77 clinical coder jobs found

We are so glad you are interested in joining Sutter Health! Organization: SHSO-Sutter Health System Office-Valley Position Overview: This position conducts review of outpatient medical records using International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage, ICD-10-CM, and Centers for Medicare and Medicaid Services (CMS) coding and reporting guidelines. Performs medical record reviews to ensure accurate assignment of medical diagnoses and procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses and to alert the physician of potential clinical conditions that may require review. Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified Risk Adjustment Coder OR CPC-Certified Professional Coder OR AHMA or AAPC Coding Certification...

Coding Specialist The coding specialist, utilizing the clinical documentation management program and clinical knowledge, analyzes inpatient and outpatient medical records for completeness of documentation, contacting the appropriate provider for additional documentation if needed. Accurate diagnosis and procedure codes are then assigned based on the documentation in the medical record, which directly impacts the appropriate DRG assignment for reimbursement. Critical data elements are abstracted by the Coding specialist on all inpatient discharges. This information is used by the organization for decision making. Responsibilities Assigns accurate ICD-CM diagnosis and procedure codes and CPT codes in a timely manner for all appropriate encounters and ensures appropriate DRG assignment based on the clinical documentation within the medical record by using CMS and American Hospital Guidelines and following AHIMA code of ethics. Utilizes clinical knowledge to interact with the...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Positions Location: Lansing, MI Job Description General Purpose of Job :   Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations.  Respond to and Investigate compliance issues within Revenue Cycle.   Lead and/or coordinate audit activity with governmental audits.   Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis.  Team members may be asked to perform additional duties as assigned by their leader.  Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization. Develops and maintains Professional and Hospital billing issues on the Revenue Cycle Compliance Work Plan....

Medical Billing Specialist Day Shift (United States of America) Hours: Monday - Thursday 8am-5pm & Friday 8am-3pm Mary Free Bed Summary We have the great privilege of helping patients and families re-build their lives. It's extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients "Ask for Mary," they experience a culture that has been sculpted for more than a century. Our hallmark is to carefully listen to patients and innovatively serve them. This is true of every employee, from support staff and leadership, to clinicians and care providers. Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital serving thousands of children and adults each year through inpatient, outpatient, sub-acute rehabilitation, orthotics and prosthetics and home and community programs. With the most comprehensive rehabilitation services in Michigan and an exclusive focus on rehabilitation, Mary Free Bed physicians,...

Medical Billing Specialist Mary Free Bed Summary We have the great privilege of helping patients and families re-build their lives. It's extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients "Ask for Mary," they experience a culture that has been sculpted for more than a century. Our hallmark is to carefully listen to patients and innovatively serve them. This is true of every employee, from support staff and leadership, to clinicians and care providers. Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital serving thousands of children and adults each year through inpatient, outpatient, sub-acute rehabilitation, orthotics and prosthetics and home and community programs. With the most comprehensive rehabilitation services in Michigan and an exclusive focus on rehabilitation, Mary Free Bed physicians, nurses and therapists help our patients achieve outstanding clinical outcomes. The growing Mary...

Business (Non-Clinical) Remote Position General Summary: Using established coding principles and procedures reviews analyzes and codes diagnostic and/or procedural information from the patient's medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. Principle Duties And Responsibilities: Identifies all diagnostic and operative procedures for coding by thoroughly reviewing the patient's...

Advanced Coding Position Positions Location: Lansing, MI Job Description General Purpose of Job: Advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, as well as assignment of the Medicare Severity Diagnosis Related Group, (MS-DRG) / All Patient Refined - Diagnosis Related Group, (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association, (AHIMA) Coding Ethics, as well as all American Hospital Association, (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Utilizes Optum CAC in accordance with established workflow. Follows University of Michigan Medicine Sparrow policies and procedures and maintains required quality and productivity...

Hcc Coder 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. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical...

Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ's and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately escalates coding/denial trends and provider education...

Job Opportunity Job ID:52414 Description: Positions Location: Lansing, MI Job Description General Purpose of Job : Ensure Revenue Cycle Coding and Billing are compliant with State and Federal regulations. Respond to and Investigate compliance issues within Revenue Cycle. Lead and/or coordinate audit activity with governmental audits. Essential Duties : This job description is intended to cover the minimum essential duties assigned on a regular basis. Team members may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position. Ensures conformance with applicable laws, regulations and Medicare/Medicaid reimbursement rules to ensure UMHS is in compliance with federal, state and/or local regulations. Monitors, analyzes and reports on laws, regulations, audits and industry standards that impact the organization. Develops and maintains Professional and Hospital billing issues on the...

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. What We're Looking For We're looking for experienced and credentialed inpatient 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...

