46 clinical coder coding jobs found

KPN Pro Fee Coding Specialist This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Reviewing the ambulatory records for the appropriate risk adjustment components Identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10 Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy] Demonstrate initiative for maintaining current knowledge of CPT,...

Our corporate activities are growing rapidly, and we are currently seeking a full-time, office-based Clinical Data Coder to join our Clinical Coding & Support team in Cincinnati, OH. This position will work on a team to accomplish tasks and projects that are instrumental to the company’s success. If you want an exciting career where you use your previous coding, pharmacy, or nursing expertise and can develop and grow your career even further, then this is the opportunity for you! Responsibilities Perform accurate coding of medical terms and medications utilizing industry-wide standards as well as company standards; Coordinate the assignment of appropriate dictionaries for meeting study requirements Develop and maintain coding guidelines; Issue queries on adverse events, medications, and medical history terms to ensure high quality coding; Work collaboratively with the Medical, Data Management, Safety and Biostatistics teams to meet needs of the study; and Produce coding...

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...

Job Summary Designs and delivers education programs on compliant documentation, coding and billing practices, regulatory requirements, and internal policies through learning experiences such as instructor-led sessions, webinars, and e-learning modules. Serves as a key resource for physicians, clinical staff, auditors, coders, and other stakeholders, ensuring understanding and adherence to applicable standards. Analyzes data and reports to identify educational needs and may conduct limited audits to support targeted training efforts. Essential Functions: Develops and delivers targeted education based on new service or program implementation, CPT/ICD-10 changes, and regulatory changes. Reviews audit data and compliance trends to identify educational gaps and address areas of risk. Designs and maintains educational content and resources, supporting accurate CPT and diagnosis coding for professional services,...

Medical Billing Specialist Join Our Team as a Medical Billing Specialist! Why Work With Us? At One Health Ohio, we believe in fostering a positive work environment that prioritizes our team and our patients. Enjoy competitive benefits and a supportive workplace where your contributions truly matter! Do you have prior billing experience in dental or medical settings? Are you looking for a role that blends your billing expertise with a clinical touch? If so, we could be the perfect next step in your career journey. Benefits Include: Affordable Health, Vision, Dental, and Life Insurance 401(K) with dollar-for-dollar matching (up to 4%) Generous Paid Time Off (PTO) Paid Holidays Essential Job Functions: Prepares and submits clean claims to various insurance companies either electronically or by paper. Answers questions from patients, clerical staff, and insurance companies. Identifies and resolves patient billing complaints. Prepares, reviews, and...

Clinical Data Coder Our corporate activities are growing rapidly, and we are currently seeking a full-time, office-based Clinical Data Coder to join our Clinical Coding & Support team in Cincinnati, OH. This position will work on a team to accomplish tasks and projects that are instrumental to the company's success. If you want an exciting career where you use your previous coding, pharmacy, or nursing expertise and can develop and grow your career even further, then this is the opportunity for you! Responsibilities Perform accurate coding of medical terms and medications utilizing industry-wide standards as well as company standards; Coordinate the assignment of appropriate dictionaries for meeting study requirements Develop and maintain coding guidelines; Issue queries on adverse events, medications, and medical history terms to ensure high quality coding; Work collaboratively with the Medical, Data Management, Safety and Biostatistics teams to meet needs of...

Kettering Health Network is seeking a full-time Risk Adjustment Coder for their office in Kettering, OH. This role focuses on coding compliance and ensures adherence to CMS billing rules while supporting clinical outcomes through documentation feedback to providers. The ideal candidate will have a High School Diploma, relevant coding certifications, and prior experience in professional fee coding. This position fosters relationships with healthcare providers and contributes to improving coding practices. #J-18808-Ljbffr

Job Title Looking to join and lead a dynamic team at Ohio State University Physicians where excellence meets compassion? Job Description With over 100 cutting-edge outpatient center locations, dedicated to providing exceptional patient care while fostering a collaborative work environment, our buckeye team includes more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders that all play an important part. As an employee of Ohio State University Physicians (OSUP), you'll be an integral part of a team committed to advancing healthcare, education, and professional growth. At OSUP, we foster a culture grounded in the values of inclusion, empathy, sincerity, and determination. We meet our teams where they are, coming together to serve each other and our community. We know that having options and robust benefit plans are important to you. OSUP prioritizes the wellbeing of...

