117 clinical coder jobs found

Medica, a nonprofit health plan, seeks a Clinical Quality Review III (RN and Certified Coder) to conduct medical record reviews, data collection, and clinical audits across its network. You will assess documentation accuracy, adherence to clinical standards, and compliance with HEDIS, STARS, CMS Cost Audit, and RADV, while sharing expertise to strengthen quality review processes. This remote role requires strong nursing and coding skills, 5+ years in quality reviews, and the ability to educate #J-18808-Ljbffr

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. This position will support risk adjustment code validation for CMS and HHS Risk Adjustment models Job Description : EDUCATION: HS Diploma or General Education Diploma (GED) CERTIFICATION & LICENSURE: CRC-Certified...

CentraCare Health – Monticello is a team of health care providers working together to deliver comprehensive, high-quality care in a compassionate environment, close to home. Our mission is to improve the health of every patient, every day. We are looking for caring, skilled professionals who are passionate about making CentraCare the leader in Minnesota for quality, safety, service and value. We offer an outstanding work environment to our employees, who are dedicated to providing a superior patient experience. Job Description The Coder II reviews electronic and written documentation to allow for accurate and timely diagnostic and procedural coding using ICD-9-CM/CPT4/HCPCS classification systems. Knowledge and use of applicable coding standards, guidelines, and regulations. As necessary, communicate with clinical staff including physicians to clarify medical record documentation, diagnosis, and codes. Safeguards patient privacy and confidentiality. Qualifications...

The Inpatient Coder II is responsible for assigning ICD-10-CM and ICD-10-PCS codes for acute care inpatient, acute rehabilitation, swing bed and LTACH services. This position queries providers regarding documentation, resolves intermediate coding edits, completes analysis and evaluation of documentation. Assignment is based on documentation in the medical record and utilization of coding guidelines, knowledge of clinical disease processes, and treatments. Provides education to coders.Responsibilities Remote States: Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Ohio, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time . Codes complex diseases, procedures and diagnoses using the ICD-10-CM/PCS classification systems, in accordance with Official Coding...

Riverview Health Hospital CoderRiverView Health, a community owned, membership based non-profit organization formed in 1898, continues to be the sole community hospital in Crookston, MN. RiverView Health operates a 25 bed Critical Access Hospital, RiverView Recovery Center; a chemical dependency outpatient treatment program, RiverView Home Care and five primary care and specialty clinics in the hospitals service area.We have a robust scholarship program for those furthering their education in a medical field, excellent benefits, and a friendly work environment. Full-time benefits include health insurance, free single vision and basic dental insurance, life insurance, long-term disability and short-term disability, and employer HSA contributions. Other benefits include employer pension matching, shift differential, incentive/premium pay, free annual biometric screening and paid volunteer time off.RiverView is an Equal Employment Opportunity employer.ResponsibilitiesThe Hospital...

Overview RiverView Health, is a community owned, membership based non-profit organization that was formed in 1898 and continues to be the sole community hospital in Crookston, MN. RiverView Health operates a 25 bed Critical Access Hospital, RiverView Recovery Center; a chemical dependency outpatient treatment program, RiverView Home Care and five primary care and specialty clinics in the hospitals service area. We have a robust scholarship program for those furthering their education in a medical field, excellent benefits, and a friendly work environment. Full-time benefits include health insurance, free single vision and basic dental insurance, life insurance, long-term disability and short-term disability, and employer HSA contributions. Other benefits include employer pension matching, shift differential, incentive/premium pay, free annual biometric screening and paid volunteer time off. RiverView is an Equal Employment Opportunity employer.  Responsibilities...

Get started on an exciting career in health information management. We’re with you every step of the way. Starts out onsite, then transitions to REMOTE 4 days/week. Job Summary: Required Services provide single path medical coding services and related medical records functions. Single path coding combines facility coding and professional coding and allows one coder to code facility and professional codes for the same patient utilizing a single coding platform. perform technically complex professional services coding for medical conditions and assign the correct International Classification of Diseases, ICD-10-CM, Procedure Coding System (PCS) Current Procedural Terminology (CPT), Health Care Financing Administration Common Procedure Coding System (HCPCS), and Evaluation and Management (E&M) codes for diagnosis, acuity of care and procedures for a wide range of medical specialties to include coding of complicated cases identified as difficult to classify such as treatment...

