46 benefit coder jobs found

ThedaCare Coder (Clinic - III) The Coder (Clinic - III) performs coding review for surgical specialties for ThedaCare Physician Services to accurately reflect services rendered. Reviews and processes charges using industry standard methodologies (CPT, ICD-10-CM, HCPCS), abides by Standards of Ethical Coding (AAPC/AHIMA), and complies with official coding guidelines and other regulatory requirements. Audits medical record documentation and educates providers on documentation improvement opportunities and risks. Educates and trains new team members to department standards. Mentors and observes team members in department responsibilities. Upholds and demonstrates department expectations and accuracy in regards to coding responsibilities including payer denials and claim edits. Job Description: Schedule: Full time, benefit eligible 40 hrs/week Business hours (i.e 8:00am-5:00pm) Remote Position Preferred skill set and experience strong in surgical coding; Urology primarily to...

Job Opportunity at SSM Health St. Mary's Hospital - Madison It's more than a career, it's a calling. Worker Type: Regular Job Highlights: Monday to Friday, 8:00 to 4:30 (flexible), full-time (.9/36 hours). This is a new role supporting imaging and procedure lab charges and charge reconciliation. The individual will help define and build the role. The position supports St. Mary's and the WI region as needed. Job Summary Supports assigned department(s) as a subject matter expert for achieving operational efficiency, compliance, and exceptional patient care. Serves as a liaison between and resource for clinical and Revenue/Financial departments with strong understanding of both components. Job Responsibilities and Requirements PRIMARY RESPONSIBILITIES Serves as a resource and subject matter expert to the department for workflows, documentation, coding, charging, and software applications. Manages all work queues using subject matter expertise to investigate/correct...

Position Summary Applies CPT-4 and HCPCS codes to medical records for the cardiovascular lab and interventional radiology departments based on physicians’ documentation. Adheres to strict federal coding rules and guidelines, achieving 95% coding accuracy while meeting billing deadlines. Essential Responsibilities Code surgical procedures performed by cardiologists and interventional radiologists. Verify supplies used during procedures. Use encoders and other reference materials effectively. Maintain appropriate non‑leading queries to physicians. Abstract services from physician documentation and procedure logs. Reconcile monthly surgical logs. Manage multiple job tasks daily (WQs, emails, surgical logs, census, etc.). Prepare Excel analysis, including V‑Lookups and pivot tables. Gather and compile data systematically, document assumptions, and validate accuracy to resolve inconsistencies. Evaluate and implement charge requests with appropriate CPT/HCPCS codes, revenue codes, and...

R1 RCM Holdco Inc. is seeking a medical coder responsible for applying CPT-4 and HCPCS codes accurately for cardiovascular and interventional radiology procedures. The role demands advanced coding knowledge, strong Excel proficiency, and effective collaboration with clinical and finance teams. The ideal candidate has 4–6 years of experience in medical coding, a high school diploma, and relevant certifications. This position offers a salary ranging from $48,131 to $81,225 annually, along with eligibility for an annual bonus and a competitive benefits package. #J-18808-Ljbffr

Department 10407 Enterprise Revenue Cycle - Coding Production Operations: Inpatient Coding Operations Status Full time Benefits Eligible Yes Hours Per Week 40 Schedule Details/Additional Information This role will comply with all departmental scheduling policies and expectations. Will support Inpatient Community Core - WI/IL division Schedule Monday - Friday 1st shift 40 hours a week. Certification required Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA). Remote opportunity Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY Pay Range $28.55 - $42.85 Major Responsibilities This role will have all responsibilities of coder I, II and III in addition to: reviews complex...

R1 RCM Holdco Inc. is seeking a medical coder responsible for applying CPT-4 and HCPCS codes accurately for cardiovascular and interventional radiology procedures. The role demands advanced coding knowledge, strong Excel proficiency, and effective collaboration with clinical and finance teams. The ideal candidate has 4–6 years of experience in medical coding, a high school diploma, and relevant certifications. This position offers a salary ranging from $48,131 to $81,225 annually, along with eligibility for an annual bonus and a competitive benefits package. #J-18808-Ljbffr

Overview Providence requires a Compliance Auditor – Remote. The Revenue Cycle Compliance Hospital Auditor evaluates compliance with federal and state laws, regulatory rules, and Providence policies and procedures across a variety of audit focus areas, including clinical and nonclinical services related to revenue cycle operations. The auditor works collaboratively with Case Management, Utilization Review, Revenue Integrity, the Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs, and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The role involves navigating and analyzing data across clinical EMR and Epic billing systems, reviewing line-item charges, revenue codes, CPT descriptions, status, orders, supporting documentation, and reimbursement. Audit findings are presented verbally and visually to reduce risk within the Providence system. Overpayments received in error are refunded following the CMS Voluntary Self Disclosure...

Overview Providence requires a Compliance Auditor – Remote. The Revenue Cycle Compliance Hospital Auditor evaluates compliance with federal and state laws, regulatory rules, and Providence policies and procedures across a variety of audit focus areas, including clinical and nonclinical services related to revenue cycle operations. The auditor works collaboratively with Case Management, Utilization Review, Revenue Integrity, the Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs, and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The role involves navigating and analyzing data across clinical EMR and Epic billing systems, reviewing line-item charges, revenue codes, CPT descriptions, status, orders, supporting documentation, and reimbursement. Audit findings are presented verbally and visually to reduce risk within the Providence system. Overpayments received in error are refunded following the CMS Voluntary Self Disclosure...

