1536 certified professional coder jobs found

Job Description Job Description Description: JOB SUMMARY: Responsible for accurate coding and billing of provider office, inpatient and outpatient charges to ensure coding and billing compliance is maintained. Maintains an extensive knowledge of CPT Procedural Coding, ICD-10 Diagnosis Coding and HCPCS Level II coding along with Evaluation and Management (E&M) documentation requirements. DUTIES & RESPONSIBILITIES: Responsible for reviewing and submitting charges from the coding workqueues (WQ). Manually enters off-premise charges in Charge Review. If applicable, manually enters in-house charges for certain Specialty areas as designated. Ability to code for many different Specialties as assigned. Provides cross-coverage in the department as needed and directed by the Coding and Compliance Manager /Data Collection Team Leader. If indicated, arrives the Surgery Schedule on a daily basis using the DAR function. Checks each patient in to create the visit number....

Job Description Job Description Certified Professional Coder / Bill Review Expert Location: Remote- Anywhere in US Responsibilities: Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds Interpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes Assign proper CPT, HCPCs codes based on the review outcome Review CPT codes for unbundled services Review billed modifiers for accuracy of use Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement Interpret fee schedule guidelines and apply those guidelines in daily reviews Document review outcomes for customers in a professional easy to understand manner Use various resources, IE: eBooks, 3M software to support reviews Participate in conference calls as needed with customers and/or attorneys Participate in virtual and in-person testimony or trial...

Job Description Job Description Description: *** MUST RESIDE IN TEXAS*** Job purpose The certified coder prepares and submits clean claims to insurance companies electronically and by paper, and provides appropriate coding for each patient’s medical history, diagnosis, tests and treatment plan. Duties and responsibilities Primarily codes from final office visit, surgical/procedural operative reports signed by providers Reviews medical records and accurately code primary and secondary diagnoses using CPT, ICD-9 and ICD-10 conventions; sequence the diagnoses and procedures using coding guidelines Verifies accuracy and submits claims to insurance using Electronic Medical Records systems and paper claims Enters patient copayment information into the EMR Reconciles charges against the schedule list to ensure no charges are missed Investigates rejected claims to see why denials were issued as necessary Re-bills rejected claims in timely manner Maintains strict...

Job Description Job Description Healthcare: Nephrology Outpatient: Position is an  IN PERSON POSITION IN OUR OFFICE IN ROCK HILL, SC!!!!! **ONLY QUALIFIED APPLICANTS TO APPLY*** ***THIS IS AN IN OFFICE POSITION, THIS IS NOT A REMOTE POSITION This position is a major contributing factor to the success of the practice. Summary of Position : Vital position as part of our billing team. Responsible for resolving, coding edits, account checks, rejections and denials to ensure proper reimbursements. Job Duties: Responsible for converting medical diagnosis and processes into standardized codes that are used when filing insurance claims. Medical Coding: After a patient completes their visit, be able to rea patients chart or file and classify the information from the appointment into different categories, reference medical coding guidelines and research correct codes, comply with medical guidelines and policies, perform initial charge review to determine appropriate...

Job Description Job Description Job Title: Certified Professional Coder Job Category: Administrative Reports To: Coding Manager Position Type: Full Time Position  Supervisory Responsibility: This position has no supervisory responsibilities Exempt/Non-Exempt: Non-Exempt Job Description Role and Responsibilities The Certified Coding Specialist is responsible for assigned work queue’s for physician services via medical records (encounter) for office visits, outpatient surgery, office procedures and hospital visits utilizing ICD-10-CM and CPT-4 codes. This requires thorough review of the medical record to validate assigned codes for optimal reimbursement. Research coding and regulatory guidelines that impact coding and billing for services to obtain relevant and timely information for internal utilization utilizing ICD-10-CM and HCPCS/CPT-4 codes. Ensures appropriate charge capture. Essential Functions: Reasonable accommodations may be made to...

