27 coder provider practice jobs found

Job Description Job Description The Medical Coder / Coder PAR at Apex Spine and Neurosurgery is responsible for reviewing clinical documentation and assigning accurate CPT, ICD-10, and HCPCS codes for spine, neurosurgical, and interventional pain management services. This role ensures compliant, complete, and timely coding to support revenue integrity, authorization accuracy, and efficient claims processing in accordance with CMS and payer guidelines. Key Responsibilities Review operative reports, clinic notes, imaging, and diagnostic studies to accurately assign CPT, ICD-10, and HCPCS codes for spine and neurosurgical procedures. Code surgical and procedural services including (but not limited to): spine surgeries, decompressions, fusions, discectomies, laminectomies, injections, nerve blocks, ablations, and other interventional pain procedures. Ensure compliance with CMS guidelines, NCCI edits, payer-specific policies, and internal coding standards. Communicate directly...

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...

Lead Medical Coder and Auditor [PR0001D] Full‑time ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast‑paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. ProSidian Seeks a Lead...

ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast-paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. Job Description ProSidian Seeks a Medical Coder and Abstractor (Full-Time) in...

Lead Medical Coder and Auditor ProSidian Consulting is looking for a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land dominance, across the full range of military operations and the spectrum of conflict, in support of combatant commanders". The Regional Health Command's Readiness Mission includes dental care of active duty Soldiers, public health services, veterinary services, and providing management and support to wounded, ill and injured Soldiers assigned to its seven warrior transition units. The ProSidian Engagement Team Members work to provide health...

Certified Medical Coder/Biller The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: Claims Processing: Prepare and submit accurate and timely insurance claims for services rendered. Verify patient insurance coverage and ensure correct billing to the appropriate payer. Review and process Explanation of Benefits (EOBs) and insurance payments. Billing and Coding: Ensure that all medical services are accurately coded according to current guidelines...

Overview Be inspired. Be valued. Belong. At Emory Healthcare At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Individuals with Orthopedic and Neuro surgery experience are encouraged to apply!!! Description This position ensures the accuracy, completeness, and compliance of medical coding and clinical documentation for professional coding services. The role supports accurate coding practices, appropriate reimbursement, and regulatory compliance by reviewing patient records and...

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary The Coder is responsible for reviewing outpatient clinical documentation via Epic and 3M CAC for assignment of ICD-10-CM diagnoses and CPT-4/HCPCS procedure coding systems. Through knowledge of coding conventions and guidelines. Ability to address commonly applied modifiers for hospital outpatient accounts. Extracts pertinent information from clinical notes, operative notes, radiology reports, laboratory reports, (including Pathology), procedure records, specialty forms, etc. Determines complex code assignment pertinent to emergency visits and diagnostic workups. Core Competencies These competencies reflect the values and behaviors expected of all Grady team members, regardless of role. They ensure that every employee contributes...

Medical Billing & Coding Specialist At Pandya Medical Center, we believe in going above and beyond for every patient. Our team members are dedicated professionals who truly care about making a difference. We listen, understand, and treasure each personal story shared by our patients. Our commitment extends beyond our clinic walls, with active involvement in community health fairs and volunteering initiatives. We are a highly reputed medical practice in North Atlanta, offering strong growth opportunities and robust benefits for our employees. Be a part of our dynamic team and take your career to the next level with Pandya Medical Center. The Medical Billing & Coding Specialist assures accurate and complete coding information is collected and reported to private insurance and Medicare to help complete the revenue cycle. The specialist will scrub encounters for accurate coding prior to claim creation, assure correct modifiers and ICD10 diagnosis codes are allocated to each...

Compliance Audit And Analysis Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship and leadership programs And more Description Primary function: Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Serves as a resource for providers...

Multi-Specialty Profee And/or Facility Medical Coder Artificial Intelligence. Automation. Cloud engineering. Advanced analytics. For business leaders, these are key factors of success. For us, they're our core expertise. We work with iconic brands worldwide. We bring them a unique value proposition through market-leading technology and business process excellence. We've created over 200 unique inventions under several patents across AI and other critical technologies. Leveraging our advanced products and platforms, we drive digital transformation, optimize critical business operations, reinvent experiences, and pioneer new solutions, all provided through a seamless "as a service" model. For each company, we provide new keys for their businesses, the people they work with, and the customers they serve. We tailor proven and rapid formulas, to fit their unique DNA. We bring together human expertise and artificial intelligence to develop digital chemistry. This unlocks new...

Culture and Values: At Pandya Medical Center, we believe in going above and beyond for every patient. Our team members are dedicated professionals who truly care about making a difference. We listen, understand, and treasure each personal story shared by our patients. Our commitment extends beyond our clinic walls, with active involvement in community health fairs and volunteering initiatives. We are a highly reputed medical practice in North Atlanta, offering strong growth opportunities and robust benefits for our employees. Be a part of our dynamic team and take your career to the next level with Pandya Medical Center. Job Summary The Medical Billing & Coding Specialist assures accurate and complete coding information is collected and reported to private insurance and Medicare to help complete the revenue cycle. The specialist will scrub encounters for accurate coding prior to claim creation, assure correct modifiers and ICD10 diagnosis codes are allocated to each...

