73 coder certified jobs found

JOB SUMMARY The Certified Coder is responsible for applying accurate diagnostic and procedural codes (ICD-10-CM, CPT, HCPCS) to patient health records to optimize reimbursement and ensure claims are submitted correctly. They are also responsible for managing and maintaining patient accounts as assigned by the Accounts Receivable Manager. This position works closely with internal and external customers to resolve unpaid claims, insurance discrepancies, and patient balances through timely and accurate follow-up. The goal of this role is to maximize reimbursement, ensure correct insurance payments, and uphold the principles of the "Flawless Reimbursement" system. RESPONSIBILITIES Coding Review patient records for completeness, documentation accuracy, and proper signatures. Apply ICD-10-CM, CPT, and HCPCS codes to ensure accurate claims and optimal reimbursement. Analyze provider documentation to assign correct Evaluation & Management (E&M) levels; query physicians when...

Pinehurst Surgical Clinic is seeking a Certified Coder to accurately code patient records, optimizing reimbursement and ensuring compliance. Responsibilities include reviewing documentation, resolving unpaid claims, and handling billing inquiries. The ideal candidate should have a high school diploma, relevant coding certification, and 1-3 years of experience. Strong analytical and customer service skills are essential in a fast-paced healthcare environment. #J-18808-Ljbffr

Blue Cross and Blue Shield of Massachusetts Inc. is seeking a Clinical Appeals Nurse Reviewer in Hingham. This full-time role facilitates the coordination of provider appeals for denied services, requiring RN licensure and coding expertise. The ideal candidate will apply clinical judgment to review appeals and work closely with various teams to resolve claims disputes effectively. A comprehensive benefits package, including medical, dental, and retirement plans, is offered to eligible employees. #J-18808-Ljbffr

Boston Medical Center Health System is hiring a Physician Practice Coder in Boston, MA. The role involves conducting CPT and ICD-10 coding reviews, performing chart audits, and ensuring accurate coding for billing. Candidates should have a strong understanding of medical terminology, and possess CPC certification along with 2-5 years of relevant experience. The compensation range for this position is between $24.04 and $33.65 per hour, reflecting education, experience, and skills. The position also offers various benefits to support employee well-being. #J-18808-Ljbffr

Why Join Our Team?At New York Cancer & Blood Specialists (NYCBS), we are dedicated to making a difference in the lives of our patients, their families, and our communities. Our passionate team of expert oncologists, hematologists, and healthcare professionals work together to provide world-class cancer care close to home. By offering cutting-edge treatments, innovative research, and a patient-centered approach, we are redefining what’s possible in the fight against cancer and blood disorders.If you want to be part of a growing organization committed to healing, hope, and advanced care, join us and help make a meaningful impact!Job Description:Certified Medical Coder- (On-Site)Location: Shirley, NY (5 days a week)Organization: New York Cancer & Blood Specialists (NYCBS)In This Role, You Will:Running daily reports for incomplete physician charges and notes for review.Once appropriately reviewed throughout the day you will send correspondence to providers on items for...

Job Title Denials Management Coder Job Purpose Responsible for reviewing denied claims for coding related errors and determining appropriate action. The Denials Management Coder will be responsible for corrections to individual accounts with include CPT and/or ICD-10 Corrections, applications of correct modifiers, etc. The coder is also responsible for ensuring that government and local guidelines are followed. Payers include but not limited to Medicare, Medicaid, Blue Cross, and commercial health insurance carriers. Duties and Responsibilities Read and interpret insurance carrier EOBs. Review medical reports, verify coding. Resolve coding related denial. Make any necessary coding corrections. Generate replacement claims (electronic and paper) Research carrier specific coding policies. Review and interpret carrier NCD and LCD policies. Communicate any coding denial trends to coding manager. Qualifications CPC/COC certification AAPC or CCS certification from AHIMA...

Inpatient Lead Coder Assigns appropriate codes to reflect all diagnoses and procedures extrapolated from physician and appropriate nursing documentation during a patient encounter according to the most current coding methodologies, including ICD-10-CM/PCS, resulting in appropriate reimbursement. Abstracts required data to input into the Medical Center's computerized data base. Converts all patient visits and encounters into appropriate DRG (Diagnosis Related Group) assignments in order to correctly submit the optimal reimbursement for each patient encounter coded. Assists the IP Coding Manager in administrative duties such as assignment of coding work, analysis of the unbilled report, and other duties as assigned. Essential Responsibilities / Duties: Assists IP Coding Manager with assignment of work to Coders, analysis of the daily unbilled report, and follow-up on unanswered physician queries and missing documentation. Assists PFS in researching unbilled accounts and...