Coding Specialist Assigns ICD diagnosis and CPT procedure codes to assigned Outpatient work types. Employment Type: Full Time Weekly Scheduled Hours: Mon-Fri 7am-3:30pm Wage Range: $21.14-$31.70 Requirements: - High school diploma/GED, or higher education - Registered Health Info Tech (R-RHIT) required Preferred Requirements: - Registered Health Info Admin (R-RHIA) - Certified Coding Specialist (C-CCS) Coding: Based on clinical documentation, computerized encoding, accepted coding classification principals, and reference material, efficiently and accurately assigns appropriate ICD diagnosis codes CPT procedure codes and modifiers on assigned chart types. Verifies accuracy of completed fields. Maintains credentials and ongoing education in order to apply current policies and principals for accurate coding. Assigns appropriate ICD codes. Assigns appropriate CPT codes. Assigns appropriate Modifiers on APC accounts. Searches chart documentation for appropriate code...

Coder III Healthcare Job Description Coder III 3-5 years experience preferred Provides high level technical competency and subject matter expertise analyzing physician/provider documentation contained in assigned Complex Outpatient (CO) and Inpatient health records (electronic, paper and hybrid) to determine the principal diagnosis, secondary diagnoses, principal procedure and secondary procedures. Provides appropriate Medical Severity Diagnostic Related Groups (MS-DRG), Present on Admission (POA), Severity of Illness (SOI) & Risk of Mortality (ROM) assignments for Inpatient records and accurate APC assignments and all required modifiers for Complex Outpatient records. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis and procedure codes, Current Procedural Terminology (CPT)-4/ Healthcare Common Procedure...

Inpatient Coder Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD-10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders in new specialties. Position Summary: Responsible for charge capture process for professional...

PPS - QRP Coder We have the great privilege of helping patients and families re-build their lives. It's extraordinarily meaningful work and the reason we greet the day with optimism and anticipation. When patients "Ask for Mary," they experience a culture that has been sculpted for more than a century. Our hallmark is to carefully listen to patients and innovatively serve them. This is true of every employee, from support staff and leadership to clinicians and care providers. Mary Free Bed is a not-for-profit, nationally accredited rehabilitation hospital serving thousands of children and adults each year through inpatient, outpatient, sub-acute rehabilitation, orthotics and prosthetics and home and community programs. With the most comprehensive rehabilitation services in Michigan and an exclusive focus on rehabilitation, Mary Free Bed physicians, nurses and therapists help our patients achieve outstanding clinical outcomes. The growing Mary Free Bed Network provides patients...

Business (Non-Clinical) Using established coding principles and procedures reviews, analyzes and codes diagnostic and/or procedural information from the patient's medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations, and accreditation guidelines. Education/Experience Required: Degree in Medical Record Sciences preferred but not required or successful completion of a certification program with certification as a...

3 days ago Be among the first 25 applicants Description Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD‑10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross‑training established coders in new specialties. Employment Type Full time Shift Day...

A healthcare provider in Michigan seeks a Professional Coder to manage accurate clinical data and ensure optimal reimbursement for various medical services. Responsibilities include coding patient records under strict compliance with ICD and CPT standards. The successful candidate must have certification in professional coding and demonstrate strong communication skills. This role requires problem-solving abilities, effective teamwork, and an understanding of medical terminology, ensuring all coding meets legal standards. Excellent customer service is essential for this position. #J-18808-Ljbffr

Overview The Professional Coder provides timely and accurate clinical and administrative data to ensure optimal reimbursement for professional services performed at acute care, inpatient, outpatient, urgent care, or physician offices to meet organizational needs. This position is responsible for ICD10CM diagnosis, CPT‑4 coding, and charge entry related to coding, documentation, billing, and reimbursement issues. Works as a liaison between centralized billing staff, practice managers, and office staff and may be required to meet with office staff and physicians as needed. This position monitors the quality of coding and stays current on professional coding changes, compliance issues, billing, documentation, reimbursement, and interpretation of coding/documentation rules. Primary patient contact is only social. He/she demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision,...

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...

Overview Join to apply for the Facility Coding Inpatient Complex Coder role at Banner Health This is a fully remote position and available if you live in the following states only: AK, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, MD, MI, MN, MO, MS, NC, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WV, WA, WI & WY. The hours are flexible as we have remote Coders across the Nation. Generally any 8-hour period between 7am – 7pm can work, with production being the greatest emphasis. A Coding Assessment will be given after a successful interview to be completed within 48 hours. Banner Health provides your equipment when hired. You will be fully supported during initial training by the Banner Coding Education team and your hiring manager, with continued support throughout your career here. Responsibilities Provides coding and abstracting for mid-tiered complexity range of acute care services at all Banner hospitals. Reviews diagnosis and diagnostic information and...

Trinity Health: Coder IV Inpatient Coder (Remote) Employment Type: Full time Shift: Description: Provides high level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments. ESSENTIAL...

A leading rehabilitation hospital in Grand Rapids is seeking a QRP Coder to ensure accurate Quality Reporting Program scores for patient admissions and discharges. The position requires a high school graduate with at least two years of clinical experience in an Inpatient Rehabilitation Hospital and excellent communication skills. The role offers a starting compensation of $20.94/hour, emphasizing teamwork and collaboration in a challenging environment. #J-18808-Ljbffr