POSITION SUMMARY Position Summary: Assigns ICD-10-CM and CPT codes for professional services using coding guidelines and principles to ensure appropriate billing processes, reimbursement follow up and analysis. Familiar with accounts receivable and collection activities. Utilizes resources available to ensure full compliance with federal Medicare and Medicaid laws and regulation provisions, and in keeping with the health center mission. POSITION QUALIFICATIONS Minimum Education High School or equivalent Coding Certification (CPC, CCS-P, CPC-H) or (RHIA or RHIT) Minimum Experience Two years coding experience preferred Knowledge of medical billing for physician services preferred Required Registration/License/Certification CPC, CCS-P, CPC-H, or other related coding certification or RHIA or RHIT.

Hive, LLC, a family of companies with a passion for changing the delivery of healthcare, is looking for a Certified Professional Coder to join their team in the Hospital & Health Care industry. This role will work alongside dedicated and talented individuals who are committed to providing top-notch end-to-end management of billing operations, patient monitoring services, and more. As a Certified Professional Coder, you will play a key role in ensuring that all medical bills are coded and processed efficiently and accurately. The successful candidate will be self-motivated, detail-oriented, and have experience working in the healthcare industry. Responsibilities + Review patient medical records to identify appropriate codes for billing purposes. + Verify accuracy and completeness of medical records to ensure appropriate coding. + Communicate with medical staff to clarify medical procedures and diagnoses to ensure accuracy of coding. + Enter data into computer...

Job Type: Regular Time Type: Full time Work Shift: Day (United States of America) FLSA Status: Non-Exempt When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. With oversight from the department Manager and exercising independent judgment within the scope of their professional practice, the Certified Professional Coder performs a variety of tasks associated with coding physician and other provider charges, and providing coding education to providers in that area. Duties include hands-on documentation review, surgical coding of physician or other qualified healthcare provider services. Coding of inpatient and outpatient Evaluation and Management by assigning the appropriate CPT, ICD-10-CM and HCPCs codes. Job Description: Essential Duties & Responsibilities including but not limited to: Coding Responsibilities: Provides review and/or coding of any professional services including but not limited to...

The ideal candidate will have experience in coding medical diagnoses and procedures to support accurate billing, revenue cycle management, and compliance with regulatory standards. This role involves working closely with healthcare providers, billing staff, and insurance companies to ensure proper coding practices, optimize reimbursement, and uphold quality standards. Key Responsibilities: Coding Accuracy & Compliance: Review medical records to accurately assign CPT, ICD-10, and HCPCS codes for diagnoses, procedures, and services. Ensure compliance with all healthcare regulations, including federal and state laws, as well as organizational guidelines. Revenue Cycle Management & Documentation: Utilize electronic health record (EHR) systems to manage coding and documentation workflows. Auditing & Quality Assurance: Regularly conduct internal audits to review coding accuracy and clinical documentation compliance. Work with teams to identify and address discrepancies,...

Job Description Job Description Coding and Billing Auditor Job is fully onsite. General Summary: Performs data quality reviews on provider records to validate the ICD-10 codes, CPT codes and clinical documentation. Audits provider (physician and midlevel providers) records for accuracy of principal and secondary diagnosis and/or procedures and ensures compliance with all reporting and documentation requirements. Educates providers, coders and charge entry personnel on coding guidelines and documentation requirements. Provides coding support to BHMG coding and billing staff. Responsibilities: 1. Audits medical records for accurate CPT coding assignment. Compiles reports with an analysis of findings from the medical record audits. Ensures the selected CPT code supports the clinical documentation contained in patient record. Consistently meets established productivity targets for record audits. 2. Audits all establish provider medical records on by annual basis: a....

Job Type: Regular Time Type: Full time Work Shift: Day (United States of America) FLSA Status: Non-Exempt When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Under the direction of the Hospital Coding Manager or Supervisor, and exercising independent judgment within the scope of the job, the Hospital Inpatient Coder II assigns applicable ICD-10 Codes, Present on Admission (POA), Hospital Acquired Condition (HAC), and Patient Safety Indicators (PSI) using current industry standards, the Official Coding Guidelines, Coding Clinic, UHDDS and regulatory requirements. Ensures the integrity and quality of patient data to achieve minimal variation in coding practices; assigns codes only as supported by physician/licensed independent practitioner (LIP) documentation within the body of the medical record. Applies in-depth knowledge of medical terminology and anatomy and physiology specific to coding. Job Description:...

