18 certified coder analyst jobs found

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. You'll enjoy the flexibility to telecommute* as you take on some tough challenges. The Medical Coding Auditor is required to determine the accuracy of claims submitted by a provider to UnitedHealth Group by comparing it to the medical record(s) submitted for the date(s) of service being reviewed. This position supports the identification of suspected Waste & Error of health insurance claims and...

Requisition number: 2371422 Job category: Medical & Clinical Operations Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You'll enjoy the flexibility to telecommute* as you take on some tough challenges. The Medical Coding Auditor is required to determine the accuracy of claims submitted by a provider to UnitedHealth Group by comparing it to the medical record(s) submitted for the date(s) of service being reviewed. This position...

Risk Adjustment Coding Auditor Location: Remote (U.S.) Employment Type: Contract-to-Hire About the Role The Risk Adjustment Coding Auditor is responsible for ensuring the accuracy, completeness, and compliance of diagnosis coding used in risk adjustment programs. This role conducts prospective and retrospective chart audits, validates diagnosis code capture, identifies documentation opportunities, and provides coding guidance to support regulatory compliance and appropriate reimbursement. The auditor serves as a subject matter expert in risk adjustment coding and works closely with internal teams to maintain data integrity and reduce financial and regulatory risk. Key Responsibilities Perform prospective and retrospective medical record reviews and audits. Validate diagnosis code accuracy, completeness, specificity, and appropriateness based on provider documentation. Review medical records to ensure proper capture of CMS-HCC diagnoses and risk adjustment...

Mayo Clinic is seeking a skilled Procedural Coder to review, analyze, and code professional medical record documentation for diverse practices. The role supports a hybrid work model and requires experience in procedural/surgical coding, with preferred credentials and specialty knowledge. Candidates should have documentation of appropriate coding credentials (RHIA/RHIT/CCS-P or CPC) and either an Associate's or Bachelor’s degree, with preference for Urology and Gynecology coding experience; HFMA #J-18808-Ljbffr

Job Description Job Description Description: Riverland Community Health is a Federally Qualified Health Center in St. Paul, where patients receive community-based Family Practice medical care in addition to mental health, dentistry, social work and other integrated services. When joining RCH, you become part of a diverse, inclusive, and welcoming team who are dedicated to serving our patients and pursuing our mission to deliver excellent healthcare for all and training for the providers of tomorrow. JOB SUMMARY: The Medical Coding Specialist / Provider Educator is responsible for the review of medical records, notes, dictation and other related documentation to ensure the accurate and timely submission of charges for professional services provided by physicians and other providers as well as diagnoses for clinic services. The Medical Coding Specialist / Provider Educator is also responsible for conducting coding audits, providing education and communication of process...

Certified Coder This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. This position is for a Certified Coder who will provide coding expertise and clinical support across a wide range of initiatives and processes. This role requires close collaboration with cross-functional teams to ensure alignment with both clinical and business objectives, while supporting the successful execution of projects. This position is full-time (40 hours/week), Monday - Friday. Employees must work an 8-hour shift...

Medical Coder $3,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work. Delivering quality care starts with ensuring our processes and documentation standards are being met and kept at the highest level possible. This means working behind the scenes ensuring a member-centric approach to care. As a Medical Coder you will determine and record the correct medical codes for all treatments and health services. Ensuring proper records is just one way your...

Medical Coder II - Remote The Medical Coding Specialist II is responsible for correctly coding healthcare claims and analyzing denials to obtain proper reimbursement. The Medical Coder accurately and efficiently codes hospital outpatient and professional service using official code sets and classifications systems to obtain the most accurate data based on documentation. Title: Medical Coder II Location: Remote Schedule: 8am 5pm in Eastern, Central, Mountain, or Pacific time zones Department: Insurance Reports To: Coding Supervisor Compensation: $26-$30 per hour, depending on qualifications Key Responsibilities: Read and analyze patient records Accurately and efficiently code for a variety of services including but not limited to, evaluation and management, laboratory, imaging, injections and infusions, and specialty surgical procedures in the clinic and hospital outpatient settings. Monitor, research, and correct claim denials within health plan requirements and...

**Requisition number:** 2377170 **Job category:** Medical & Clinical Operations _This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges._ At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start **Caring. Connecting. Growing together.** As the organization accelerates its digital transformation, Benefit Digitization and AI 10.0 efforts are key to improving efficiency, enhancing member and provider experiences, and managing long term costs. To achieve these goals, dedicated roles are needed to design, implement, and manage the digital capabilities that support these initiatives. This...

