15 compliance coder jobs found

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT 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-10 CM/CPT 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-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

Allied Health Professional Total Rewards of an Allied Health Professional Duties include but are not limited to the following: Basic Functions: Applies comprehensive knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services and the organizational structure to ensure proper code selection. Selects and assigns codes from the current version of several coding systems to include current versions of the International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS). Adheres to accepted coding practices, guidelines and conventions when choosing the most appropriate diagnosis, operation, procedure, ancillary, or Evaluation and Management code to ensure ethical, accurate, and complete coding. Monitors ever-changing regulatory and policy requirements affecting...

Pay Range: $47.69 - $67.19 Ensure SEARHC meets federal and state regulations and internal policies in regard to healthcare coding, documentation, and billing practices. Review health records to verify coding and clinical documentation meets applicable coding and billing requirements, Medicare/Medicaid regulations, federal and state laws, and SEARHC policy. SEARHC is a non-profit health consortium which serves the health interests of the residents of Southeast Alaska. We see our employees as our strongest assets. It is our priority to further their development and our organization by aiding in their professional advancement. Working at SEARHC is more than a job, it’s a fulfilling career. We offer generous benefits, including retirement, paid time off, paid parental leave, health insurance, dental, and vision benefits, life insurance and long and short-term disability, and more. Key Essential Functions and Accountabilities of the Job Conduct Audits: Review health record...

USA Government Jobs - 1201 North Muldoon Road - Responsibilities: Code outpatient encounters using ICD-10-CM, CPT, and HCPCS per guidelines; Review electronic health records to abstract and ensure complete data capture; Ensure provider documentation supports diagnoses and procedures, and resolve coding discrepancies; Maintain compliance with regulatory guidelines and VA CMS/JCAHO requirements; Collaborate with clinical staff to clarify documentation and improve data quality

Datavant is looking for an experienced outpatient coder to join their team. This role is fully remote and ideal for detail-oriented individuals with expertise in medical coding. Responsibilities include reviewing medical records, assigning codes, and ensuring compliance with coding standards. A minimum of 3 years of experience and relevant certifications are required. Datavant offers benefits including medical insurance, paid time off, and continued education opportunities. #J-18808-Ljbffr

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

ALASKA HEART INSTITUTE is seeking a Certified Billing Specialist to join their Business Office team in Anchorage. The role focuses on accuracy and compliance in cardiology billing for outpatient, inpatient, and ambulatory settings. Ideal candidates will have at least two years of experience in medical billing, along with a CPB or CPC certification. This full-time position offers a $3,000 sign-on bonus with a two-year commitment and a pay range of $23-33 per hour based on experience. #J-18808-Ljbffr

Job Details Job Location: Anchorage - ANCHORAGE, AK 99508 Position Type: Full Time Job Category: Admin - Clerical Job Title: Certified Billing Specialist Department: Business Office Location: Anchorage, AK Status: Full-Time, On-Site Certification Required: Active Professional Biller (CPB) or Certified Coder (CPC) Sign on bonus: $3,000 (2yr commitment) Pay range: $23-33/HR dependent upon experience and education Supervision received: Reports to Business Office Manager Supervision exercised: None About the Role Alaska Heart & Vascular Institute (AHVI) is seeking an experienced and detail-oriented Billing Specialist to join our in-office Business Office team in Anchorage. This role is ideal for a billing professional who thrives in a collaborative environment and is looking to deepen their expertise in cardiology billing across outpatient, inpatient, and ambulatory settings. As part of a highly knowledgeable team of coders, billers, and clinical professionals, you’ll play a key...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

About Us 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. Benefits 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: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

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...

Laboratory Technician Perform in all areas involved in pre-analytic, analytic, and post-analytic testing. Maintain the policies and procedures as technical supervisor in assigned areas of the laboratory to ensure that all regulatory requirements are maintained. Perform routine clinical tests, collect blood samples, prepare media, report results. Uphold the organization's vision, mission, and corporate values. Demonstrate understanding of and compliance with organization's policies, procedures, code of conduct and work rules. Ensure absolute patient identification and match with required test; perform specimen collection, ensuring high customer service and strict attention to accuracy, integrity, and quality. Supervise phlebotomist daily performance. Prepare samples outsourced to another laboratory, i.e. Quest send-outs. In charge of laboratory safety compliance. Follow established QC program within parameters for acceptable levels of performance, ensuring that these levels are...

Description Providence is calling for Compliance Auditor - Remote The Revenue Cycle Compliance Hospital Auditor conducts audits to evaluate compliance with a wide variety of Federal and State laws, regulatory rules & regulations, PSJH policies and procedures. Areas of audit focus for this position may involve clinical and non-clinical services, including but not limited to revenue cycle: Rev Cycle departments, Rev Cycle Billing Offices, External Vendor; HIM Coding, Revenue Integrity RI, Chargemaster CDM, EPIC, and Clinical Documentation CDT. This position works collaboratively with Case Management, Utilization Review, Revenue Integrity, our PB Professional Revenue Cycle Compliance Team, Clinical Risk, Internal Legal Affairs and Finance under the supervision of the Rev Cycle Compliance Senior Manager. The Revenue Cycle Compliance Hospital auditor navigates and analyzes data across both the Clinical EMR and Epic Billing systems. This includes reviewing...

TITLE :Medical Billing Specialist on site in Kenai AlaskaREPORTS TO :CFOWORK WEEK :Hours not to exceed 40 per weekWAGE CLASSIFICATION :Non-exempt $21.00 per hourOSHA RISK CLASSIFICATION :LowSUMMARY POSITION STATEMENTThis position exists to ensure the financial well-being of the PCHS organization through timely and accurate filing of insurance claims and collection of patient accounts and ensure proper posting of payments into existing PCHS systems for medical dental optometry and / or behavioral health.This position may be responsible for any or all the essential functions listed below in the electronic health record systems.ESSENTIAL FUNCTIONS / ROLES & RESPONSIBILITIES OF THE POSITIONCollaborate with staff providers team members patients and insurance companies to get all claims processed and paid.Capable of performing all aspects of medical billing independently including but not limited to charge entry posting insurance payments rejections and follow-up.Assign correct...