58 coder professional jobs found

Join Our Caring Community Become a part of our caring community and help us put health first. The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department's strategy. Makes decisions on moderately complex to complex issues regarding...

Senior Provider Reimbursement Professional - Certified Medical Coder Become a part of our caring community and help us put health first. The Senior Provider Reimbursement Professional - Certified Medical Coder performs research, analysis, documentation, and interpretation for the provider reimbursement programs for an organization that provides health insurance. The Senior Provider Reimbursement Professional works assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Role Overview: Identifies reimbursement policy and process recommendations (primarily with respect to proposed new code edits and the specifics of existing code edits that are reviewed), ensuring compliance with government regulations, contractual considerations, and relevant business decisions. Analyzes provider reimbursement patterns and trends. Begins to influence department's strategy. Makes decisions on...

Pro Fee Coder Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). The Pro Fee Coder will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the requirements of hospital data or physician data retrieval for billing and reimbursement. Coder I may validate APC calculations to accurately capture the diagnoses/procedures documented in the clinical record for hospitals. The Coder I performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and compliance requirements. Coder I may...

ICD-10 Coding Specialist You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be willing to travel to NYC twice a year for required meetings. Position Purpose: The focus of this position is to establish processes to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review. Analyze moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance. Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. Provide...

Risk Adjustment Medical Record Coder The Risk Adjustment & Quality Division at BCBST is seeking a skilled Risk Adjustment Medical Record Coder to support our mission of delivering accurate and compliant coding practices. In this role, you will perform first-pass reviews of member medical records to identify and capture active conditions that map to risk values. This is a remote, day-shift position with flexibility to work up to 8 additional hours per week in accordance with BCBST policy. Preferred Qualifications: CRC (Certified Risk Adjustment Coder) certification is a plus. If not currently certified, you must obtain it within one year of hire. Strong expertise in HCC (Hierarchical Condition Category) coding, with experience in MA (Medicare Advantage) and ACA (Affordable Care Act) programs highly preferred. What Sets You Apart: Self-motivated and proactive, thriving in a remote work environment A true team player, ready to engage in team chats and support colleagues...

Risk Adjustment Medical Record Coder The Risk Adjustment & Quality Division at BCBST is seeking a skilled Risk Adjustment Medical Record Coder to support our mission of delivering accurate and compliant coding practices. What You'll Do: In this role, you will perform first-pass reviews of member medical records to identify and capture active conditions that map to risk values. This is a remote, day-shift position with flexibility to work up to 8 additional hours per week in accordance with BCBST policy. Preferred Qualifications: CRC (Certified Risk Adjustment Coder) certification is a plus. If not currently certified, you must obtain it within one year of hire. Strong expertise in HCC (Hierarchical Condition Category) coding, with experience in MA (Medicare Advantage) and Affordable Care Act (ACA) programs highly preferred. What Sets You Apart: Self-motivated and proactive, thriving in a remote work environment A true team player, ready to engage in team chats and...

Inpatient Medical Coder 2 This area codes inpatient medical records to facilitate the reimbursement and data collection for the individual business units of the OSU Medical Center and The James Cancer Hospital. ICD-10-CM/PCS codes are assigned for the diagnoses and procedures for all inpatients treated within the OSU Health System. Medical record abstract data is reviewed for accuracy in EPIC/IHIS before completing the chart. This position is responsible for coding some or all the following types of records: inpatient record types. The position is primarily responsible for coding medical records and other documents at the conclusion of the patient's visit. This requires selection of appropriate admitting diagnosis, principal and secondary diagnoses, and sequencing diagnoses and procedures. Codes flow from the Encoder Software to EPIC/IHIS Resolute Billing system. This staff member is responsible for complete and accurate coding and MS-DRG and APR-DRG assignment for hospital...

Job Title Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

Inpatient Hospitalist Coding At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Description Fulltime Remote Position (40 hour work week) Inpatient Hospitalist Experience needed for this role. Responsible for reviewing clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM/CPT4 codes and modifiers for billing, internal and external reporting, research, and regulatory compliance....

Inpatient Medical Coder 2 This area codes inpatient medical records to facilitate the reimbursement and data collection for the individual business units of the OSU Medical Center and The James Cancer Hospital. ICD-10-CM/PCS codes are assigned for the diagnoses and procedures for all inpatients treated within the OSU Health System. Medical record abstract data is reviewed for accuracy in EPIC/IHIS before completing the chart. This position is responsible for coding some or all the following types of records: inpatient record types. The position is primarily responsible for coding medical records and other documents at the conclusion of the patient's visit. This requires selection of appropriate admitting diagnosis, principal and secondary diagnoses, and sequencing diagnoses and procedures. Codes flow from the Encoder Software to EPIC/IHIS Resolute Billing system. This staff member is responsible for complete and accurate coding and MS-DRG and APR-DRG assignment for hospital...

Ed Remote Coder Join the winning team and work with the best! We are excited to announce that in 2022 and 2023, UASI was awarded the top workplace award by the Cincinnati Enquirer. Our 40 years in business and long-term partnerships with our valued clients contribute to our stability and the long tenure of our team. We are currently seeking experienced coding specialists to perform accurate code assignments for ED records (facility and profee) while working remotely from a home office. The ideal candidate will be flexible, detail-oriented, have the ability to work independently, quality conscious and be able to adapt well to change. Additional qualifications include: AHIMA or AAPC certification. A minimum of three years' experience coding ED records in an acute care setting is required. Technical competency with remote-based connectivity including virtual private networks, multi-factor authentication via smartphone, and video conferencing platforms. Proficiency with office...

