplied, etc). This position is remote....

NC

Outpatient Surgery Coder

Nemours Children's Health Orlando, FL

Job Description Outpatient Surgical and Observation Coder! Role responsibilities include assessing documentation for each service rendered in the hospital's place of service, in order to accurately code principal diagnoses (i.e. preponderance of care sequence), secondary conditions, procedures, and social determinant codes using American Hospital Association guidelines, Current Procedural Terminology guidelines, payer specific rules for commercial and/or Medicaid insurance, and drug administration for specified service lines impacting Florida's enhanced ambulatory grouping. This includes excellent working knowledge of revenue charge capture and the impact to hospital billing (i.e. soft vs. hard coded charges),working knowledge of revenue codes, relevant grouper function and financial impact; assessment and entry of surgical charges (i.e. supplies, implants), and pharmacy charges (i.e. contrast, patient supplied, etc). This position is remote. Applicants must reside in one of...

GB

Ambulatory CDI Nurse Coder RN, ICD-10 & HCC Specialist

Greater Baltimore Medical Center (GBMC) Towson, MD

GBMC Health Partners is seeking a Clinical Documentation Improvement Nurse/Nurse Coder to join our Primary Care team. The ideal candidate is a clinically experienced nurse coder who is EMR savvy, knowledgeable in HCC and ICD-10 coding, with exposure to ambulatory medicine. Responsibilities include chart review, identifying documentation improvement opportunities, and educating practice physicians on documentation and coding changes. EPIC experience preferred. #J-18808-Ljbffr

SE

Coding Auditor, Facility

Scout Exchange OR

Title - Coding Auditor Location - Clackamas, OR Job Type - Permanent Job Summary: To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP),...

HS

Permanent - Outpatient Facility Medical Coder

Healthcare Staffing Plus OR

JOB DESCRIPTION To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding...

AI

Inpatient Facility Medical Coder

American IT Staff Seattle, WA

To independently and efficiently perform the responsibilities assigning accurate diagnosis and procedures codes to the patients health information records for: Emergency Department (ED), Ambulatory Surgical Center (ASC), Hospital Ambulatory Surgical Center (HAS), Observations (OBS), Inpatient (IP) and other selected facility records. Maintain an acceptable level of performance in quality and productivity for ICD-10-CM, ICD-10-PCS, and HCPCS/CPT classification and nomenclature systems. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and Kaiser Permanente organization/institutional coding directives. Ability to communicate...

UP

Risk Adjustment Certified Coder

UNIVERSITY PHYSICIANS ASSOC INC. Knoxville, TN

This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. University Health Networ k is seeking a full-time Certified Medical Coder to join our team. This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding HCC diagnoses using ICD-10-CM guidelines. CPT and E/M experience is not required for this role. Essential Duties and Responsibilities (this list does not include all duties assigned) Performs coding services while meeting daily production and quality goals Conduct thorough reviews of clinical documentation to ensure accuracy and compliance with coding standards. Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers for professional services. Collaborate with healthcare providers to clarify diagnoses and procedures to...

DM

Coder I - Billing & Audit - FT - Days - MSS - Hybrid Eligible

Dormont Manufacturing Company Florida, NY

Location Miramar, Florida Summary Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and modifier code assignments. For hospital coding, reviews medical record documentation (i.e., provider orders); may code outpatient diagnostic and therapeutic encounters requiring minimal procedural coding. Submits daily productivity report to HIM manager by defined deadline....

CF

Senior Medical Coding Specialist (Remote)

CareFirst BlueCross BlueShield Baltimore, MD

Position Overview The Senior Medical Coding Specialist acts as an internal expert to ensure that value‑based reimbursement and medical policy models are developed and implemented to support Payment Integrity. This role provides expert knowledge to support effective partnership with provider entities, guidance on the appropriate quality‑measure capture and proper use of CPT and ICD‑10 codes in claims submissions. The specialist utilizes coding expertise, combined with medical policy, credentialing and contracting rules knowledge, to build effective guidelines and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity. This role also provides expertise and mentoring to other team members and will sit within the Payment Integrity team. Essential Functions Consult on proper coding rules in value‑based contracts to ensure appropriate quality‑measure capture and proper use of...

UH

RN Field Coder

Universal Health Services San Antonio, TX

RN Field Coder Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Job Summary: The RN Field Coder will be responsible for documentation and coding review of medical records where...

