25 coder lead jobs found

Job Description About the Role: Join our innovative healthcare information management team as a Lead Inpatient Medical Coder. This pivotal position is essential in connecting clinical data with technology, driving the development of advanced AI solutions for medical coding and billing. You will leverage your expertise to significantly influence our product development initiatives. Requirements and Qualifications: At least 3 years of extensive experience in inpatient medical coding within a hospital setting. Expertise in accurately identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and their modifiers from patient records. Comprehensive knowledge of the evidence requirements for precise coding. Hands-on experience with grouper software for MS-DRG and APR-DRG assignment. Excellent communication skills for effective collaboration with the billing department on coding-related matters. Up-to-date with the latest ICD-10-CM,...

Overview Cotiviti has multiple openings for full-time coders....these roles will focus on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. Experience with E&M coding & auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule. Responsibilities Clinical Validation - Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement. Apply client specific coding guidelines when applicable. Learns new appeal categories as production need requires. Stays current on coding guidelines appropriate to the position. Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards. Reviews quality feedback from QA. Submits questions for clarification as needed. Utilizes the “QA Resolution” process when disagreement...

Scheduled Hours 40 Position Summary Position reviews medical record documentation to determine appropriate billing codes and necessary documentation. Primary Duties & Responsibilities Reviews the documentation in the record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient’s conditions and treatment. Codes evaluation and management to appropriate CPT code and codes diagnosis to appropriate ICD-9 code. Meets with physicians to review documentation, resolve coding and secure signature of all unsigned dates of service, tagging files for follow up. Acts as lead person and assists coders with IBC staff with medical terminology and policy interpretation as required. Assists with efforts to increase physician awareness of documentation requirements. Prepares case reports and initiates follow-up for billing process. Working Conditions Job Location/Working Conditions: Normal office environment....

Medical Coding Auditor Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The Medical Coding Auditor is responsible for researching and resolving grievances and appeals within the commercial line of business, applying advanced adjudication expertise, clinical interpretation, and decision-making. This...

Department Overview The Coding Trainer is responsible for constructing and implementing coding training programs for coding specialists. Creates presentations, develops learning material, handbooks and other training materials as needed. Conducts regular audits to ensure understanding and retention of basic and advanced coding concepts. Represents Enterprise Coding as coding expert in specialty projects. Function/Duties of Position Primary Responsibilities: Trains and instructs coders on CPT, Diagnosis, modifiers, CCI edits and documentation requirements as appropriate regarding all industry standards for each clinical department across OHSU Reviews, develops, modifies, and/or adapts relevant training materials, presentations and curriculum Audits medical record documentation to identify under-coded and up-coded services; prepares reports of findings and meets with codersand leadership to provide education and training on accurate coding practices and compliance issues both for...

Medical Coding Auditor Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The Medical Coding Auditor is responsible for researching and resolving grievances and appeals within the commercial line of business, applying advanced adjudication expertise, clinical interpretation, and decision-making. This...

Medical Coding Auditor Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The Medical Coding Auditor is responsible for researching and resolving grievances and appeals within the commercial line of business, applying advanced adjudication expertise, clinical interpretation, and decision-making. This...

Lead Medical Coding Specialist The Lead Medical Coding Specialist works in conjunction with the Coding Supervisor to ensure accuracy, consistency and efficiency in relation to code assignment for reimbursement and reporting purposes. The Lead Medical Coding Specialist will complete quality reviews for coding staff in order to validate code and reimbursement assignments. This position is a "working" Lead position and is expected to work alongside staff as well as provide direction. Essential Job Functions Assist Coding Supervisor in the supervision of Medical Coding staff for Emergency Facilities, Inpatient, Observation and Ancillary services coding Assists in managing staffing schedule and departmental overtime Performs quality review of staff for accuracy/efficiency and identifies charge capture opportunities Completes metric reporting as required by agreed upon deadlines and assists in month end close processes In conjunction with the Coding Supervisor, ensures standard...