Job Title Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

Op Coder 2 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Various (United States of America) Job Summary: A new chapter awaits at Wellstar! We value your experience and want to help you continue your career in a supportive environment. Experience the Wellstar Difference Competitive pay & benefits Career growth & development programs Flexible schedules Supportive, team-oriented culture Employee wellness programs The OP Coder 2 position reports directly to the Supervisor of Coding. Key responsibilities of the role include: reviewing...

Baylor Scott & White Health Job Posting Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: + We serve faithfully by doing what's right with a joyful heart. + We never settle by constantly striving for better. + We are in it together by supporting one another and those we serve. + We make an impact by taking initiative and delivering exceptional experience. Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Eligibility on day 1 for all benefits Dollar-for-dollar 401(k) match, up to 5% Debt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more Immediate...

Allegheny Health Network Job Posting General Overview: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD 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 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 guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these updates in daily work (5%) Performs other duties as...

Health Information Coding Specialist Health Information Coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Job Duties: Reviews the content of the medical record for hospital and professional inpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient severity and...

Senior Medical Coder The Senior Medical Coder plays a critical role in supporting clinical trials by ensuring the accurate, consistent, and timely coding of medical terms using standardized dictionaries (e.g., MedDRA, WHO Drug). This individual brings advanced knowledge of medical terminology, clinical trial processes, regulatory requirements, and coding best practices. The Senior Medical Coder serves as a subject matter expert and collaborates cross-functionally with clinical operations, data management, safety/pharmacovigilance, biostatistics, and medical writing teams to maintain high-quality data that meet global regulatory standards. Medical Coding Perform complex medical coding for adverse events, medical history, procedures, and concomitant medications using MedDRA and WHODrug dictionaries. Review and validate coding performed by other coders to ensure consistency and accuracy. Identify ambiguous or unclear terms and query clinical sites or data management for...

Inpatient Coder 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 Salary: DOE Reading and transcribing patient charts. Turning patient information into the correct codes. Submitting billing as an insurance claim. Acting as a liaison between insurers, medical offices, and patients. Handling confidential information and abiding by HIPAA laws. Conducting audits. Ensuring maximum reimbursement for services provided. Reviewing patient medical records and assigning codes to diagnoses and procedures. Submitting claims to insurance companies for reimbursement. Interpreting the type of care a patient receives and using medical coding to assign a special designation for their services. Certified Medical Coder preferred

Job Description Job Description Description: University Physicians' Association is seeking qualified applicants for a full-time Certified Medical Coder position for University Gastroenterology located within the UT Medical Center. The Certified Coder Position is normal business hours Monday-Friday. Coder audits medical provider clinical documentation inpatient and outpatient while adhering to Medicare guidelines and reviews documentation. Identifies areas for documentation improvement and effectively communicates with providers. Ensure the provider has entered the correct coding and adding modifiers as needed. Must be reliable and have the ability to maintain a high level of confidentiality within all aspects of job performance. Essential Duties and Responsibilities: Performs coding services and audits documentation before claims are submitted Partners with providers and staff to improve quality and efficiencies in coding and documentation Maintains...

Job Description Job Description Description: University Health Network is looking for a full-time Certified Medical Coder to focus on risk adjustment for the clinically integrated network associated with The University of Tennessee Medical Center and University Physicians’ Association. This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings . Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region. This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding procedures and diagnoses using ICD-10-CM, CPT, HCPCS, and modifiers for professional services associated with The University of Tennessee Medical Center and University Physicians’ Association. Essential Duties and Responsibilities (this list does not include all duties assigned) Performs coding...

Job Description Job Description Description: Position Summary The Certified Vascular Surgery Coder is responsible for accurately coding vascular surgery procedures and related clinical services to ensure proper billing, compliance, and reimbursement. This role requires in-depth knowledge of vascular anatomy, surgical terminology, CPT/ICD-10 coding, and payer guidelines. The ideal candidate is detail-oriented, analytical, and committed to supporting both clinical operations and revenue cycle integrity. This position works closely with Vascular Surgeons, APPs, the billing team, and administrative leadership. Key Responsibilities Review clinical documentation, operative reports, and provider notes to assign accurate CPT, ICD-10, and HCPCS codes for vascular surgery procedures and outpatient visits. Ensure coding is compliant with federal, state, and payer-specific guidelines. Collaborate with Vascular Surgeons and APPs to clarify documentation and ensure accurate code...

Join to apply for the Coding Auditor Sr role at Elevance Health JR171732 Coding Auditor Sr CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. Location: Virtual. This role enables associates to work virtually full-time, with the exception of required in‑person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work‑life integration, and ensures essential face‑to‑face onboarding and skill development. Candidates not within a reasonable...

Coding Auditor Sr Anticipated End Date: 2025-12-12 Job Description JR171732 Coding Auditor Sr. CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from physician and hospital medical records to ensure proper ICD-10 coding and compliance with risk adjustment requirements. Location Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. Hours 8:00 a.m. - 5:00 p.m., Monday - Friday How you will make an impact Audits coders that diagnosis data retrieved from physician and hospital medical records and/or data...