88 analyst siu certified coder jobs found

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. Responsibilities Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent with medical record documentation. Provide detailed written summary of medical record review findings. Must be able to articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc. Research and accurately apply state or CMS guidelines related to the audit with minimal...

Salary: $25.89 - $28.48 Hourly Location : Springfield, IL Job Type: Civil Service Job Number: 2401379 Department: SIU HealthCare Coding-SMS Division: Administration Opening Date: 04/24/2026 Closing Date: 6/22/2026 3:30 PM Central FLSA: Non-Exempt Bargaining Unit: Non-Represented Shift: Days ExemptorNon_Exempt: Non-Exempt We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform...

We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform all audits based on specific departmental need. *****On-Site Only**** Examples of Duties PBS Auditor: 100% Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods. Demonstrate in-depth knowledge and experience with SIU-HC supported applications, including but not limited to...

Job Details Transcribe Speech and language samples from people with aphasia using broad principles of the International Phonetic Alphabet. Job Description Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. Learn and apply specialized coding systems, such as Correct Information Unit (CIU) analysis to transcribed data Manage and rganize data sets using excel Assist with general duties of reseach and lab operations as warranted Work Shift Workday Day (United States of America) Worker Sub Type Temporary Employee Entity Albert Einstein Medical Center Primary Location Address 60 Township Line Road, Elkins Park, Pennsylvania, United States of America Benefits Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement...

GENERAL DESCRIPTION OF POSITION: This position is vital in the health care delivery system in function with the fiscal aspect of the Clinic. Adhere to policies and procedures in conducting all clinical charges, payments, adjustments for proper billing and collections. Bills and submits claims to insurances/programs through AthenaOne EMR, follows up on claims statuses, resolves claim denials, submits appeals, post payments and adjustments, and manages collections. Great customer service and telephone etiquette, computer knowledge, professional appearance, attention to detail, able to multitask and work in a fast paced environment. Ability to work well under stress and maintain calm under pressure and work well with team members and willingness to cross-train. Functions as a member of a collaborative health care team to create and maintain a patient centered medical home. ESSENTIAL JOB FUNCTIONS: (with or without accommodations) Communication : Communicates with outside...

## CMS HCC Coder - Hybrid remote - Orange, CA.Applyremote type: Hybrid Remotelocations: Orange, CAtime type: Full timeposted on: Posted Yesterdayjob requisition id: R2056Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.This position is hybrid- remote in Orange, CA. The Hierarchical Condition Categories (HCC) Coding Analyst will effectively interface with provider partners, to successfully, monitor...

All CDC recommended vaccines are required vaccinations at Oaklawn. Seasonally, and upon determination of Senior leadership, the Influenza Vaccine may be mandatory; in those years, compliance is required. For all vaccines, Religious Exemptions and Medical Contraindications are available. Coder Abstractor - Health Information Services Job Summary: Under limited supervision, codes and abstracts patient records using the appropriate coding/abstracting system. Communicates with Medical Staff and hospital staff to improve the documentation to support the coding process. Essential Functions: Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his/her goals and objectives in a manner that helps others to achieve their goals and objectives. Code outpatient (for example day surgery, observation, emergency room, outpatient service, diagnostic) records using the appropriate coding system for diagnoses (ICD-10) and procedures (CPT & PCS) Maintain coding...

Certified Coder, Special Investigations Unit (SIU) SummaCare - 1200 E Market St, Akron, OH Full-Time / 40 hours / Days *Hybrid or Remote Join a mission-driven health plan where precision and expertise protect both members and resources-we're seeking a certified coder who can identify discrepancies others miss, analyze coding patterns with accuracy, and turn complex clinical data into clear, actionable insights; if you bring deep knowledge of coding standards, a sharp analytical mindset, and a passion for ensuring integrity in healthcare claims, this is your opportunity to make a meaningful impact and strengthen the quality of care delivery. Summary : Performs review of medical claims to ensure compliance with industry standard coding practices and plan payment policies through a comprehensive medical record evaluation for all provider types. Determines correct coding and appropriate documentation required while ensuring state, federal and company policies are...

Summary This position is located in the Health Information Management (HIM) section at the Alaska VA Medical Center. Medical Records Technicians (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. Learn more about this agency Duties Help Total Rewards of a Allied Health Professional Duties include but are not limited to the following: Basic Functions: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Selects and assigns codes from the current version of several coding systems to include current versions of the International Classification of Diseases...

Medical Biller, CMG Business Office This position participates in various functions including the review, correction, submission/resubmission, and/or appeal of rejected, denied, unpaid, or improperly paid insurance claims. This position is responsible for billing and follow-up functions for payors in all financial class categories. Serves as a resource for Medical Biller Is, seeking guidance from Supervisor when necessary. This positions also provides patient customer service and releases billing records to approved entities. This position responsible for the timely and accurate completion of assigned tasks to facilitate proper claim processing. Responsibilities Acts a resource for Medical Biller Is with resolving intermediate to complex account and claims issues. Provides guidance to other departmental roles (including Customer Service, Collections, Payment Posting) as it pertains to plan eligibility, claims processing details, and patient balance explanations as needed....