Our patients have the peace of mind knowing that their health and well-being are our primary concerns. We give our health plan clients the confidence that their members are well taken care of. With over 11,000 at-risk members, we provide primary care and other services to seniors and families in our medical centers that are comfortable, convenient and staffed with caring professionals. Our activity and wellness facilities are filled with health plan members who know us for our distinct events and programs that cater to the communities we serve. Every day, we deliver on our promise to bring value based, quality healthcare to our patients.   Overview The Certified Outpatient  Medical Risk Adjustment Professional Coder  is responsible for reviewing encounter notes and other supporting documentation and assigning diagnosis codes and procedure codes to create claims. Also, responsible for assigning appropriate level II codes to quality measures for HEDIS reporting. Follows...

Job Summary Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, third party payers and other regulatory agencies. Functions includes but are not limited to reviewing surgical operative reports and abstracting clinical diagnoses, procedure codes and other pertinent information in order to bill appropriately for services. Will ensure physicians are continually educated on correct coding techniques to maximize reimbursement. Come join a remarkable team where quality care meets quality service, in every dimension, every time. This position requires onsite visits. #JoinTeamAubergine #NovantHealth Let Novant Health be the destination for your professional growth. At Novant Health, one of our core values is diversity and inclusion. By engaging the strengths and talents of each team member, we ensure a strong organization capable of providing remarkable...

Workforce Classification: Hybrid Kinwell was founded on the principle of personalized, whole-hearted care for every patient. We believe the best healthcare is a conversation, and one that includes nutrition, fitness, sleep, and behavioral health. Our Clinicians and Clinic Support staff drive real change in their patient's well-being. Along the way, we are setting a new standard for primary care, making it more accessible, impactful, and holistic. We are dedicated to building great places to work. We value all teammates and respect a diversity of thought, ideas, and cultures-all focused on the common goal of nurturing the health of those we serve. Kinwell fosters a culture that promotes employee growth, collaborative innovation, and inspired leadership. We bring agility to work every day and thrive on the opportunity to create something refreshing and new. This is where you come in. If you are looking for a new primary care opportunity, one based on the quality of care, not...

COMPANY DESCRIPTION Borland Groover is one of Florida's leading gastroenterology providers. Founded in 1947, our mission is to provide exceptional care and improve the lives of our patients. We value ourselves on delivering quality care (quality), doing the right thing (accountability), caring for our patients (compassion), and taking care of our employees (collaboration). If you love the vision of Borland Groover, and find your values aligning with ours, apply to join our team! POSITION SUMMARY The Certified Professional Coder at Borland Groover is a part of the medical billing team and is responsible for accurately applying procedural and diagnosis codes and entering charges into the billing system in a timely fashion. A Certified Professional Coder (CPC), is a healthcare professional who specializes in medical coding. Medical coding involves the translation of medical diagnoses, procedures, and services into numeric or alphanumeric codes. These codes are used for...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Reimbursement Professional - Certified Medical Coder (MCCAU Code Edit Policy Team) updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. Begins to influence department’s...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Reimbursement Professional - Certified Medical Coder (MCCAU Code Edit Policy Team) updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. Begins to influence department’s strategy....

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Reimbursement Professional - Certified Medical Coder (MCCAU Code Edit Policy Team) updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. Begins to influence department’s...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Reimbursement Professional - Certified Medical Coder (MCCAU Code Edit Policy Team) updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. Begins to influence department’s...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Reimbursement Professional - Certified Medical Coder (MCCAU Code Edit Policy Team) updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. Begins to influence department’s...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Reimbursement Professional - Certified Medical Coder (MCCAU Code Edit Policy Team) updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. Begins to influence department’s...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Reimbursement Professional - Certified Medical Coder (MCCAU Code Edit Policy Team) updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. Begins to influence department’s...

Become a part of our caring community and help us put health first The Senior Provider Reimbursement Professional (MCCAU Code Edit Policy Team)-Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Provider Reimbursement Professional - Certified Medical Coder (MCCAU Code Edit Policy Team) updates, maintains, and reviews fee scheduling and pricing structures. Ensures contracted rates and reimbursement policies are priced and applied accurately. Identifies reimbursement policy and process recommendations and ensures compliance with government regulations. Analyzes provider reimbursement patterns and trends. Begins to influence department’s...