54 creative coder jobs found

Associate Director - Medical Science Liaison - Gastroenterology (Dallas TX) Join to apply for the Associate Director - Medical Science Liaison - Gastroenterology (Dallas TX) role at BioSpace Associate Director - Medical Science Liaison - Gastroenterology (Dallas TX) 1 day ago Be among the first 25 applicants Join to apply for the Associate Director - Medical Science Liaison - Gastroenterology (Dallas TX) role at BioSpace At Lilly, we unite caring with discovery to make life better for people around the world. We are a global healthcare leader headquartered in Indianapolis, Indiana. Our employees around the world work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to our communities through philanthropy and volunteerism. We give our best effort to our work, and we put people first. We’re looking for people who are determined to make life better for people around the world. Organization...

Under general supervision of the Director, the Coder II provides consistency and efficiency in outpatient claims processing and data collection to optimize APC reimbursement and facilitate data quality in outpatient services. Reviews, audits, and reports on charge capture. Maintains patient confidentiality at all times. ESSENTIAL JOB FUNCTIONS Every effort has been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the incumbent will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or is a logical assignment to the position. Analyzes IP, OP, Recurring, & SDC records and appropriately codes per coding guidelines, ICD-10-CM and CPT rules and updates, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous,...

Overview The Area Supervisor is responsible for managing the daily scheduling of the ROI Specialists at specified client sites. The Area Supervisor will act as the liaison between MRO and Client Management staff to ensure that all ROI activities are compliant with established client policies, federal and state regulations and are completed in a timely manner. Responsibilities Manages workflow among on-site employees at multiple client sites to ensure maximum productivity and quality standards are met. Adjusts work assignments as needed to cover peak periods, leave and vacancies at the staffed hospital sites. Provides coverage in event of backlogs, illness, vacation or leave of absence of ROI Specialists. Performs Quality Assurance monitoring of work performance for the ROI Specialists. In conjunction with and under the direction of the Area Manager, conducts productivity and work performance reviews for ROI Specialist in accordance with MRO/customer policies and procedures and...

Coder I, Coding DHR Health - US:TX:McAllen - Days Summary: Position Summary: Review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM codes for billing, internal and external reporting, research, and regulatory compliance. Accurately code outpatient conditions and procedures as documented in the ICD-10-CM Official Guidelines for Coding and Reporting. Resolve error reports associated with billing process, identify and report error patterns, and, when necessary, assist in design and implementation of workflow changes to reduce billing errors. Assigns codes for diagnoses, treatments, and procedures according to the appropriate classification system for outpatient encounters. Reviews appropriate provider documentation to determine principal diagnosis, co-morbidities and complications, secondary conditions and surgical procedures. Utilizes technical coding principals and APC reimbursement expertise to assign appropriate...

Join Our Caring CommunityHumana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands.As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices.This is a hybrid position that requires occasional travel within the assigned market.ResponsibilitiesDeliver coding and documentation education to providers and clinic staff within IPA clinics.Be a consultative resource and ongoing support for providers in assigned clinics.Conduct documentation audits to identify gaps, trends, and opportunities for improvement.Perform quarterly chart reviews to support coding accuracy and...

Multispecialty Coder The Multispecialty Coder will code for multispecialty surgery physicians primarily single path coding. Multi-specialty surgical coding experience, any trauma, urology, ENT, plastics, genSurg, OB/GYN, cardiovascular, interventional radiology, etc. Ability to extract data and apply appropriate ICD-10 diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding managerthe coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM official guidelines for coding and reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer...

At Houston Methodist, the Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION Associate’s degree or higher in a CAHIIM accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree EXPERIENCE One year of relevant inpatient coding experience or successful completion of the Houston Methodist Coding Apprentice Program or Outpatient to Inpatient Coder Transition Program LICENSES AND CERTIFICATIONS Required Must have one of the following:• RHIT - Certified Health Information Technician (AHIMA)• RHIA - Registered Health Information Administrator (AHIMA)• CCS - Certified Coding Specialist (AHIMA)...

Overview The Revenue Cycle Medical Billing Specialist is responsible for the overall account resolution of patient accounts within the revenue cycle management (RCM) process. Ensures timely billing of claims to payers and follow up of denials, appeals, recoupments and balance management. Ability to audit and provide feedback on the billing process and outcomes. Works cooperatively with other departments to ensure timely billing, reporting and patient account management. Supports the organization’s strategic plan and workplace inclusion initiatives. Abides by the organization’s mission in performing job duties. Demonstrates an understanding and commitment to PPGT’s culture of quality, safety and risk awareness. Responsibilities Reviews submission of claims by third party billing team to the clearinghouse to ensure accuracy. Processes reimbursements and payment adjustments with attention to detail, timeliness, and accuracy. Makes corrections and prepares appeals related to claim...

