42 cpc certified professional coder jobs found

Virtua Health Coding Specialist Codes and abstracts hospital medical records (including Inpatients, Observation, Outpatient Surgery, Invasive Outpatients, and Emergency Department) for diagnostic and procedural coding. Utilizes federal, state procedures/guidelines to assure accuracy of coding and abstracting and productivity standards. Collaborates with medical staff and clinical documentation improvement (CDI) staff to clarify documentation. Maintains performance in accordance with corporate compliance requirements as it pertains to the coding and abstracting of medical records, as well as Diagnosis Related Group (DRG) assignment. Accurately reviews each record and knowledgeably utilizes ICD-10-CM, ICD-10-PCS, CPT-4, and encoder to accurately code all significant diagnoses and procedures according to American Hospital Association (AHA), American Health Information Management Association (AHIMA), Uniform Hospital Discharge Data Set (UHDDS) hospital specific guidelines and...

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...

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

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...

Inpatient Coder Opportunity 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...

Senior Inpatient HIM Coder We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts. Requirements and Qualifications: A minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment. Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. In-depth understanding of supporting evidence requirements for accurate coding. Practical experience using grouper software for MS-DRG and APR-DRG assignment. Strong communication skills to interact effectively with the billing department...

Job Title Duties and Responsibilities: Reviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse. Creates appropriate letters to substantiate the validity of claims. Meets with facility liaison to review documentation, resolve coding, and tagging files for follow-up. Investigates and problem-solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with facility liaison or other clinical staff as needed to provide documentation feedback and to develop appeals. Researches payer policies and processes. Reviews clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment. Works assigned work queues and tasks and reviews remittance advice for rejections and accuracy of payment amounts as...

Inpatient Medical DRG Coder Hospital (Remote) A DRG coder is a medical coding professional who specializes in assigning Diagnosis-Related Group (DRG) codes for inpatient hospital stays. DRG (Diagnosis-Related Group): It's a classification system used primarily for inpatient hospital billing. It groups patients with similar clinical conditions and resource usage into categories. Hospitals are reimbursed based on these DRG codes rather than individual services. Responsibilities Review clinical documentation to assign accurate ICD-10-CM and ICD-10-PCS codes. Communicate with physicians to clarify diagnoses and procedures through the query process. Utilize electronic encoder applications to assign codes in compliance with practice policies and regulatory guidelines. Maintain a minimum accuracy rate of 98% while meeting internal productivity standards. Achieve productivity expectations: Inpatient 1624 encounters per day or 23 encounters per hour. Complete reports and perform...

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...

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...

We Are More Than A Health System We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more in our careers and in our communities. Job Description Summary: This position performs facility coding and abstracting functions of Inpatient. Responsibilities And Duties: 1. 60% Assigns appropriate admit, principal and secondary diagnoses and/or procedure codes by reading documentation present in medical record and applying knowledge of correct coding guidelines as appropriate for hospital service and/or patient type while maintaining 95% quality and meeting and maintaining the minimum Coder productivity requirements. Assign Present on Admission PO indicators to all inpatient account diagnoses as required by official coding guidelines. Accurately Assign DRG/MSDRG/APR-DRG at the...

Pro-Fee Hospital Multispecialty E/M & Surgery Coder (FT) GeBBS Healthcare Solutions, an industry leader in Health Information Management and Revenue Cycle Management solutions, is seeking highly motivated individuals with a passion for excellence for careers in the healthcare industry. Here is your opportunity to be part of this exciting team! GeBBS is looking for a Professional Fee Hospital Coder with multi-specialty E/M and Surgery coding experience on a full time basis. Responsibilities This position will provide accurate coding (EM, Surgery, CPT, diagnoses) and resolve coding related edits for hospital inpatient and outpatient professional services. Coders will be required to use ICD-10-CM, CPT, Modifiers and HCPCS Level II codes. Coding will be in the following settings: Hospital Emergency Departments Hospital Observations Hospital Outpatient and Medical Office Hospital Inpatient Multispecialty experience including: OB, Cardio, Urology, Neurology, GI,...

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...

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...

Medical Coding Coordinator Become a part of our caring community and help us put health first. Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you come in, the Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures,...

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...

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...

Coder Analyst Specialist, Clinical Document Integrity Part Time, 59 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives....

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....

Position Summary Assign diagnosis and procedure codes using the appropriate coding classification system on all episodes of care inpatient encounters according to coding conventions, guidelines, and hospital policy, analyzing questionable documentation to ensure the accuracy of the information and resolve identified issues. Ensure the accurate selection of the principal diagnosis, principal procedure, and all applicable diagnoses and procedures. Ensure compliance with official guidelines (ICD-10-CM, ICD-10-PCS, and/or AHA Coding Clinic), AHIMA Standards of Ethical Coding, and LifePoint Health Support Center (HSC) policies and procedures. Position Duties Achieve and maintain 95% accuracy on quality reviews and assigned productivity standards. Maintain knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the coding area. Follow coding workflows for service type to include addressing compliance reviews. Submit physician queries when...

Scheduled Hours 40 Position Summary Reviews medical record documentation to determine appropriate billing codes and necessary documentation. Job Description Primary Duties & Responsibilities: Reviews the documentation in the record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patients conditions and treatment. Codes evaluation and management to appropriate CPT code and codes diagnosis to appropriate ICD-10 code. Meets with physicians to review documentation, resolve coding and secure signature of all unsigned dates of service, tagging files for follow up. Acts as lead person and assists coders with IBC staff with medical terminology and policy interpretation as required. Assists with efforts to increase physician awareness of documentation requirements. Prepares case reports and initiates follow-up for billing process. Performs other duties as assigned. Working Conditions: Job...