OrthoVirginia is seeking a Certified Orthopedic Surgical Coder | Charge Capture to translate surgical activity into accurate charges and reimbursement. Onsite role supporting the Operatory team, with duties spanning case review, coding, and charge reconciliation. You will collaborate with surgeons, clinical teams, and Materials Management to ensure precise implant and supply billing, prevent misses, and maintain revenue integrity. Experience in orthopedic surgery and coding is essential. #J-18808-Ljbffr

Job Overview Fairview is looking to hire a Coder 2 Hospitalist Coding to join our Health Information Management team. This is a 1.0 FTE (80 hours per two-week pay period), full-time, benefit-eligible position offering flexibility in the work environment. The ideal candidate has a strong understanding of professional coding guidelines, medical terminology, and healthcare documentation. Previous hospitalist coding and Evaluation and Management (E/M) coding experience is highly desired. Candidates should be detail-oriented, organized, and comfortable working independently while maintaining established productivity, accuracy, and quality standards. Previous experience with Epic or other electronic health record systems is preferred. The Coder 2 analyzes clinical documentation; assign appropriate diagnosis, procedure, and levels of service codes; abstract the codes and other clinical data. Performs a variety of technical functions within the Outpatient coding area, codes outpatient...

A healthcare coding company is seeking a skilled medical coder to handle complex coding tasks for diverse medical specialties. This position starts on-site and transitions to remote work four days a week. The ideal candidate will have an associate's degree in Health Information Management or related field and recognized coding certifications. Responsibilities include accurate coding, reviewing documentation for errors, and educating clinical staff to ensure coding compliance. Excellent attention to detail and communication skills are essential to succeed in this role. #J-18808-Ljbffr

Responsibilities The Inpatient Coder II is responsible for assigning ICD-10-CM and ICD-10-PCS codes for acute care inpatient, acute rehabilitation, swing bed and LTACH services. This position queries providers regarding documentation, resolves intermediate coding edits, completes analysis and evaluation of documentation. Assignment is based on documentation in the medical record and utilization of coding guidelines, knowledge of clinical disease processes, and treatments. Provides education to coders. Remote States: Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Ohio, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time .Codes complex diseases, procedures and diagnoses using the ICD-10-CM/PCS classification systems, in accordance with Official Coding...

Medical Coding AuditorOptum 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.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 ensures claims are accurately documented. Candidates must be able to...

Posterity Group LLC is a veteran owned, service-disabled small business, headquartered in Rockville, MD, that specializes in federal government contracting and staffing. We are tasked with staffing The Richard L. Roudebush VA Medical Center  with Medical Coders. The Medical Coder is expected to do the following: Accurately attaching images to the appropriate electronic health record elements. Verifying that images are uploaded correctly and are legible for viewing. Locating Financial Identification Numbers (FINs) and accurately linking documents to the correct veteran record. Indexing documents within the correct section, note title, date of service, and visit location. Performing 100% internal QA on all work before submission. Requirements Knowledge and understanding of medical clinics and clinical documentation. Ability to locate Financial Identification Numbers (FINs) and accurately link documents to the correct veteran record in Cerner/Oracle. Ability to index documents...

Certified Medical Coder JOB TYPE: Full Time LOCATION: HHS/Finance REPORTS TO: Reimbursement Specialist-Lead SALARY RANGE: $15.15 - $20.50 Any individual who receives an offer of employment or will receive a payroll check are required to submit to a drug and alcohol test as a condition of obtaining employment. Mille Lacs Band Member/American Indian preference applies SUMMARY: The Certified Medical Coder performs highly technical and specialized functions for health and Humans Services. The coder will review, analyze and codes diagnostic and procedural information that determines Medicare, Medicaid and Private Insurance Payments. The primary function of this position is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement. The coding function ensures compliance with established guidelines, third party reimbursement policies, and state and federal regulation and accreditation guidelines. QUALIFICATIONS: • CPC, CCS, CCS-P certification is required. • Associates...

Senior Medical CoderOptum 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 Senior Medical Coder performs concurrent review of FFS coding rules within Epic, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials.Schedule: Monday to Friday, 8 AM- 5 PMLocation: Remote - NationwideYou will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.Primary...

