23 coder inpatient jobs found

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary: We are seeking a talented individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to validate the conditions that were documented in the medical record, the ICD-10-CM/PCS code assignments and determine the accuracy of DRG assignment that is clinically supported as defined by review methodologies specific to the...

Position Summary The Certified Medical Biller and Coder is responsible for accurately reviewing medical documentation, assigning appropriate diagnosis and procedure codes, and supporting the billing process to ensure timely and compliant reimbursement. This role plays a critical part in maintaining the integrity of the revenue cycle by ensuring claims are coded correctly, submitted efficiently, and compliant with payer and regulatory guidelines. The position requires strong knowledge of CPT, ICD-10-CM, HCPCS coding systems, payer requirements, and medical billing workflows. Essential Duties and Responsibilities Review provider documentation and assign accurate CPT, ICD-10-CM, and HCPCS codes Ensure coding compliance with Medicare, Medicaid, and commercial payer guidelines Verify documentation supports medical necessity and appropriate coding Apply correct modifiers and place-of-service codes Prepare and review claims prior to submission to ensure...

Position Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. Collaborates with physician reviewers, as needed. Ability to prioritize and organize workload and complete tasks independently....

Help safeguard accuracy, integrity, and regulatory compliance across our organization. We are seeking a skilled Compliance & Coding Audit Specialist to support the Corporate Compliance Program through detailed auditing, monitoring, and provider education related to coding, billing, and clinical documentation practices. What You’ll Do Conduct ongoing coding, billing, and documentation audits to ensure compliance with hospital policies and federal and state regulations Interpret medical records and related documentation using advanced coding knowledge to assess accuracy and risk Execute compliance audit assignments with a high degree of independence, confidentiality, and professional judgment Analyze findings, prepare audit documentation, and identify trends or improvement opportunities Present audit results directly to physicians and providers, delivering clear feedback and education on documentation and coding best practices...

Physician Medical Coder Job Listing   PLEASE READ JOB DESCRIPTION    Profee coder to review coding denials and correct/validate CPT, ICD-10, HCPCS and modifiers for physician services.  Our coders will review medical records, research payer policy, and NCDs to make coding corrections and resubmit corrected claims in an accurate and timely manner. We work closely with other team members and management to translate clinical documentation consistently and accurately into ICD-10 and CPT codes with proper sequencing and modifiers. Through these efforts, the individual within this role will identify and report error patterns, resolve errors or issues associated with coding and billing processes, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors.     Job Requirements     At least one active certification is required. Additional certifications a plus. Accepted certifications...

CNY Family Care's commitment to excellence sets us apart and guides us as we provide care for our community. The Medical Coder and Auditor will be responsible to conduct prospective audits of coding and billing; analyze physician and provider documentation in outpatient office health records; correct evaluation and management (E/M) service levels, appropriate procedure codes, and any necessary modifiers.  Medical Coder and Auditor Responsibilities: Navigate the patient health record, office visit notes, and procedure reports in the determination of diagnoses, reason for visit, procedures, and modifiers to be coded. Code outpatient records utilizing coding books, online tools, and references, in the assignment of ICD, CPT, and HCPCS codes and modifiers. Document individual encounter audit findings and communicates results to providers. Access charge work queues to validate and assign charges. Perform all required EMR functions as efficiently as possible and according...

Billing & Coding Integrity Specialist Full Time (Benefit Eligible) Monday - Friday (No weekends or holidays), 8:00 am - 5:00 pm  This role is an on‑site position and is not eligible for remote work. The Patient Financial Services Department is seeking a full time Billing and Coding Integrity Specialist to join the team. Under the direction of the Director of Patient Financial Services the specialist is responsible for implementing and promoting consistent revenue integrity practices that will improve compliance, accurate billing, and charge capture at the point of service to ensure optimal reimbursement for Keystone Health.  The specialist is responsible for auditing and monitoring appropriate coding guidelines and regulations. Recommending any corrective action and assists with implementing the corrective action.  This position is also responsible for providing billing/coding training and education to providers and staff and maintaining a current...