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...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

Senior Medical Coding Analyst CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix's autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers' coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding...

Outpatient Clinical Documentation Specialist The Risk Adjustment CDS will provide clinically based prospective concurrent and retrospective reviews of medical records for WellSense of members enrolled in value-based agreements to evaluate risk adjustment capture based on clinical documentation. The Risk Adjustment CDS will review risk adjustment gap lists for members including suspect conditions and perform chart reviews to determine clinical validity of open gaps. The Risk Adjustment CDS will utilize Physician documentation queries to communicate clinical indicators to Physicians/Other Qualified Health Care Providers in preparation for up-coming visits and/or in identifying patients that need to be seen for a visit. The goal of the risk adjustment reviews includes facilitation of appropriate physician documentation of care delivery to accurately reflect patient severity of illness and risk of mortality. Specific reviews are both determined internally and by requirements/requests...

What We're Looking ForWe'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 you to help shape the future of healthcare from your own workspace!What You Will DoAssign diagnostic and procedural codes using ICD-9-CM, ICD-10-CM, and ICD-10-PCS codesAccurately sequence and abstract medical codes from patient records, ensuring precision and adherence to documentationOversee and audit the work of Level 1 & 2 Coders, where applicableChampion documentation improvement opportunities and coding issues, facilitating resolution with relevant stakeholdersUphold an overall 95% coding accuracy rate and a 95% accuracy rate for MS-DRG assignmentsMaintain a minimum production of 1 chart per hour or site-specific productivity benchmarksFoster professional communication...

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Under the general supervision of the Facility Outpatient (OP) Coding Manager and OP Coding Supervisor, the Facility OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The facility OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description: Essential Duties & Responsibilities including but not limited to: Hospital Coding: ·...

A healthcare leader is seeking a Medical Coder to work remotely in Quincy, Massachusetts. The role involves accurately assigning ICD-10 diagnosis codes, performing billing tasks, and ensuring compliance within the Ambulatory Surgical Center setting. Ideal candidates will have a high school diploma, relevant coding certification, and at least two years of medical billing or coding experience. The role supports the ASC revenue cycle and offers pay ranging from $18-$34 per hour based on skills and experience. #J-18808-Ljbffr

Revenue Cycle - Medical Coder ASC page is loaded## Revenue Cycle - Medical Coder ASCremote type: Remotelocations: Quincy, MAtime type: Full timeposted on: Posted Todayjob requisition id: R-100367**Job Summary:**Shields Health Care Group is an independent, Massachusetts-based medical service provider with a national reputation for blending exceptional customer service with superior technology. Patients, partners and colleagues define our 30 + years of quality diagnostic services as a true mark of successful teamwork. Known for our advanced diagnostic imaging, we are a sought after provider – not only because of our technology but also because of our teamwork and tremendous opportunities for professional growth. The Medical Coder will accurately assign ICD-10 diagnosis codes and review CPT/HCPCS surgical procedure codes for accuracy, compliance, and proper reimbursement within the Ambulatory Surgical Center (ASC) setting. This role supports the ASC revenue cycle by ensuring compliant...

Medical Coder IRI believes in commitment, integrity and strategic workforce solutions. Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow. We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity. Our team works hard to deliver a tailored approach for each and every client, critical in matching...

Inpatient Lead Coder Assigns appropriate codes to reflect all diagnoses and procedures extrapolated from physician and appropriate nursing documentation during a patient encounter according to the most current coding methodologies, including ICD-10-CM/PCS, resulting in appropriate reimbursement. Abstracts required data to input into the Medical Center's computerized data base. Converts all patient visits and encounters into appropriate DRG (Diagnosis Related Group) assignments in order to correctly submit the optimal reimbursement for each patient encounter coded. Assists the IP Coding Manager in administrative duties such as assignment of coding work, analysis of the unbilled report, and other duties as assigned. Essential Responsibilities / Duties: Assists IP Coding Manager with assignment of work to Coders, analysis of the daily unbilled report, and follow-up on unanswered physician queries and missing documentation. Assists PFS in researching unbilled accounts and...

