16 coder lead professional jobs found

Alignment Health is a remote company focused on senior care. The Medical Risk Adjustment (MRA) Coding Auditor role supports departmental quality assessment audits of internal coding analysts and vendors to ensure accurate and complete data submission to CMS. General Duties / Responsibilities Supports regular quality assurance audits of the internal Coding Analyst Team to validate and confirm coding & abstracting quality (95% HCC accuracy), ensuring coding quality and performance improvement standards are maintained. Tracks and reports progress of QA audits performed on coding vendors to verify coding accuracy and quality of data submitted to AHP for CMS submission. Works with Risk Adjustment Management on any MRA data validation or coding audit to ensure completeness and coding accuracy of all CMS submissions; this may include data reconciliation, data flow integrity, UAT testing, review of high‑cost/low‑risk score members, retrospective chart reviews, or other related data...

Job Type: Full-time Description The Certified Coder will play a key role in converting diagnoses and treatment procedures into ICD-10, CPT and HCPCS codes. The Coder will review and accurately code office and hospital procedures for reimbursement. Essential Functions Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements, and complications. Researches and analyzes data needs for reimbursement. Analyzes medical records and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Reviews and verifies documentation supports diagnoses, procedures, and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements...

A healthcare institution is seeking a Professional Billing Lead Coder for a remote position. This role requires coding expertise in professional services with responsibilities including accurate coding of medical records and leading coding staff. Candidates should have at least 5 years of coding experience, comprehensive knowledge of CPT and ICD coding, and at least two coding certifications. This position emphasizes communication skills and attention to detail, supporting quality patient care and operational objectives. #J-18808-Ljbffr

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today! Job Overview This position reviews and accurately codes and abstracts hospital services, inpatient procedures, overnight/multi‑night stay services or complex professional medical services. The coder applies appropriate coding guidelines to assign ICD and CPT codes, conforming to Medicare, Medicaid, and third‑party payer requirements to ensure accurate reimbursement. In the inpatient setting, the coder collaborates with the Clinical Documentation Improvement team to ensure accurate DRG...

Professional Billing Lead Coder (Remote) page is loaded## Professional Billing Lead Coder (Remote)locations: Work From Home-City Tax Exempttime type: Full timeposted on: Posted Todayjob requisition id: R0017223**If you are a current University Health or University Health Physicians employee and wish to be considered, you must apply via the internal career site.****Please log into to search for positions and apply.**Professional Billing Lead Coder (Remote)101 Truman Medical Center# **Job Location**Work From Home-City Tax ExemptLees Summit, Missouri# **Department**Corporate Professional Billing# **Position Type**Full time# **Work Schedule**7:30AM - 4:00PM# **Hours Per Week**40# **Job Description**The coding leads serve as liaisons and leaders between coding staff, the operation, and the Director. The coding leads are recognized as the subject matter experts for coding and for meeting operational objectives. The Lead Coder position is responsible for accurate coding of professional...

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, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time The Lead Outpatient Coder is an experienced, credentialed coding professional who serves as the point-of-contact for coders, assists manager with managerial duties, able to take lead on department projects, as well as other departments' coding questions. Responsibilities Serves as a coding resources to clinic and outpatient coders. Ensures the accuracy of clinical data collection from outpatient medical records. Codes diseases, procedures, and diagnosis using the ICD-10-CM and CPT classification systems, in accordance with Official Coding Guidelines, CMS guidelines, and Mosaic compliance standards. Completes complex coding assignments for the purpose of...

Overview Position Summary: Scheduled Hours 40. Reviews medical record documentation to determine appropriate billing codes and necessary documentation. Responsibilities Review documentation in the record to identify all pertinent facts necessary to select comprehensive diagnoses and procedures that fully describe patient conditions and treatment. Evaluate and manage codes, selecting appropriate CPT codes and assigning diagnoses to appropriate ICD-10 codes. Meet with physicians to review documentation, resolve coding issues, secure signatures of all unsigned dates of service, and tag files for follow‑up. Act as lead person and assist coders with IBC staff with medical terminology and policy interpretation as required. Assist with efforts to increase physician awareness of documentation requirements. Prepare case reports and initiate follow‑up for billing processes. Perform other duties as assigned. Required Qualifications Certified Coding Associate (CCA) – AHIMA Certified Coding...