Coder IIIOptum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together.Coder III is a member of the Health Information Management Team responsible for ensuring the accuracy and completeness of clinical coding, validating the information in the databases for outcome management and specialty registries, across the entire integrated healthcare system. The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual patient health information records for data retrieval, analysis and claims processing. This position is expected to perform...

Coder IIOptum 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.The Coder II is a member of the Health Information Management Team responsible for ensuring the accuracy and completeness of clinical coding, validating the information in the databases for outcome management and specialty registries, across the entire integrated healthcare system. The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual patient health...

The Inpatient Coder II is responsible for assigning ICD-10-CM and ICD-10-PCS codes for acute care inpatient, acute rehabilitation, swing bed and LTACH services. This position queries providers regarding documentation, resolves intermediate coding edits, completes analysis and evaluation of documentation. Assignment is based on documentation in the medical record and utilization of coding guidelines, knowledge of clinical disease processes, and treatments. Provides education to coders. Responsibilities Remote States: Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Ohio, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. Codes complex diseases, procedures and diagnoses using the ICD-10-CM/PCS classification systems, in accordance with Official Coding...

Job Overview Fairview is looking to hire a Coder 2 Hospitalist Coding to join our Health Information Management team. This is a 1.0 FTE (80 hours per two-week pay period), full-time, benefit-eligible position offering flexibility in the work environment. The ideal candidate has a strong understanding of professional coding guidelines, medical terminology, and healthcare documentation. Previous hospitalist coding and Evaluation and Management (E/M) coding experience is highly desired. Candidates should be detail-oriented, organized, and comfortable working independently while maintaining established productivity, accuracy, and quality standards. Previous experience with Epic or other electronic health record systems is preferred. The Coder 2 analyzes clinical documentation; assign appropriate diagnosis, procedure, and levels of service codes; abstract the codes and other clinical data. Performs a variety of technical functions within the Outpatient coding area, codes outpatient...

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. Follows...

Job Overview Fairview is looking to add a Coder 3 to our team. This is a full-time, benefit-eligible position designed for an experienced coding professional with advanced expertise in complex coding. Job Overview Fairview is looking to add a Coder 3 to our team. This is a full-time, benefit-eligible position designed for an experienced coding professional with advanced expertise in complex coding. The Coder 3 is responsible for handling highly complex coding assignments and requires expert-level knowledge of coding guidelines, regulations, and reimbursement practices. The ideal candidate will demonstrate strong critical-thinking and research skills, exceptional attention to detail, and the ability to independently resolve complex coding scenarios. A CIRCC (Certified Interventional Radiology Cardiovascular Coder) credential is preferred. This is a clinical or hospital-based coding position for an experienced coder working with specialty professional or hospital outpatient...

Inpatient Hospital Based CoderFairview is looking for an Inpatient Hospital Based Coder to join our team! This is a position approved for a 1.0 FTE (80 hours per pay period) on the day shift. This position provides inpatient coding utilizing ICD-10-CM and ICD-10 PCS Coding Classification systems. Utilizes an encoder and computer assisted coding (CAC) software to achieve accuracy and thorough coding. Researches complex coding scenarios and queries physicians on documentation for clarification.This is an HB Inpatient coding position for an experienced, trained inpatient coder. An Inpatient Coder analyzes clinical documentation; assigns appropriate diagnosis, procedure, and abstracts the codes and other clinical data. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Assist in the...

Certified Medical Coder JOB TYPE: Full Time LOCATION: HHS/Finance REPORTS TO: Reimbursement Specialist-Lead SALARY RANGE: $15.15 - $20.50 Any individual who receives an offer of employment or will receive a payroll check are required to submit to a drug and alcohol test as a condition of obtaining employment. Mille Lacs Band Member/American Indian preference applies SUMMARY: The Certified Medical Coder performs highly technical and specialized functions for health and Humans Services. The coder will review, analyze and codes diagnostic and procedural information that determines Medicare, Medicaid and Private Insurance Payments. The primary function of this position is to perform ICD-10-CM, CPT and HCPCS coding for reimbursement. The coding function ensures compliance with established guidelines, third party reimbursement policies, and state and federal regulation and accreditation guidelines. QUALIFICATIONS: CPC, CCS, CCS-P certification is required. Associates degree...

Medical Coding Auditor 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. 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 ensures claims are accurately documented. Candidates must be able...