14 coder provider practice jobs found

At Managed Care Network, Inc., we’re a dynamic and growing managed care company committed to delivering exceptional service in the Workers’ Compensation and Auto Insurance industries. With a team of over 100 dedicated professionals, we’re expanding—and we want you to be part of our journey. Position Overview: The Fee Schedule Specialist is responsible for the review, analysis, and processing of medical bills for New York State Workers’ Compensation and Auto/No-Fault claims. This role ensures accurate reimbursement determination through the application of state fee schedules, Medicare methodologies, PPO contracts, and client-specific guidelines. The ideal candidate will possess strong analytical skills, attention to detail, and a working knowledge of medical coding, billing practices, and payer-side bill review operations. Candidates with CPC-A or CPB certification are strongly encouraged to apply. Key Responsibilities: •    Review and analyze medical bills, records, and...

We are seeking a part-time, detail-oriented and energetic Certified Medical Coder/Biller to join our healthcare team. In this vital role, you will be responsible for accurately coding medical diagnoses, procedures, and services to ensure proper billing and reimbursement. Your expertise will help streamline the revenue cycle process, improve compliance with healthcare regulations, and support the delivery of high-quality patient care. The ideal candidate is passionate about medical coding, possesses strong organizational skills, is fast learner, and is self-motivated. Responsibilities Review medical records and documentation to assign accurate ICD-10 diagnosis codes, CPT procedure codes, and DRG classifications. Ensure all coding aligns with current guidelines and insurance requirements to facilitate timely reimbursement. Prepare and submit precise medical claims using Electronic Medical Record systems. Verify patient insurance information and resolve billing...

CodaMetrix is revolutionizing Revenue Cycle Management with its AI-powered autonomous coding solution, a multi-specialty AI-platform that translates clinical information into accurate sets of medical codes. CodaMetrix’s autonomous coding drives efficiency under fee-for-service and value-based care models and supports improved patient care. We are passionate about getting physicians and healthcare providers away from the keyboard and back to clinical care. Overview Reporting to the Senior Manager, Medical Coding & Audit, as a Senior Medical Coding Analyst, this role will be a key member of the team responsible for ensuring that CodaMetrix meets—and exceeds—our customers’ coding quality expectations. They will leverage their strong background in coding, billing, and auditing across service lines to review, analyze, and enhance coding processes, both internally and externally. They will play a pivotal role in improving the quality and efficiency of coding operations by...

This position has the primary function of coordinating and supporting the Deputy Chief Compliance Officer with administrative, analytical, and program coordination activities. This position will provide support related to compliance auditing activities and programs, assisting with developing and coordinating the Compliance Audit Plan, supporting proactive and reactive audits of professional fee billings in clinic and facility settings, including federally qualified health centers. Proactively support audit activities related to billing and coding risks to the SOM, identifying and calculating potential overpayments based on audit results, participating in the repayment process if necessary, reviewing research billing compliance issues and assisting the Deputy Chief Compliance Officer in designing and managing a comprehensive billing/auditing program.  The position supports compliance-related activities by gathering information, coordinating documentation reviews, monitoring...

Job Summary Designs and delivers education programs on compliant documentation, coding and billing practices, regulatory requirements, and internal policies through learning experiences such as instructor-led sessions, webinars, and e-learning modules. Serves as a key resource for physicians, clinical staff, auditors, coders, and other stakeholders, ensuring understanding and adherence to applicable standards. Analyzes data and reports to identify educational needs and may conduct limited audits to support targeted training efforts. Essential Functions: Develops and delivers targeted education based on new service or program implementation, CPT/ICD-10 changes, and regulatory changes. Reviews audit data and compliance trends to identify educational gaps and address areas of risk. Designs and maintains educational content and resources, supporting accurate CPT and diagnosis coding for professional services,...

Billing Compliance Reviewer  Dana-Farber Cancer Institute  Boston, MA  Full Time Overview Reporting to the Director of Billing Compliance, the Billing Compliance Reviewer plans and executes risk-based audits, analyzes documentation and coding for medical necessity and regulatory adherence, and recommends corrective actions to mitigate compliance risk. The role evaluates the accuracy and integrity of hospital and professional billing practices to ensure compliance with federal and state regulations, payer requirements, national coding guidelines, and internal policies. The Billing Compliance Reviewer is responsible for developing clear findings, collaborating with clinical and administrative stakeholders to resolve issues, and supporting continuous improvement in charge capture, documentation, and coding processes. This role works collaboratively with Coding, HIS, Billing and other internal and external teams to evaluate complex billing issues and initiate...

We are looking for a Medical Coder (Behavioral Health, E/M) to help define how automated and human-in-the-loop coding works at scale. In this role, you will serve as an internal authority on behavioral health E/M coding , partnering closely with Brellium's Customer Success, Product, and Engineering teams. You will help ensure that coding recommendations are accurate, defensible, and aligned with payer expectations — balancing appropriate revenue capture with audit-safe compliance. This is a highly impactful role for an experienced coder who enjoys shaping policy, improving systems, and applying clinical coding expertise in a modern, technology-driven environment. What You'll Do Own Coding Quality & Compliance Review and validate E/M coding for behavioral health encounters in a pre-bill workflow Ensure coding decisions align with documentation, payer guidance, and compliance best practices Define clear standards for when revenue capture is appropriate vs when...

Overview: The Documentation and Coding Consultant 1 provides training, consultation, review, and feedback to clinicians on their medical service documentation and coding to ensure KPNW receives appropriate reimbursement and conforms to applicable guidelines and regulations. This is a hybrid position that is a blend of working both remotely and in office. Must reside in the Northwest Service Region (Oregon or Washington). Major Responsibilities / Essential Functions: Consulting and Coding services Provides expert consultation to specialists or primary care clinicians as assigned on coding and documentation education and questions. Within assigned clinical specialties, maintain current knowledge to ensure that KPNW coding and documentation meets regulatory guidelines and audit standards. Follow coding specificity guidelines using coding rules and guidelines. General coding knowledge and understanding of Risk Adjustment models and submission...

ruralMED Management Resources, an Ovation Healthcare partner, seeks a Hospital Outpatient Specialty Coder. This role, under general direction, is responsible for critical access hospital coding; including emergency department, infusions, Critical Access Hospital Specialty Clinic, professional fees, and Rural Health Clinic. They will ensure the timely and accurate coding of medical claims while maximizing reimbursement for services. Duties and Responsibilities: Employee must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation.  Specific job duties will vary based upon client assignment.  Employee will also abide by ruralMED’s policies as a condition of employment. Charge Entry Receive and review charge entry data from practice sites Identify and investigate incomplete or missing charges Coding: Abstract clinical information; translates medical...