Location: Mount Holly - 175 Madison Avenue Remote Type: 100% Remote Employment Type: Employee Employment Classification: Per Diem Time Type: Part time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 0 Please note all candidates must complete & pass onsite testing in Marlton, NJ prior to an interview. Summary Codes and abstracts hospital medical records (including Inpatients, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department) for diagnostic and procedural coding. Utilizes federal, state procedures/guidelines to assure accuracy of coding and abstracting and productivity standards. Collaborates with medical staff and clinical documentation improvement (CDI) staff to clarify documentation. Maintains performance in accordance with corporate compliance requirements as it pertains to the coding and abstracting of medical records, as well as Diagnosis Related Group (DRG) assignment. Position Responsibilities Accurately...

Location: 100% Remote Remote Type: On-Site Employment Type: Employee Employment Classification: Regular Time Type: Full time Work Shift: 1st Shift (United States of America) Total Weekly Hours: 40 Additional Locations: Mount Holly - 175 Madison Avenue Summary Codes and abstracts hospital medical records (including Inpatients, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department) for diagnostic and procedural coding. Utilizes federal, state procedures/guidelines to assure accuracy of coding and abstracting and productivity standards. Collaborates with medical staff and clinical documentation improvement (CDI) staff to clarify documentation. Maintains performance in accordance with corporate compliance requirements as it pertains to the coding and abstracting of medical records, as well as Diagnosis Related Group (DRG) assignment. Position Responsibilities Accurately reviews each record and knowledgeably utilizes ICD-10-CM, ICD-10-PCS, CPT-4,...

Medical Coding and Billing Compliance Auditor Location: Remote Division: Coding Compliance About the Role: The Medical Coding Auditor is a detail-oriented position responsible for reviewing medical coding accuracy, documentation integrity, ensuring compliance with federal and state regulations, payer guidelines, and internal policies. The ideal candidate will bring strong analytical skills, extensive coding knowledge, and a passion for maintaining the highest standards of quality and compliance. The candidate will demonstrate a strong background in Microsoft Office applications including PowerPoint, Word, Excel, Outlook, TEAMS, and SharePoint. The Medical Coding Auditor will have a background in physician feedback and education on documentation integrity and coding accuracy. The ideal candidate will have extensive knowledge of CPT coding, ICD-10-CM coding, E/M coding, HCC methodologies, modifiers, telehealth, and HCPCS coding. The candidate will understand and know where to access...

KPN Pro Fee Coding Specialist This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Reviewing the ambulatory records for the appropriate risk adjustment components Identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10 Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy] Demonstrate initiative for maintaining current knowledge of...

Job Details Physician Office | Kettering | Full-Time | First Shift Responsibilities & Requirements Responsibilities & Requirements This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Reviewing the ambulatory records for the appropriate risk adjustment components Identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10 Reviews and researches pending and denied claims pertaining to professional fee...

Coder - Professional Functioning within the health system# mission, values, objectives, procedures and policies, the Coder - Professional codes all physician office medical records as assigned by reviewing the entire medical record to determine if the documentation supports the code assignment as well as reviewing the chart for any specific regulations such as medical necessity. Education: An associate#s degree or completion of a certified coding program is required. Licensure/Certification: Current CPC or AHIMA Certified Physician Coder is required. Will consider candidate who is actively enrolled in certification program. To retain position, if individual without a current certification is hired into a Coder - Professional position, s/he must successfully obtain certification within one year of hire. Experience: A minimum of two years of coding experience in a physician#s office or hospital setting is preferred. Skills: Must be knowledgeable in grouper mechanics,...

JOB SUMMARY Performs coding and abstracting duties of inpatient records within Medical Records Department. Reviews for completeness of documentation to substantiate diagnosis and procedures. May perform other duties within the department as assigned. Preforms functions required under the Clinical Documentation Improvement Program, which includes interaction with the CDI monitor tool. QUALIFICATIONS Education High School education. Graduate of medical records program with either a credential of CCS/RHIT preferred or eligible to sit for credentialing exam. Courses in Medical terminology, Anatomy and Physiology and Pathophysiology. Training and Experience Previous medical records coding in an acute care setting preferred. Must be familiar with medical records documentation. Preferred familiarity with the MS-DRG system. Data entry ability. Pass coding test with 85% accuracy. Health and Background Requirements Employment contingent upon...