Mymlc is seeking a Lead Outpatient Coder to be a point of contact for coders and assist with managerial duties. This position involves coding procedures and ensuring compliance with regulations, along with providing feedback to improve coder quality. Candidates should have at least 2 years of outpatient coding experience and relevant certifications. The role can be remote but is preferred for candidates residing in certain states. The company offers comprehensive benefits and a commitment to community health, making it an attractive employer. #J-18808-Ljbffr

Houston Methodist is hiring a Lead Outpatient Coder responsible for accurately assigning diagnostic and procedure codes to outpatient encounters. This role involves ensuring compliance with regulatory guidelines and facilitating communication between management and staff. The ideal candidate will have an Associate’s degree or higher with experience in outpatient coding, and must possess necessary certifications such as RHIT or CCS. Strong skills in medical terminology and coding systems are essential. #J-18808-Ljbffr

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based on documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

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...

Medical Biller - P/T or F/T - O'Fallon, MO - Gateway Asthma & Allergy Esse Health is the largest independent physician practice in the St. Louis Metropolitan area with over 100+ physicians, in 35+ locations, serving nearly 130,000 patients. We are leading the healthcare community by placing patients and their physicians at the center of health decisions. Esse Health is more than a healthcare provider - it's a place where medicine is a calling and not just a profession. It's a team of extraordinary medical professionals with the latest ideas for keeping patients healthier. We are searching for a part-time Medical Biller for our Gateway Asthma & Allergy office located in O'Fallon! Opportunity: Part-time or Full-time - we are open to hearing the schedule you desire! Let us know what days and hours you would like work (during regular business hours, Monday - Friday)! This position also shares in rotating coverage of a Saturday morning shift No nights or holidays Outpatient...

Become a part of our caring community The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Reviews medical records to report conditions that map to HCCs by reviewing medical record documentation and applying the appropriate ICD-10 diagnosis codes. Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. Works on projects that may include making phone calls to providers. Works within broad guidelines with...

Coder Reimbursement Specialist - Hospital Full‑time position. The Coding and Reimbursement Specialist (CCS) is responsible for coding and abstracting clinical data from the medical record, including inpatient, outpatient, commercial, Medicare, Medicaid, Illinois Public Aid, and all other payor types. Accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis and DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. The CCS manages workload, assigns work to three inpatient and two outpatient coders, and oversees day‑to‑day operations of the coding/reimbursement area. The CCS monitors regulatory sources to keep HIM coding and other staff informed and trained on coding rules, regulations and related issues, works closely with patient financial services to resolve claim denials, assists in...

Job Posting Phelps Health is a 2000-employee-strong hospital and healthcare system serving the heart of small-town Missouri. No matter where you start with us, we're committed to taking our team to the top. If you're ready for the challenge of providing life-saving care or supporting those who do, read on to find your fit in the Phelps Health family. General Summary The coder is responsible for ensuring appropriate levels of service being billed according to the American Medical Association (AMA) and Center for Medicare and Medicaid Services (CMS) guidelines, insurance credentialing, and provider/staff education in relation to coding and billing guidelines. Maintain routine chart audits for providers. Essential Duties And Responsibilities Assigns ICD-10-CM, CPT, and HCPCS Level II codes to completed and signed medical documentation creating an appropriate assigned medical claim. Abstracts specified data and information from patient records in order to determine...

Position Summary Reviews medical record documentation to determine appropriate billing codes and necessary documentation. Working Conditions Job Location/Working Conditions: Normal office environment. Key Responsibilities Review 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. Code evaluation and management to appropriate CPT code and code diagnoses to appropriate ICD-10 codes. Meet with physicians to review documentation, resolve coding, and secure signatures for all unsigned dates of service; tag files for follow up. Act as lead person and assist coders with medical terminology and policy interpretation as required. Assist with efforts to increase physician awareness of documentation requirements. Prepare case reports and initiate follow-up for billing process. Performs other duties as assigned. Education and Certifications Education...