Denials Specialist/Medical Biller (Hybrid) Digestive Health Specialists, P.A., a leading gastroenterology group based in Winston Salem, is currently recruiting for a Billing Specialist to join our team. We are a well-established and growing practice; founded originally in 1979 and have grown to serve our patients now in 5 locations. Patients choose our practice for our experienced providers and staff who provide friendly, compassionate, high-quality and affordable care. No weekends, nights or call would apply for this position. Job Overview : Responsible for the reimbursement and/or resolution of patient insurance account balances with the goal of working accounts to resolution. This role performs account management and analysis; as well as complete, timely and accurate follow up of insurance (hospital, physician or ASC) account balances with the objective of optimizing insurance reimbursement. Primary Job Duties : Maintain a professional and compassionate demeanor in...

Medical Coding Specialist (NY HELPS) - FT - Day Shift HOURLY RANGE: $26.57 - $34.83 NY HELPS: This title is part of the New York Hiring for Emergency Limited Placement Statewide Program (NY HELPS). For the duration of the NY HELPS Program, this title may be filled via a non-competitive appointment, which means NO EXAMINATION IS REQUIRED, but all candidates must meet the minimum qualifications of the title for which they apply. At a future date (within one year of permanent appointment), it is expected employees hired under NY HELPS will have their non-competitive employment status converted to competitive status, WITHOUT HAVING TO TAKE A CIVIL SERVICE TEST. Employees will then be afforded with all of the same rights and privileges of competitive class employees of New York State. While serving permanently in a NY HELPS title, employees may take part in any promotion examination for which they are qualified. DISTINGUISHING FEATURES OF THE CLASS: The work involves performing the...

Overview Under general supervision, a Certified Professional Coder is responsible for correctly coding professional healthcare claims in order to obtain reimbursement from private insurance companies and government healthcare programs. This is NOT a remote position. Responsibilities May include any and/or all of the following: Accurately enter patient information into LifeLinc’s billing software. Verify patient insurance is valid and active. Organize files and collect data to be entered. Analyze and verify data for errors. Report problems with data received or missing data. Follow-up on data that has not been received. Keep sensitive patient and company information confidential. Appropriately compose and type routine correspondence, memos, letters, etc. Performs other duties as assigned. Qualifications EDUCATION and/or EXPERIENCE High school diploma or general education degree (GED) is required Minimum of 1-year related experience, training, and/or equivalent...

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center. Position Summary: The Lead Medical Coder serves as a certified professional coder and assists the Medical Coding Office Manager with oversight of daily coding operations. Performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; performs chart analysis, research coding issues; peer reviews; and serves as a medical documentation and coding technical expert to TONHC providers. Scope of Work: This position is located within Tohono O'odham Nation Health Care (TONHC). The work involves performing specialized medical record tasks and resolving problems using established processes, coding conventions, and guidelines. Performance of duties reflects directly on patient care by recording services performed on the patient. The...

Medical Biller Under general supervision, the incumbent is responsible for examining, verifying, and maintaining data involved in processing medical care claims for alternate resources reimbursement and performing other third-party billing-related duties. The primary function of this position is to bill/process all medical care claims timely to ensure reimbursement from third-party payers. The work involves the review of medical claims to ensure accuracy and completeness and obtain missing information. The incumbent performs various accounting, budget, or financial management support-related duties or assignments related to medical billing. Essential duties and responsibilities include: Responsible for received claims up until Third-Party Payer has paid the claim. Receives and examines alternate resource claims to ensure they are complete with appropriate supporting documents. Verifies accuracy of health claim number that claimed amounts are authorized and that the...

Physician Coder, Full-time (CPC/CCA) Join our dedicated team at Harrison County Hospital in Corydon, IN, where your expertise as a Certified Physician Coder will make a significant impact in the healthcare community. This onsite position offers the unique opportunity to collaborate with healthcare professionals and enhance patient care through accurate coding practices. You will play a vital role in ensuring excellence in our medical billing processes while maintaining our commitment to customer-centricity. Being a part of our organization means contributing to an environment that values professionalism and compassion. If you are passionate about coding and eager to work in a supportive, dynamic setting, this role is perfect for you. You can get great benefits such as Medical, Dental, Vision, 401(k), Life Insurance, Health Savings Account, Flexible Spending Account, Paid Time Off, Snack/Drink Room, and Employee Discounts. Take the next step in your career and help us uphold our...

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 Under general supervision, reviews, analyzes and assures the final diagnoses and procedures as stated by the practicing providers are valid and complete. Accurately codes office and hospital procedures for providers to ensure proper reimbursement. Provides education to the providers to ensure proper documentation and assignment of ICD-10-CDM, HCPCS and CPT codes. Reports to the Coding Operations Manager. Will support Meeting House Lane Medical Practice, PC and SB Administrative Services. Responsibilities: Audits records to ensure proper submission of services prior to billing on pre-determined selected charges. Receives hospital information to properly bill provider...

We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R – Respect S – Stewardship Billing and Coding Specialist Summary Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty. A Day in the Life Review provider documentation (including hospital procedures) and translate services into correct codes. Append payer specific modifiers and claim criteria when applicable. Review incomplete encounters and code based on available documentation in EHR systems. Know and understand several different coding systems, including ICD-10-CM, ICD-10-PCS, CPT, Level 1 HCPCS and Level 2 HCPCS. Use computers / billing software to create and bill encounters that generate...

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...

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....

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...

TEKSYSTEMS IS HIRING FOR AN INPATIENT AUDITOR - FULLY REMOTE MUST SIT EST OR CST JOB SUMMARY: Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. JOB RESPONSIBILITIES: • Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. o Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the purpose of reimbursement, research and compliance with federal and state regulations. o Audits complex inpatient cases such as trauma, rehab, neurology, critical care, etc. utilizing the...