Position Description & Qualifications Serco is excited to continue our support to the Defense Heath Agency (DHA) Medical Coding Program Branch (MCPB). The DHA is a joint, integrated Combat Support Agency that enables the Army, Navy, and Air Force medical services to provide a medically ready force to Combatant Commands in both peacetime and wartime. The essential mission of the DHA Medical Coding Program Branch (DHA-MCPB) is to improve the accuracy and quality of medical coding and documentation across DHA in support of the DHA mission. Medical Coding Auditing consists of a systematic, unbiased, independent examination of medical documentation and coding to validate that all codes entered into the Military Health System (MHS) systems are in conformity with official coding policies, regulations, requirements, and standards. The auditing task involves developing or following a disciplined, systematic process that defines what is to be audited and why, how errors are defined and...

Coding Specialist Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Identify appropriate assignment of CPT and ICD-10 Codes for outpatient ancillary services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Apply coding knowledge to analyze/correct...

Evaluation & Management Medical Coder Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. As an Evaluation & Management Medical Coder, you will provide coding and coding auditing services directly to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. The ideal candidate will possess prior experience of any kind talking to physicians,...

We are seeking a knowledgeable and experienced AAPC/AHIMA-certified Professional Coder to support Quality Assurance (QA) activities for HEDIS measure charts. The ideal candidate will have strong expertise in HEDIS measures, chart review, and quality validation, along with the ability to independently interpret NCQA guidelines. ________________________________________ Key Responsibilities: • Perform Quality Assurance (QA) on HEDIS measure charts and abstraction results • Review and validate accuracy, completeness, and compliance of HEDIS data • Analyze HEDIS measurement specifications and ensure adherence to NCQA guidelines • Conduct detailed chart reviews to identify gaps, inconsistencies, and coding errors • Interpret and apply HEDIS technical specifications during QA validation • Perform independent research on HEDIS requirements using the NCQA manual • Collaborate with internal teams to resolve discrepancies and improve data quality • Provide feedback and...

$3,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The SDS/Observations Medical Coder position is full-time (40 hours/week) Monday to Friday. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: * Identify appropriate assignment of CPT and ICD-10 Codes for outpatient Ambulatory Observation services while adhering to...

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified Inpatient 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Job Description Job Description Join Senior CommUnity Care as a Medical Coder - Risk Adjustment Specialist and partner directly with physicians and Medical Directors to improve documentation, support CMS reporting, and strengthen value-based care for older adults in the PACE program. Medical Coder - Risk Adjustment Specialist- Remote Schedule: M-F 8:00 AM-5:00 PM Salary: $58,000-$66,000 (Based on Experience) Essentials: Collaboration for Risk Adjustment Integrity: Works closely with Medical Directors and PACE providers to uphold the integrity and accuracy of the risk adjustment reporting process. Engages in continuous dialogue with healthcare professionals to ensure that coding accurately reflects participant acuity. Medication Documentation Review and Diagnostic Coding: Reviews and interprets provider documentation to extract critical information. Assigns ICD-10-CM/CPT/HCPCS codes to diagnoses and procedures from documented information in the medical...

Job SummaryWe are seeking an experienced Certified RN Medical Coder to support a full-time COC / SPD project focused on building out coding for benefit plans.This role combines clinical knowledge with technical coding expertise to ensure accuracy, consistency, and compliance across plan documentation.You'll work closely with a team of certified coders and business analysts in a collaborative, fast-paced environment where precision and partnership drive success.Why this Opportunity?Top ranked company in Fortune's 2024 World's Most Admired Companies for over a decade consecutively.This healthcare client is ranked number one in key attributes of reputation :Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness.Job Responsibilities :Determine and assign appropriate codes to benefit plan language as part of the COC / SPD project.Review coding selections made by peers...

Job SummaryWe are seeking an experienced Certified RN Medical Coder to support a full-time COC / SPD project focused on building out coding for benefit plans.This role combines clinical knowledge with technical coding expertise to ensure accuracy, consistency, and compliance across plan documentation.You'll work closely with a team of certified coders and business analysts in a collaborative, fast-paced environment where precision and partnership drive success.Why this Opportunity?Top ranked company in Fortune's 2024 World's Most Admired Companies for over a decade consecutively.This healthcare client is ranked number one in key attributes of reputation :Innovation People management Social responsibility Quality of Management Financial soundness Long-term investment value Quality of products Services and global competitiveness.Job Responsibilities :Determine and assign appropriate codes to benefit plan language as part of the COC / SPD project.Review coding selections made by peers...