Culture and Values At Pandya Medical Center, we believe in going above and beyond for every patient. Our team members are dedicated professionals who truly care about making a difference. We listen, understand, and treasure each personal story shared by our patients. Our commitment extends beyond our clinic walls, with active involvement in community health fairs and volunteering initiatives. We are a highly reputed medical practice in North Atlanta, offering strong growth opportunities and robust benefits for our employees. Be a part of our dynamic team and take your career to the next level with Pandya Medical Center. Job Summary The Medical Billing & Coding Specialist assures accurate and complete coding information is collected and reported to private insurance and Medicare to help complete the revenue cycle. The specialist will scrub encounters for accurate coding prior to claim creation, assure correct modifiers and ICD10 diagnosis codes are allocated to each CPT code,...

Are you seeking a career with a growing company, a place where you can make an impact in the community? Then Positive Impact Health Centers is the company for you. What makes us different? We offer our employees the following: • 1 Health Wellness day per quarter • Parental Leave • Free parking at our locations/bus line accessibility • Competitive Salary & Benefits • Automatic 3% Safe Harbor & 2% Profit Sharing (Retirement Program) • 100% allotted for benefit elections for employees, 50% allotted for benefit elections for employees' spouse/dependents • Credit Union Positive Impact Health Centers (PIHC) is a community leader in providing HIV prevention, care and treatment services. The PIHC model of care assures that persons with HIV have access to medical, pharmacy, dental, behavioral health and social services, providing the best opportunity for patients to achieve high-quality health outcomes. Job Summary : The Medical Billing &...

DESCRIPTION Position Overview Responsible for ICD-10 and CPT Coding of all hospital and clinic services for the providers at Pinnacle in a timely fashion with a 95% accuracy rate. Essential Functions Essential Duties and Responsibilities Working Locked Encounter report in eClinicalWorks, create claims and review for correct ICD10 codes and placement. Review CPT codes for accuracy and apply modifiers as required. Appeal Surgeries that are denied by payor. Keep Manager aware of problems with Surgical and/or Progress Notes Keep up to date on coding changes with Payors and HIPAA laws. Other Assist in drafting/developing coding policies and procedures/job aids. Promote compliance by attending required compliance training and report any perceived or actual compliance concerns to the Compliance Committee. Participate in regular coding training and team meetings by preparing educational information to present....

Join Datavant, the leading data collaboration platform in healthcare, dedicated to ensuring the world's health data is secure, accessible, and actionable. Our mission drives us to provide essential data solutions for a variety of healthcare organizations, including providers, health plans, researchers, and life sciences companies. At Datavant, you will be part of a passionate team focused on transforming the future of healthcare through innovative data connectivity. What We Are Looking For: As an HCC (Hierarchical Condition Category) Auditor, you will be pivotal in reviewing medical records that have been coded in a standardized system, ensuring each patient’s conditions are accurately represented for risk adjustment and reimbursement. Your expertise will help translate clinical documentation into precise codes, reflecting the complexity and severity of patients' health statuses while confirming the accuracy of your work. What You'll Be Doing: Audit coded charts...

Job Description Job Description Description: Job Title: Certified Medical Coder/Biller Location: Richmond Hill, GA | Hybrid Remote Employment Type: Full-time Reports to: Billing Manager Department: Revenue Cycle Management Job Summary: The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: 1. Claims Processing: · Prepare and submit accurate and timely insurance claims for services rendered. · Verify patient insurance coverage...

Overview Be inspired . Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Description Primary function: Reporting to the Manager, Compliance Audit and Analysis, develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk...

Overview Become a part of our caring community and help us put health first Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Durable Medical Equipment (DME) auditing and is part of the PPI Coding Disputes Team with Humana. The Disputes Auditor – DME Outpatient Coding on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Responsibilities Will be an experienced medical coding auditor with in-depth experience in outpatient DME coding disputes...

Job Title: Certified Medical Coder/Biller Location: Richmond Hill, GA | Hybrid Remote Employment Type: Full-time Reports to: Billing Manager Department: Revenue Cycle Management Job Summary: The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: 1. Claims Processing: • Prepare and submit accurate and timely insurance claims for services rendered. • Verify patient insurance coverage and ensure correct billing to the appropriate...

Lifeguard Pediatrics – Warner Robins, GA About Us Lifeguard Pediatrics is a trusted, physician-owned pediatric clinic serving families across Middle Georgia. We are dedicated to providing comprehensive, compassionate, and community-centered care. With a growing need for developmental and behavioral health services in our region, we are expanding our care team to include in-house autism diagnostic services. Position and Responsibilities The biller and coder is responsible for the accurate and timely submission of medical claims to insurance companies and other payors. The medical biller posts payments or adjudications as appropriate. Using knowledge of billing practices and standards including third party payor requirements, the medical biller will investigate denials to process appeals and collect payment. In addition, this position is responsible for reviewing coding for outpatient services for reimbursement and research compliance. Medical Billing: Performs claim...

This is a remote based position. Applicants can be located nationwide Back Outpatient Coding Auditor #2675 United States Apply X Facebook LinkedIn Email Copy Position Description About You You are a person who is passionate about performing quality reviews and audits of the assigned staff. We need someone who ensures standards are met in accordance with department and organization policy. In the role of Outpatient Coding Auditor, you will demonstrate skills in organization, prioritization, professionalism and coaching others. Tell us about your experience with Outpatient Coding Auditing. Are you a team player and a self-motivator? We are counting on you to manage multiple projects using your problem-solving skills. We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you. About The Position Advanced knowledge...

Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be...

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 upon 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...