SJ

Certified Coder

St. Joseph’s Healthcare System Paterson, NJ

Join to apply for the Certified Coder Abstractor role at St. Joseph's Health 4 days ago Be among the first 25 applicants Join to apply for the Certified Coder Abstractor role at St. Joseph's Health Job Description Under general supervision and according to established policies and procedures, reviews and abstracts the demographic, financial and clinical data from the inpatient medical record for the purpose of assigning ICD diagnosis/procedures, HCPCS, and CPT4. Ensures that inpatient and outpatient records are coded, abstracted and entered into computer system in an accurate and timely manner. Job Description Under general supervision and according to established policies and procedures, reviews and abstracts the demographic, financial and clinical data from the inpatient medical record for the purpose of assigning ICD diagnosis/procedures, HCPCS, and CPT4. Ensures that inpatient and outpatient records are coded, abstracted and entered into computer system in an accurate and...

RM

Certified Medical Coder & ICD/HCC Auditor

Riverside Medical Clinic Riverside, CA

Job Description Responsibilities Come and join the RMC Family! We have been in the community since 5. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice medicine, and receive care. SUMMARY: Responsible for abstracting, reviewing, auditing and the education of all coding and compliance processes, as they relate to CPT, HCPCS and ICD and/or HCC activity. QUALIFICATIONS : To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge,...

IG

Remote HCC Coder

Insight Global New York, NY

This range is provided by Insight Global. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $26.00/hr - $27.00/hr Direct message the job poster from Insight Global Professional Recruiter at Insight Global We are looking for a full-time REMOTE HCC/Risk Adjustment Medical Coder for a contract up to 12 months with possible extensions or conversions. Must hold an active CPC or CCS, as well as 3+ years of HCC/risk adjustment coding experience. ****The pay rate is $25-26.50 per hour depending on experience**** Job Summary: Insight Global is hiring HCC/Risk Adjustment Medical coders to support a backlog for inpatient and outpatient Medicare Advantage projects. Candidates must obtain an active Coding certification (CPC) through AAPC or AHIMA. The role primarily involves risk adjustment coding, focusing on HCC ICD-10 codes. Experience with problem list coding is a plus but not required. Responsibilities include...

MH

Coder I - Billing & Audit - FT - Days - MSS - Hybrid Eligible

Memorial Healthcare System Hollywood, FL

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical Condition Category), procedural and...

MH

Hospital Based Outpatient Coder I - HIM - FT - Days - Remote Eligible

Memorial Healthcare System United States

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.For physician billing, collaborates with billing department to ensure all bills are satisfied. For hospital, routes to billing charge entry errors...

MH

Coder I - MPG - FT - Days - MSS - Remote Eligible

Memorial Healthcare System United States

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data. Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). May assign and sequence basic CPT (Current...

PH

Health Information Management Inpatient Coder, FT, Days, - Remote

Prisma Health Columbia, SC

Job Summary Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis present on admission (POA) indicator is assigned appropriately. Codes for multiple facilities. Adheres to Prisma Health Coding and Compliance policies and procedures for assignment of complete, accurate, timely and consistent codes. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. Codes medical information into the Prisma billing/abstracting systems using established professional and regulatory coding guidelines. Performs Inpatient coding including major traumas and Neonatal Intensive Care Unit (NICU) records by assigning International Classification of Diseases (ICD) and International Classification of Diseases-Procedure Coding System (ICD-PCS) codes as well as the Diagnosis Related...

WR

RN Field Coder

Wellington Regional Medical Center McAllen, TX

RN Field Coder Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Job Summary: The RN Field Coder will be responsible for documentation and coding review of medical records where...

UH

RN Field Coder

Universal Health Services McAllen, TX

Responsibilities Prominence Health is a value-based care organization bridging the gap between affiliated health systems and independent providers, building trust and collaboration between the two. Prominence Health creates value for populations and providers to strengthen integrated partnership, advance market opportunities, and improve outcomes for our patients and members. Founded in 1993, Prominence Health started as a health maintenance organization (HMO) and was acquired by a subsidiary of Universal Health Services, Inc. (UHS) in 2014. Prominence Health serves members, physicians, and health systems across Medicare, Medicare Advantage, Accountable Care Organizations, and commercial payer partnerships. Prominence Health is committed to transforming healthcare delivery by improving health outcomes while controlling costs and enhancing the patient experience. Learn more at: https://prominence-health.com/ Job Summary: The RN Field Coder will be responsible for...

27 ambulatory risk adjustment coder jobs found