Health Information Management Services FULL-TIME / 8A-5P / 80 HOURS PER PAY Under the general direction of the Coding Supervisor of Health Information Management Services, this employee is responsible for the coding and abstracting of all Inpatient visits or Specialty Outpatient Surgery/Observation visits or both based on physician documentation in the Medical Record. He/she is responsible for collaborating with the Clinical Documentation Specialists to ensure appropriate documentation to validate accurate diagnostic and procedural information on each inpatient record. Accurate coding/abstracting and correct DRG or APC assignment is expected while adhering to the guidelines of the current coding classification systems and AHIMA's Standards for Ethical Coding. He/She is also responsible for following up on outstanding accounts for billing. All work is carried out in accordance with The Joint Commission on Accreditation of the Healthcare Organizations and Premier Health Partners...

Anderson Hills Pediatrics' Expectations of all Employees: Adhere to all Anderson Hills Pediatrics' Policies and Procedures Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times Maintain a positive and respectful attitude with all work-related contacts Consistently reports to work prepared to perform the duties of the position Meets productivity standards and performs duties as workload necessitates Primary Function : Assists the Billing Manager with the claims submission and revenue cycle of the practice. Major Duties and Responsibilities : • Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information • Update patient demographic information including insurance coverage; make changes/corrections as...

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...

Outpatient Medical Coder 2 Department: James | Radiation Oncology Scope of Position This area codes inpatient and outpatient medical records to facilitate the reimbursement and data collection for the individual business units of the OSU Health System. ICD-10-CM codes are assigned for the diagnoses and procedures for all inpatients treated within the OSU Health System. ICD-10-CM diagnoses codes and CPT-4 procedure codes are applied to all outpatients treated within the OSU Health System. Medical record data is then abstracted into a clinical abstracting system. This position is responsible for coding some or all the following types of records: inpatient, outpatient clinic, and ancillary areas. Position Summary The position is primarily responsible for coding/billing of medical records and other documents for the patient's visits. This requires selection of appropriate diagnosis, principal and secondary diagnoses, deciphering handwriting of professional staff, and...

Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations.Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation.Striving for...

A healthcare organization in Kettering, Ohio, is seeking a Certified Risk Adjustment Coder. This full-time role involves reviewing ambulatory records and coding outpatient patient records to ensure accurate risk adjustment. Candidates must hold an Associate or Bachelor’s degree in Health Information Management and have at least one year of coding experience. Certification as a Certified Risk Adjustment Coder (CRC) is required. Strong communication skills and teamwork abilities are essential for successful collaboration with providers and clinical documentation specialists. #J-18808-Ljbffr

Job Details Physician Office | Kettering | Full-Time | First Shift Responsibilities & Requirements Job Overview: The Certified Risk Adjustment Coder is responsible for reviewing the ambulatory records for the appropriate risk adjustment components. The Risk Adjustment Coder will identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes. The Risk Adjustment Coder will leverage the MEAT (Monitor, Evaluate, Assess, Treat) criteria for accurate documentation by providers. When appropriate, the Risk Adjustment Coder will query providers to clarify the HCC codes placed, inquire on additional documentation to support the HCC code placed, or discuss overall opportunities within the record. The Risk Adjustment Coder will supplement the educational offerings of the MSO by providing right-time feedback to providers when documenting or coding the risk adjustment on patient records. The Risk Adjustment Coder...

Location:Remote - OhioDepartment:HIM Revenue CycleWeekly Hours:0Status:Per DiemShift:Days (United States of America)Job Summary:As the Inpatient Hospital Coder III, you will translate health care services and procedures into standardized codes on inpatient accounts. You will work with Epic work quests to maintain timeliness of coding, billing and accounts receivable.You will communicate with providers, coders and clinical documentation specialists as needed for comprehensive patient record documentation.You will formulate, monitor and respond to all compliant documentation clarification requests to query the provider for resolution of incomplete documentation.The above summary is intended to describe the general nature and level of work performed in this role. It should not be considered exhaustive.REQUIREMENTSAssociate’s or bachelor’s degree in HIT/HIM OR High school diploma AND Certificate of Completion of AHIMA Coding Basics Program and Coding Assessment and Training Solutions...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...