Physicians' Choice is currently seeking a highly proficient and seasoned Medical Coding Auditor specializing in Evaluation and Management (E/M) services, with a comprehensive understanding of Emergency Medicine, to join our esteemed team. If you possess extensive expertise in current E/M coding guidelines and have a strong background in auditing, we invite you to apply for this exceptional opportunity. Job Description:  As a Medical Coding Auditor you will play a vital role in ensuring accurate and compliant coding practices within our organization. You will be responsible for conducting detailed audits of medical records, coding documentation, and related billing processes to verify compliance with established coding guidelines, regulatory requirements, and internal policies. Responsibilities: Perform comprehensive audits of medical records, coding documentation, and billing processes. Evaluate the accuracy, completeness, and appropriateness of medical...

Overview Top candidates will have experience with Oncology Coding.   As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA   This position is responsible for abstracting, coding, and interpreting of outpatient clinic and provider services for professional and/or facility billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding. This position codes and charges complex or specialty services and may serve as a resource for other coders. This position is not responsible for...

Adventist HealthCare seeks to hire an experienced Lead Coding Specialist for our Medical Coding Department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing. As a Lead Coding Specialist, you will: Conduct reviews to validate I-10-CM diagnosis codes and PCS procedure codes for inpatient bill hold related to PSI, PPC & other reimbursement conventions to be resolved prior to final coded data. Manages daily DNFB and DNFC reports and work queues for un-coded or outstanding records. Under the direction of the coding manager, the coding specialist lead should be proficient in communicating with the coding team. Oversees coding corrections, abstracts elements for HSCRC submissions, and ensures coding compliance with coding standards. Liaison between coding and other departments, managing coding-related tasks and denials. Provides mentoring support to coders on coding...

Job Title:   Accounts Receivable (AR) Specialist Company:   Client First RCM, LLC Location:   In-Office/Remote/Hybrid– Pennsylvania Job Type:   Full-time About Us Client First RCM, LLC is a multi-specialty Revenue Cycle Management company serving providers across multiple states. We specialize in ethical, accurate, and efficient medical billing services with a focus on provider success and patient satisfaction. Job Summary We are seeking a dependable and detail-oriented Accounts Receivable (AR) Specialist to join our in-office team in Pennsylvania. This position plays a key role in managing AR follow-ups, claim resolution, and reimbursement activities across multiple medical specialties. Responsibilities: Follow up on unpaid or underpaid claims via phone, web portals, and written communication Resolve claim denials and rejections using EOBs and remittance advice Submit corrected claims and appeals with appropriate documentation Post...

Supporting the Vice President & Chief Compliance Officer, the Compliance Specialist assists in carrying out the activities of the Frederick Health Compliance Program, including risk assessment, training & education, audits, policy development and internal investigations. Requirements: BA/BS required. MBA/MHA preferred. 5-10 years' experience in healthcare compliance and internal auditing. Certification preferred. Knowledge of laws, regulations, policies and procedures of governmental authorities and payers. Experience in developing and carrying out training and education of staff. Excellent oral and written communication skills. Strong organizational skills and ability to prioritize and manage multiple tasks. Ability to maintain a high level of confidentiality. The following experience & credentials are strongly preferred: Experience in healthcare revenue cycle or patient accounting (coding and/or billing) internal auditing and compliance....

Provider Coding Specialist Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day. A Brief Overview Under the supervision of the Coding Supervisor, the Provider Coding Specialist is responsible for analyzing and assigning ICD-10-CM diagnostic codes, CPT, and HCPCS codes to professional surgical patient accounts, based on the medical information provided and consistent with regulatory guidance and best practices in the industry and Organization policy and procedure. Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify documentation to ensure accurate code assignment. Organizes and prioritizes...

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation.   Supervisory Responsibilities: This position has no supervisory responsibilities.   General Requirements: All duties performed will be done accurately and in a timely manner.   1.        Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. 2.        Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. 3.        Must...