24 certified professional coder jobs found

 Ophthalmology practice is seeking an experienced, organized Surgery Scheduler with strong medical billing and insurance knowledge. This is a full-time, onsite position in Las Vegas. Responsibilities: • Coordinate cataract, corneal, and oculoplastic surgeries from scheduling through postoperative appointments • Verify insurance eligibility, surgical benefits, deductibles, copays, and coinsurance • Obtain prior authorizations and required medical clearances • Prepare patient financial estimates and collect surgical payments • Coordinate with patients, physicians, surgery centers, and insurance companies • Maintain accurate surgery schedules, documentation, and follow-up • Assist with claim follow-up, denials, EOB review, and unresolved balances when needed Qualifications: • At least two years of surgery scheduling, medical billing, insurance verification, or related experience • Strong understanding of authorizations, CPT and ICD-10...

About the Role Wellness Direct LLC is an established behavioral health practice based in Cedar Grove, New Jersey, seeing patients remotely nationwide. This role, however, is hybrid and based out of our Cedar Grove office — see Location & Schedule below for the on-site expectation. This is one opening, filled at either the Specialist or Lead level depending on the experience the candidate brings; the level is determined during the interview process. The role owns full-cycle revenue cycle work in TherapyNotes: claims, ERA/EOB processing, denials, coding accuracy, patient billing support, and — at the Lead level — credentialing and oversight of the billing function. Specialist vs. Lead •     Specialist — Owns the day-to-day billing, coding, and claims work. Reports to the Billing Manager. No supervisory responsibility — a fit if you want to stay hands-on rather than manage people. •     Lead — Everything above, plus end-to-end credentialing and payer enrollment,...

APS Medical Billing, located in Toledo, Ohio, is seeking certified professional coders with experience in pathology to become part of our progressive team. This position works with clients to ensure proper documentation for charge capture and remains current with industry guidelines. Requirements Demonstrated ICD-10-CM proficiency Demonstrated understanding of the CPT guidelines for separate procedures, bundling and add-on-codes Experience in abstracting medical records for accurate CPT code assignments Experience in surgical pathology preferred Experience in reviewing, resolving and preventing coding denials Understanding and application of CMS initiatives including NCCI Edits, MIPS and NCD/LCD polices Competitive wages; benefit package (Health, Health Savings Account, Dental, Vision, Personal Health Care Advisor, EAP, Life, 401k, Paid Holidays, Vacation & Earned Time Off (ETO). APS Medical Billing is an Equal Opportunity Employer....

REMOTE NATIONWIDE 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 equitable. Ready to make a difference? Join us to start  Caring. Connecting. Growing together. The key challenge of this role centers around your ability to work quickly, accurately, and independently. You'll be challenged with daily production goals as well as maintaining a high accuracy rate to achieve your quality goals. Extensive use of electronic medical records in an ICD-10 environment is also required. Hours : This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 5am - 5pm. We offer 2-3 weeks of paid training. The...

JOB SUMMARY: Support the Director of Health Information Management (HIM) by conducting comprehensive claim audits and reviewing hospital outpatient and professional fee (ProFee) claims for coding accuracy, revenue integrity, and billing compliance. Utilizing proprietary software, this role evaluates coding opportunities, identifies revenue cycle improvement recommendations, and assists clients in optimizing claim quality and reimbursement outcomes. The ideal candidate is an experienced outpatient facility coding professional with strong analytical skills, extensive knowledge of revenue cycle operations, and the ability to communicate complex coding concepts clearly to both clients and internal team members. 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 to be an exhaustive statement of...