Coding Auditor/Trainer (Coding Coordinator) US-OR-Portland Position Type: Regular Full-Time Posting Department: Enterprise Coding Posting Salary Range: $42.32 - $58.12 per hour Department Overview The Coding Trainer is responsible for constructing and implementing coding training programs for coding specialists. Creates presentations, develops learning material, handbooks and other training materials as needed. Conducts regular audits to ensure understanding and retention of basic and advanced coding concepts. Represents Enterprise Coding as a coding expert in specialty projects. Primary Responsibilities Trains and instructs coders on CPT, Diagnosis, modifiers, CCI edits and documentation requirements as appropriate for all clinical departments across OHSU. Reviews, develops, modifies, and adapts relevant training materials, presentations and curriculum. Audits medical record documentation to identify under‑coded and up‑coded services; prepares reports of findings and meets...

Overview Medical Group Clinical Supervisor - Cardiology Clinic at Columbia Memorial Hospital. The Medical Group Clinical Supervisor supervises patient care clinics and staff in an ambulatory care setting, working with the Clinic Manager and health care team to provide leadership and coordinate patient care. The position aligns with CMH mission, vision and values and adheres to CMH policies and procedures. Responsibilities Actively supervise patient care clinics and staff in an ambulatory care setting. Collaborate with the Clinic Manager and other health care team members to provide leadership and coordinate patient care. Demonstrate CMH mission, vision and values in daily practice and adherence to policies and procedures. Qualifications Knowledge/Skill/Ability: Thorough knowledge of ambulatory care principles and procedures; skills in good patient care; team leadership skills; excellent customer service; ability to communicate effectively orally and in writing; read/write...

Medical Group Clinical Supervisor The Medical Group Clinical Supervisor actively supervises patient care clinics and staff in an ambulatory care setting. The position works in a collaborative relationship with the Clinic Manager and other members of the health care team to provide leadership and to coordinate the care of patients. The individual who holds this position exemplifies the CMH mission, vision, and values and acts in accordance with CMH policies and procedures. Job Requirements: Knowledge of/Skill/Ability to: A thorough knowledge of ambulatory care principles and procedures Knowledge and skills in techniques of good patient care Team leadership skills Excellent customer service skills The ability to communicate effectively orally and in writing Must be able to read and write English, as well as speak and understand English Excellent computer skills 1-2 years experience working with EMR preferred Education and/or Experience: Bachelor degree or equivalent...

A healthcare analytics company is hiring full-time coders for remote positions, focusing on claims audits for appeals. Candidates should have coding experience, preferably with E&M coding and auditing. Responsibilities include daily audits, applying coding guidelines, and maintaining communication with team leads. A high school diploma and certification as a medical coder is required. This position offers competitive pay ranging from $22 to $29 per hour along with a comprehensive benefits package. #J-18808-Ljbffr

Why consider this job opportunity: Salary up to $98,750 annually Unique benefits package including alternative medicine coverage, generous PTO, and up to 16 weeks paid parental leave Opportunity for career advancement and meaningful mission-driven work Supportive and collaborative work environment with a focus on employee well-being Flexibility to adapt work schedules based on business needs What to Expect (Job Responsibilities): Oversee, mentor, and evaluate claims examiners, ensuring performance management and KPI monitoring Lead claims processing and inventory management for timely and compliant claims adjudication Analyze quality review findings to identify and address root causes of errors in claims processing Act as the escalation point for complex claims, leading investigations and implementing corrective solutions Collaborate cross-functionally with internal departments to improve policies and procedures What is Required (Qualifications): Strong understanding...

Compensation: $20.40 - $25.50 per hour (based on years of experience) Overview The Certified Senior Coder reviews provider service records to ensure accurate coding for all services to maximize reimbursement and meet coding requirements from insurance carriers and regulatory agencies (Medicare and Medicaid). Additionally, acts as a resource to providers for coding issues. Responsibilities Will participate and maintain a culture within The Corvallis Clinic that is consistent with the content outlined in the Service and Behavioral Standards document. To this end, employee will be expected to read, have familiarity, and embrace the principles contained within. Codes services correctly; understands and appropriately uses all CPT, ICD-10 and modifiers. Understands and follows all bundling edits. Ensures that documentation supports charges billed, e.g. E/M auditing, procedures, DOS, use of modifiers, and ICD-10. Process and input billings accurately in the practice management...