Medical Coding Specialist II - Profee Radiology Middleton, WI, United States (Remote) Job Description Work Schedule: This is a full-time, 1.0 FTE position that is 100% remote. This will have flexible shifts scheduled Monday - Friday and will be discussed in the interview. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. To be eligible to work remotely, you must be in an approved remote work state for UW Health. We’ve included a link below to view the full list of approved remote work states. We are seeking a Medical Coding Specialist II to: Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local...

Humana seeks a Risk Adjustment Coder to conduct quality assurance coding of medical records, ensuring compliance with CMS standards. The role involves mapping conditions to Hierarchical Condition Categories (HCCs) using ICD-10 diagnosis codes. Required qualifications include certification from AAPC or AHIMA and the ability to work 40 hours weekly, with a focus on maintaining coding standards. Benefits include health insurance, a 401(k) plan, and paid time off. #J-18808-Ljbffr

BayCare Clinic in Green Bay, WI is seeking a dedicated Coding Specialist to join their team. This full-time role includes responsibilities such as reviewing medical records and assigning accurate codes for services performed. The position offers flexibility with remote work and comes with a comprehensive benefits package, including insurance options and a 401k plan. Candidates should have a coding certificate and familiarity with computer applications. This is a unique opportunity to contribute positively to patient care. #J-18808-Ljbffr

Become a part of our caring community. Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will perform quarterly...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

The Opportunity We are looking for a Medical Billing Specialist (Back Office) to support day-to-day billing operations and back-office revenue cycle workflows. This person will play a critical role in ensuring claims are submitted accurately, denials are worked efficiently, and billing-related operational tasks are completed on time. This is primarily a back-office execution role. The ideal candidate has strong medical billing fundamentals, is detail-oriented, and is comfortable working in a high-volume, process-driven environment. This role will partner closely with client-facing RCM team members and escape more complex issues as needed. What You’ll Do Submit and track medical claims across payer channels Work claim rejections, denials, and unpaid claims through to resolution Investigate payer issues and perform follow-up on claim status Support manual billing workflows and operational tasks required to keep accounts moving Maintain billing accuracy across documentation,...

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER Join our team as a Medical Coding Specialist! We are looking for a certified coding professional with strong attention to detail and a commitment to accuracy. Candidates should hold a CPC or CCS-P certification and have completed an accredited Medical Coding Specialist Program or possess equivalent education and experience. Medical coding experience and insurance processing knowledge are preferred. The Medical Coding Specialist is responsible for reviewing electronic encounter documentation to verify that practitioner-submitted codes are accurate, adhere to coding protocols, and comply with all applicable guidelines. This role is responsible for accurately assigning medical codes to patient records and supporting providers through education on coding and documentation requirements while contributing to coding-related initiatives and research as needed. The position includes reviewing insurance claims to identify...

Datavant is hiring an experienced Outpatient Coder to join their fully remote team. The ideal candidate should have expertise in Emergency Department coding as well as at least 3 years of outpatient coding experience. This position allows you to work flexibly from your own workspace while contributing to significant healthcare improvements. Key responsibilities include coding medical records for accuracy and maintaining high standards for coding efficiency. Datavant offers a range of employee benefits including health coverage and professional development support. #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. We’re looking for experienced and credentialed outpatient 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 shape the future...

Become a part of our caring community. Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will perform quarterly...

Job Description Work Schedule: This is a full-time, 1.0 FTE position that is 100% remote. Qualified candidates should be able to work 8 hours per day Monday- Friday. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states. Approved Remote Work States Listing Be part of something remarkable Join the #1 hospital in Wisconsin! We are seeking a Medical Coding Specialist II to: Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. Maintain an understanding and apply knowledge of National Correct Coding...

Humana Inc is seeking a Risk Adjustment Coder to conduct quality assurance coding of medical records and ICD-10 diagnosis codes. This remote position demands accuracy and independence while adhering to regulations and analyzing coding information. Candidates must hold a certification from AAPC or AHIMA and have experience in a goal-oriented environment. The role offers competitive benefits and a salary range between $48,300 and $65,900. #J-18808-Ljbffr

## Risk Adjustment CoderApplylocations: Remote Kentucky: Work at Home - Utah: Work at Home - Washington: Work at Home - Virginia: Work at Home - Texastime type: Full timeposted on: Posted Todayjob requisition id: R-421015# **Become a part of our caring community**The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment.The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record.* Reviews medical records to report conditions that map to HCCs by reviewing medical record documentation and applying the appropriate ICD-10 diagnosis codes.* Follows state and federal regulations as well...

Humana is seeking a Risk Adjustment Coder to perform quality assurance coding of medical records and ICD-10 diagnosis codes. This remote position requires extensive coding knowledge and the ability to ensure accuracy in documentation. The ideal candidate should hold a certification from AAPC or AHIMA and have at least a year of coding experience. Responsibilities include reviewing medical records and ensuring compliance with required regulations while working independently. Benefits include a comprehensive health plan and competitive salary range of $48,300 to $65,900 annually. #J-18808-Ljbffr

Humana Inc is seeking a Risk Adjustment Coder to conduct quality assurance coding of medical records and ICD-10 diagnosis codes. This remote position demands accuracy and independence while adhering to regulations and analyzing coding information. Candidates must hold a certification from AAPC or AHIMA and have experience in a goal-oriented environment. The role offers competitive benefits and a salary range between $48,300 and $65,900. #J-18808-Ljbffr