Job Summary The Medical Billing & Revenue Cycle Specialist will be responsible for managing and supporting the medical billing process from claim submission through payment and resolution. This individual will work closely with our administrative team, therapists, payers, and other team members to ensure accurate and timely billing, follow up on outstanding claims, resolve denials and billing issues, and support efficient revenue cycle processes. The ideal candidate is organized, detail-oriented, proactive, and comfortable working independently while also collaborating closely with a growing healthcare team. Responsibilities Prepare, review, and submit accurate claims to commercial insurance companies, Medicaid/managed Medicaid plans, and other applicable funding sources. Review claims and billing information for accuracy and completeness prior to submission. Monitor claim status and follow up on unpaid, denied, or rejected claims. Investigate and...

This is a non-remote position. We are seeking a detail-oriented, on-site Ophthalmology Coding Auditor to join our premier private practice. Under direct supervision of the Billing Manager, the Coding Auditor audits ophthalmology and optometry medical records for compliance with federal coding regulations and guidelines. Successful candidates will have extensive knowledge of auditing and education on CPT, ICD-10, and HCPCS codes and guidelines. In this role, you will work directly alongside our clinic team to review clinical documentation, surgical charts, and diagnostic reports, ensuring accurate coding, regulatory compliance, and optimal reimbursement. You will serve as our internal expert, identifying billing risk areas and providing face-to-face feedback and education to our providers and staff to support the financial health of our practice.   Key Responsibilities   Perform On-Site Audits: Conduct regular retrospective and prospective reviews of clinical...

ASAAR Medical is seeking a HCC Coder & Provider Engagement Specialist ***This is NOT a REMOTE Position *** May require travel *** Duties: Reporting to the Director of MRA and Risk Adjustment Coding. The HCC / MRA Coder will offer real-time support and coordination for Primary Care Providers and Care Coordinators for MRA Risk Coding in a value-based care setting. Engages providers by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts ASAAR Medical's overall success first. Review patient charts and pursues excellence: Seeks out learning, strives to develop and expand personally, and continuously helps practices upgrade their capability to contribute to the ACO. Helps to educate clinician and non-clinician office staff on coding guidelines, documentation standards, and appropriate Medicare Risk Adjustment (MRA) procedures. Assists in education and transition with onboarding new providers, optimally within...

JTS is hiring a Level 3 Remote Coder (Outpatient Coders with 3+ years of experience wiiling to train to become Inpatient Coders)   ***This remote role offers a unique career growth opportunity: current outpatient coders will receive hands-on training and one-on-one mentoring to build inpatient coding expertise over a 9-month development period.  Upon successful completion, candidates transition into a permanent Inpatient Coder position — a clear, supported pathway to advance your coding career with JTS.  All candidates must possess and maintain certification through either the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC.)***   Level 3 coding candidates must have 3+ years outpatient coding experience with expertise in Same Day (Outpatient Surgery) and Observation encounters. Ancillary encounter coding may also be expected.   Encoder experience required, preferably 3M, Codify or Optum but will also...

Certified Claims Call Center Processor I at AllCare Health with the Claims department in Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages, an excellent benefits package including affordable healthcare, 401k retirement, wellness programs, and flexible schedule options. Summary of the Position The Certified Claims Call Center Processor I serves as a primary point of contact for provider offices and their authorized representatives, responding to inbound calls and electronic inquiries regarding professional and facility claims processing and adjudication. This role combines customer service and certified claims processing responsibilities by independently resolving provider inquiries, researching claim issues, and adjudicating professional claims in accordance with company policy, contract language, coding guidelines, and applicable regulatory requirements....

Claims Processing Supervisor AllCare Health | Claims Department We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Claims Processing Supervisor ensures that internal and external departmental performance requirements are consistently met. This role oversees the day-to-day activities of the Claims Processing team, assigns work and coordinates efficient workflows to meet contractual and operational requirements, and serves as a hands-on resource for staff regarding training, questions, and claims processing best practices. Essential Duties Provides one-on-one support and initial training for new hires and facilitates monthly mandatory training sessions for Claims Processing staff. Establishes and maintains a professional, supportive, and provider...

Coding Auditor AllCare Health | Quality Department | Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members. This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes. Essential Duties Ensures the accuracy and...