Job Description Job Description Description: NOTE: This is not a Remote position General Statement of Duties The Certified Coder is a member of the Billing Team and is responsible for insuring the accuracy and completeness of clinical coding. Also assists with claims submission and follow up, researches claim denials and follows up with insurances and patients. Communicates with patients, insurance companies, and staff to ensure the health center’s billing and collections processes are carried out in accordance with established policies. Overall responsibility is to maximize revenues and cash flow to the organization. Requirements: Responsibilities and Essential Functions Certified Medical Coder · Review codes for all documented professional services provided Applies CPT, ICD, HCPCS and modifiers following coding guidelines · New vs Established evaluation and management code selection · Missing orders for services that are documented but not coded · Age...

Overview 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...

Job Description Job Description Certified Medical Coder (Remote Production Role) Our mission to change wound care and improve the lives of others isn’t easy, but it’s worth it! One in ten residents in a skilled nursing facility will develop a skin condition requiring expert medical care. We believe that every person deserves the very best wound care. Building and leading wound care teams is how we do it! Our wound care providers bring education and encouragement to the people who take care of our patients 24/7. When they get better at their jobs, our patient’s wounds heal faster and that is our goal! Main Responsibilities (may include but are not limited to): Meet minimum production goals while maintaining accuracy requirements Review provider medical coding of services rendered for medical claim submission Review and respond to medical coding inquiries submitted...

Outpatient Coders 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. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this...

Overview This level 2 coding position provides support to the Enterprise Coding Department for coding of physician’s fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA. Responsibilities For Professional Services coding positions: review clinical documentation and apply the correct coding and modifiers to evaluation and management services and non-surgical procedural services. Ensure that the documentation supports the levels or types of service billed, is in compliance with Medicare/Medicaid billing regulations, and provider documentation guidelines, CPT documentation and CMS coding guidelines. For Facility Services coding positions: review documentation of outpatient diagnostic and ancillary services for diagnostic radiology, pathology, and other ancillary facility services at OHSU. Provide support to the Enterprise Coding Department for abstracting of records, coding, and charge router submission of Facility...

Department Overview This level 2 coding position provides support to the Enterprise Coding Department for coding of physician’s fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA. Function/Duties of Position Coding Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS). Assign correct CPT, ICD-10-CM, and HCPCS codes for professional charges, which could include all E&M services including outpatient and inpatient; diagnostic services; procedural services; and/or Charge Routers and Charge entry. Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU. Monitor activity for compliance with federal and/or state...

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. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses...

The Associate Director, Congress and Medical Education Strategy & Execution is responsible for executing and contributing to the global medical strategy and tactical implementation for congresses and medical education, and supporting Otsuka's non-promotional scientific communication initiatives across the diverse Rare Disease portfolio. This role leads scientific engagement through impactful congress planning & execution educational programs, and evidence-based content that support Otsuka's mission to improve patient outcomes through deep scientific understanding and collaborative partnerships. The Associate Director partners closely with global and regional cross-functional stakeholders - including Global Medical Affairs, Clinical Development, Global Integrated Evidence & Innovation (GIE&I) and Commercial, to ensure scientific alignment, operational excellence and consistency in Otsuka's external scientific exchange. Job Description Key Responsibilities Include:...

Department Overview This level 2 coding position provides support to the Enterprise Coding Department for coding of physician’sfees and/or facility fees. This position requires experience in coding and requires certification with AAPC orAHIMA. For Professional Services coding positions: This position is responsible for reviewing clinical documentation and applying the correct coding and modifiers to evaluation and managementservices and non-surgical procedural services. This position ensures that the documentationsupports the levels or types of service billed, ensures the documentation is in compliance withMedicare/Medicaid billing regulations, and provider documentation guidelines, CPT documentationand CMS coding guidelines. For Facility Services coding positions: This position is responsible for reviewing documentation of outpatient diagnostic and ancillary services for diagnostic radiology, pathology, and other ancillary facility services at OHSU. This position provides support...

Department Overview This level 2 coding position provides support to the Enterprise Coding Department for coding of physician's fees. This position requires experience in coding and requires certification with AAPC or AHIMA. Function/Duties of Position Coding Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS). Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; and/or Charge Routers and Charge entry. Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned professional services at OHSU. Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS...