65 coder professional jobs found

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

3 days ago Be among the first 25 applicants Description Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD‑10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross‑training established coders in new specialties. Employment Type Full time Shift Day...

Penn State Health - Hershey Medical Center Location: US:PA: Hershey Work Type: Full Time FTE: 1.00 Shift: Day Hours: Varied 8hr Days Recruiter Contact: Carlee Maiman at clewis9@pennstatehealth.psu.edu (MAILTO://clewis9@pennstatehealth.psu.edu) SUMMARY OF POSITION: Provides direct supervision of practice site clerical support staff to provide optimal clinical operations. Responsible for clerical supervision and management including; cost effective management of office supplies, high integrity adherence with organizational policies surrounding quality of patient registration, point of service cash collections and cash control, scheduling, and other clerical support functions, patient satisfaction with clerical staff experience, and clerical staff employee engagement. Abides by, and upholds in performance of direct reports, all related local, state, federal and accrediting body rules and regulations; promotes an exceptional patient experience, by providing customer...

UPMC Corporate Revenue Cycle is hiring a Coder I- Profee to join our Coding Department! This position will work on Physician Coding for Anesthesia & Pain Management. This will be a work-from-home position working Monday through Friday during business hours. In this role, you will assign ICD and limited CPT codes. Coders review the physician documentation to determine the appropriate ICD-10 code and verify the CPT code, but in some cases assign basic CPT codes. Resolve basic coding edits. Complete the charging process. Ensure diagnosis codes meet local medical necessity guidelines for ancillary tests that were ordered-- requires knowledge of billing and coding guidelines. Utilize coding resources (CCI edits, 3M, ICD and CPT Publications) along with any other applicable specialty reference material to ensure accurate coding. Responsibilities: Utilize standard coding guidelines and principles and coding clinics to assign the appropriate ICD and CPT for all records to...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

A healthcare organization is seeking an Inpatient Coder to work remotely. The role involves reviewing charge edits and coding with CPT, HCPCS, and ICD-10 codes. Candidates should have an Associate's degree in an allied health field and Certified Coding Specialist credential, with experience across multiple surgical specialties preferred. Strong communication skills and a solid understanding of medical coding are essential for ensuring accurate charge capture. Join a dedicated team that values diversity and equal opportunity. #J-18808-Ljbffr

Tenor Health Foundation is seeking a coder responsible for abstracting clinical and demographic data, ensuring accurate application of code assignments to all services. Candidates should have a high school diploma and knowledge of ICD-10, CPT4/HCPCS coding. Experience with medical terminology and human anatomy is required. A high degree of accuracy, strong organizational skills, and effective communication with medical staff are essential for this role. Preferred candidates will have a CCS certification or prior coding experience. #J-18808-Ljbffr

Clinical Coder Level I HIM Impatient Specialist (Full-Time, Remote) Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines. Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work? Location: Lancaster, PA Remote position. ONLY candidates residing in NJ, PA and Delaware will be considered or willing to relocate to one of these three states. Hours: Full-time, Monday through Friday - flexible start and end time/ 40 hours per week. Position Summary: Codes and abstracts information from inpatient and outpatient records by careful analysis and...

Job Title Penn State Health - Penn State Health Corporation Location: US:PA:Camp Hill Work Type: Full Time FTE: 1.00 Shift: Day Hours: Monday - Friday, 8:00a - 4:30p Summary Of Position Responsible to review the health record, electronic reports, and other reporting tools to identify conditions treated and the services provided to each patient. Utilize the appropriate coding systems (ICD-10-CM, CPT, HCPCS) to accurately code diagnoses, services, and procedures performed by providers performing billable services. Performs the necessary functions to bill, collect, analyze, and adjudicate ambulance and medical transportation billing and collection functions for Emergency Medical Service (EMS) service lines. Validates insurance eligibility and benefits verification. Obtains insurance authorizations as needed. Responsible for the resolution and collection of an assigned group of accounts, performing follow-up, adjustments, refunds, and administrative duties as assigned. Has the...

Penn Highlands Healthcare has been awarded on the Forbes list of Best-in-State Employers 2022. This prestigious award is presented by Forbes and Statistica Inc., the world leading statistics portal and industry ranking provider. Summary As a CERTIFIED CODER, you will code hospital inpatient records and ambulatory outpatient records with a high degree of accuracy for the purpose of reimbursement, research and compliance with federal regulations according to diagnosis, operations, and procedures using accepted classification systems. Performs data entry of statistical and medical data from records and clinical abstracts via a computer terminal (CRT). After probationary period, Certified Coders may be eligible for remote option. Qualifications Other information: High School Diploma or Equivalent Required A Certified Coding Credential is required One year ICD-10-CM and PCS coding experience One (1) to three (3) years experience What We Offer Career Advancement Opportunities...

Coder III UPMC Corporate Revenue Cycle is hiring a Coder III to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. This position will be working on inpatient codes. As the Coder III, Technical you will code all inpatient accounts, ICD10 diagnoses, and PCS procedures. Responsibilities: Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and PCS codes following review of the medical record in the electronic health record. Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation in the EHR available at the time of coding adhering to Official Coding Guidelines. Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits as published in Optum. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD10-CM and PCS codes for all record types to ensure...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Remote Medical Biller & Coder Rooted Talent Solutions is actively seeking remote medical billers and coders to join our healthcare support team. This is a remote, independent contractor opportunity involving medical claim processing, coding, and administrative support for healthcare providers. We're hiring both experienced professionals and motivated individuals looking to enter the field. If you're detail-oriented, organized, and eager to work from home, this could be the right opportunity for you. Responsibilities Process and submit medical claims accurately and on time Assign appropriate ICD-10, CPT, and HCPCS codes Review documentation for coding compliance Follow up on denied or unpaid claims as needed Communicate with providers, payers, or clients when necessary Maintain HIPAA compliance and data security standards Qualifications Preferred: Experience with medical billing, coding, or claim processing Familiarity with EHR or billing software Strong...

Medical Coder The Medical Coding Specialist is responsible for abstracting and coding diagnosis information and/or medical conditions documented in physician office medical records using CMS, ICD-10 and/or Department defined criteria and guidelines. The Specialist will receive and review medical records electronically and document ICD-10 codes or medical record compliance issues using computer software. The Medical Coding Specialist is responsible for meeting average daily production goals while maintaining a minimum 91% accuracy rate on a consistent basis. Must be AAPC or AHIMA certified. Skills: Experience required to be certified by AACP or AHIMA. Required successful completion of at least one AHIMA or AAPC certification program with achievement correlating professional credential (RHIT, CCS, CPC, etc.) active and in good standing. Required ICD-10 proficiency validation. Required 1-3 years hands on production abstracting or auditing medical records for diagnosis/medical...

Coding Auditor Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. POSITION OVERVIEW Coder Certification Required. The Coding Auditor is responsible for determining that ICD-10, CPT-4, and HCPCS coding is supported by the clinical documentation in the medical record as well as validating medical necessity per CMS Local Coverage Determination (LCD). Applies working knowledge of medical terminology, anatomy, CPT-4 and ICD-10 codes and...

Coder I Job Category: Clinic Support Premier Orthopaedics, in partnership with Philadelphia Hand to Shoulder, is seeking a dedicated and skilled Coder to join our team remotely. As two of the region's most respected providers of orthopedic and upper extremity care, we offer a collaborative, patient-focused environment that prioritizes clinical excellence, innovation, and ongoing professional development. This role is responsible for accurately reviewing medical records and assigning ICD-10 and CPT codes in compliance with all applicable policies and regulations. It manages patient demographics, clinical documentation, and billing data across practice management systems and hospital records to ensure proper coding and reimbursement. The position also supports and educates clinical staff and providers on documentation and coding standards to promote compliance, accuracy, and effective communication. This is a full time remote Monday-Friday position. Key Responsibilities:...

Revenue Cycle Outpatient Coder The Revenue Cycle Outpatient Coder is a Health Information Management Professional responsible for ICD-10-CM and CPT-4 code assignment and abstracting of outpatient episodes of care according to ICD-10-CM and CPT-4 Coding Guidelines and Principles. Keeps abreast of clinical conditions, coding guidelines and reimbursement reporting requirements. Brings identified concerns to management for resolution. Job Duties Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. Performs ICD-10-CM and CPT-4 coding and data abstraction within established minimum accuracy and productivity rates. Attends mandatory staff education sessions and department meetings. Refers coding issues to supervisor in a timely manner for determination and guideline development. Complete and submit a weekly productivity log. Minimum Qualifications 3 years experience coding outpatient medical records. Knowledge and ability to translate...

Inpatient Coder One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. The Atlantic Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. This position performs the primary function of coding inpatient or outpatient records to include Ambulatory, ER and Miscellaneous Ancillary charges. Utilizes 3M Encoder to code and classify inpatient and/or outpatient records according...

Seeking Breakthrough Makers Children's Hospital of Philadelphia (CHOP) offers countless ways to change lives. Our diverse community of more than 20,000 Breakthrough Makers will inspire you to pursue passions, develop expertise, and drive innovation. At CHOP, your experience is valued; your voice is heard; and your contributions make a difference for patients and families. Join us as we build on our promise to advance pediatric careand your career. CHOP does not discriminate on the basis of race, color, sex, national origin, religion, or any other legally protected categories in any employment, training, or vendor decisions or programs. CHOP recognizes the critical importance of a workforce rich in varied backgrounds and experiences and engages in ongoing efforts to achieve that through equally varied and non-discriminatory means. A Brief Overview This role will be responsible for reviewing medical record documentation including procedure reports and assigning appropriate CPT...

UPMC Corporate Revenue Cycle is hiring a Coder II to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. In this position, you will be working on edits. We are looking for individuals with a strong understanding of Evaluation and Management codes. As a Coder II, you will review all pertinent physician, nursing and ancillary documentation in the medical record. Depending on type of service and place of service, you will determine the level of acuity, procedure performed, billable supplies and diagnosis to substantiate medical necessity. You will review and sequence all codes to to maximize reimbursement and address any potential bundling issues. Apply modifiers as needed. LMRP/CCI edit and coding denial resolution. Responsibilities: Utilize computer applications and resources essential to completing the coding process efficiently. Meet and maintain charge lag and appropriate coding...

Specialized Coder Opportunity 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! The Opportunity: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position will pay between $29.75 and $32.70/hr based on experience Specialized Coders Wanted —$3,000 Sign-On Bonus Awaits -- We are seeking candidates with experience in Cardiology, Vascular or Thoracic...

JOB LOCATION: Wilkes-Barre General Hospital POSITION PURPOSE The coder is responsible for abstracting all clinical and demographic data and accurately applying code assignment to all inpatient, outpatient, and emergency services with diagnoses, procedures and conditions as indicated in the patient medical record. Using a computerized encoding system, assigns ICD-10-CM, ICD-10-PCS, CPT4/HCPCS, DRG and APCs in accordance with official coding and reimbursement guidelines from the American Medical Association, the American Hospital Association, and the American Health Information Management Association. All work is carried out in accordance with the Health Information Management department and the Tenor Health approved policies and procedures POSITION QUALIFICATIONS Education: High school diploma with ICD-10-CM, ICD-10-PCS, CPT4/HCPCS coding knowledge and or experience. Medical terminology and human anatomy and physiology required Experience/Specialized...

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...

Job Details Compliance Auditor Job Description JOB SUMMARY Under general supervision, performs risk-based audits of clinical documentation, coding, and billing records to ensure that documentation supports services billed and complies with applicable regulatory and organizational requirements. This position independently validates documentation and coding compliance, identifies areas of compliance risk, and supports internal audit activities and external audit readiness across hospital-and provider-based settings. This role is outcome-driven and requires the ability to independently manage audit workload, documentation, and deadlines. ESSENTIAL FUNCTIONS • Performs risk-based audits of clinical documentation, physician, technical, and specialty billing and payment records by analyzing medical records, coding records, and health system bills to validate that documentation supports services billed and complies with applicable regulations and guidelines. • Evaluates...