Professional Surgical Coder I Under experienced leadership the Professional Surgical Coder I is an advanced coding position that is responsible for accurate and timely assignment of codes to diagnoses and procedures for all outpatient and inpatient diagnostic and procedural coding. Using established department policies and procedures in conjunction with the current versions of ICD-10 and CPT-4, the Professional Surgical Coder I will determine the proper diagnosis, assign co-morbidities and complications, secondary diagnoses and any HAC (Hospital Acquired conditions) documented. As well as both E/M codes and procedure codes. The Professional Surgical Coder I is expected at South Shore Physician Ambulatory Enterprise to query providers when documentation requires clarification and he/she proactively works with medical leadership to address concerning documentation trends. The Professional Coder I works with direct support from and under the direction of the Billing and Coding...

Title: Certified Risk Coder Reports to: Manager, Risk Coding Classification: Individual Contributor Location: Boston (Remote) Job description revision number and date: 2.0, 01.06.2025 Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non‑profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 with 9 health centers and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices across Massachusetts. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary The Certified Risk Coder will be a part of an emerging coding team and coding service that performs...

Non-Clinical - Coder Beth Israel Deaconess Hospital Milton is seeking a Non-Clinical - Coder for a travel position. The shift is from 07:00 PM to 07:00 AM, with three shifts per week for a total of 36 scheduled hours. The contract starts on 06/22/2026 and ends on 09/19/2026, lasting 13 weeks. The job description includes a guarantee of 72 contract hours biweekly, excluding any on-call time. The position is located in Lynn and involves working in a male-only patient population. The Recovery Specialist role requires BLS certification and involves ensuring the safety and structure of the program milieu, conducting client well-being checks, and managing admissions and record keeping. Minimum qualifications include a high school diploma or GED, preferred experience with substance use populations, and a valid MA Driver’s License. Candidates must be separated from any BILH affiliated facilities for six months prior to consideration.

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. Under the general supervision of the Facility Outpatient (OP) Coding Manager and OP Coding Supervisor, the Facility OP Coder will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP coder will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The facility OP coder is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description: Essential Duties & Responsibilities including but not limited to: Hospital Coding: •...

POSITION SUMMARY: Assigns appropriate codes to reflect all diagnoses and procedures extrapolated from physician and appropriate nursing documentation during a patient encounter according to the most current coding methodologies, including ICD-10-CM/PCS, resulting in appropriate reimbursement. Abstracts required data to input into the Medical Center's computerized data base. Converts all patient visits and encounters into appropriate DRG (Diagnosis Related Group) assignments in order to correctly submit the optimal reimbursement for each patient encounter coded. Assists the IP Coding Manager in administrative duties such as assignment of coding work, analysis of the unbilled report, and other duties as assigned. Position : Inpatient Lead Coder Department : Clinical Documentation Schedule : Full Time ESSENTIAL RESPONSIBILITIES / DUTIES: Abiding by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and...

Gather Health is seeking a Risk Adjustment Coding Specialist to support accurate diagnosis documentation as part of its value-based care initiatives. This role plays a crucial part in ensuring compliance with coding practices and enhancing quality outcomes under Medicare Advantage contracts. The ideal candidate has at least two years of professional coding experience, living in the Boston area. Benefits include comprehensive health insurance, retirement plans, and generous PTO. #J-18808-Ljbffr

Details Client Name Beth Israel Deaconess Hospital Milton Job Type Travel Offering Non-Clinical Profession Non-Clinical Specialty Coder Job ID 36975139 Job Title Non-Clinical - Coder Weekly Pay $992.0 Shift Details Shift 7p-7a Scheduled Hours 36 Job Order Details Start Date 06/22/2026 End Date 09/19/2026 Duration 13 Week(s) Job Description ID: 63418047 Shift: 8H Night Description: Contract Guarantee hours= 72 Hours Biweekly on all Assignments these guaranteed hours do not include any on-call time worked Requisition Comments and Notes:06/22 start date - BILH coversheet required at time of submission. Location: Tewksbury - Transitional Support Services - LOCALS Only!! BILH COVERSHEET REQUIRED FOR SUBMISSION: Recovery Specialist in a MALE ONLY environment - Wed-Sat 3rd shift - 10:30p-700a - 32H/week - Clients are provided with the medical and emotional support that they need during the one of the most pivotal stages in...