Job Description Job Description Position Summary The Certified Medical Coder reviews clinical documentation and assigns medical codes in accordance with established guidelines, documentation standards, and organizational procedures. This individual contributor role supports compliant billing, accurate revenue cycle outcomes, and timely resolution of documentation issues through appropriate escalation. Qualifications Required Active professional coding certification (e.g., CPC, CCS, equivalent) Working knowledge of medical coding guidelines and documentation standards Preferred Prior experience in medical coding or revenue cycle operations Familiarity with EHR and coding systems Key Responsibilities and Expected Performance Outcomes Key Responsibilities Review assigned encounters and clinical documentation each day to support complete, accurate coding. Assign medical codes in accordance with current coding guidelines, documentation standards, and...

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement. This position may offer the opportunity to work from home, depending on experience and performance. Key Responsibilities: Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations. Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses. Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements. Review and verify accuracy of billing data within...

Overview The Area Supervisor is responsible for managing the daily scheduling of the ROI Specialists at specified client sites. The Area Supervisor will act as the liaison between MRO and Client Management staff to ensure that all ROI activities are compliant with established client policies, federal and state regulations and are completed in a timely manner. Responsibilities Manages workflow among on-site employees at multiple client sites to ensure maximum productivity and quality standards are met. Adjusts work assignments as needed to cover peak periods, leave and vacancies at the staffed hospital sites. Provides coverage in event of backlogs, illness, vacation or leave of absence of ROI Specialists. Performs Quality Assurance monitoring of work performance for the ROI Specialists. In conjunction with and under the direction of the Area Manager, conducts productivity and work performance reviews for ROI Specialist in accordance with MRO/customer policies and procedures and...

Coder II Under general supervision of the Director, the Coder II provides consistency and efficiency in outpatient claims processing and data collection to optimize APC reimbursement and facilitate data quality in outpatient services. Reviews, audits, and reports on charge capture. Maintains patient confidentiality at all times. Every effort has been made to make this job description as complete as possible. However, it in no way states or implies that these are the only duties the incumbent will be required to perform. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or is a logical assignment to the position. Analyzes IP, OP, Recurring, & SDC records and appropriately codes per coding guidelines, ICD-10-CM and CPT rules and updates, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear...

Join Our Caring Community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support coding accuracy...

Medical Dental Coder Harlingen Annex - Harlingen, TX 78550 Description This position is vital in the health care delivery system in function with the fiscal aspect of the Clinic. Adhere to policies and procedures in conducting all clinical charges, payments, adjustments for proper billing and collections. Bills and submits claims to insurances/programs through AthenaOne EMR, follows up on claims statuses, resolves claim denials, submits appeals, post payments and adjustments, and manages collections. Great customer service and telephone etiquette, computer knowledge, professional appearance, attention to detail, able to multitask and work in a fast paced environment. Ability to work well under stress and maintain calm under pressure and work well with team members and willingness to cross-train. Functions as a member of a collaborative health care team to create and maintain a patient centered medical home. Essential Job Functions Communication: Communicates with outside...

Coder II, Coding US:TX:McAllen | Health Information Management | Full Time This is a mid-level, work from work position. Coder is responsible for: Analyzing provider documentation Assign and sequence ICD-10-CM, CPT/HCPCS appropriately Append billing modifiers when appropriate Reconcile CPT(s) Resolves billing edits according to 3M Code editor Participates in educational activities and attends staff meetings. Position Education/Qualifications: Coding credential from an accredited coding organization required Credentials from AHIMA, AAPC preferred Extensive knowledge of medical terminology Knowledge of Coding Guidelines Knowledge of CPT rules and regulations Knowledge of NCCI policies Highly reliable Must be a team player with good people skills and possess strong initiative to get daily work finished and processed Maintain productivity levels Job Knowledge/Experience: Extensive experience in medical coding, medical terminology, and anatomy and physiology...

Job Family: General Coding Travel Required: None Clearance Required: None What You Will Do: The Neurosurgery Medical Coder must be proficient in surgical coding for all Neurology Surgery type cases. E/M experience is also required for associated providers. The coder will review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM Official Guidelines for Coding and Reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and...

Medical Coder Revenue Cycle Management is looking for a full-time Medical Coder to join our team. Remote opportunity after in-person training. The Medical Coder is responsible for reviewing medical documentation and accurately assigning CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS codes depending on the encounter type. The position ensures accurate billing, compliance, and optimized reimbursement across outpatient and/or facility (inpatient) settings. Essential Functions: Assign accurate diagnosis and procedure codes based on medical record documentation using CPT, ICD-10-CM, HCPCS, and/or ICD-10-PCS. Review provider documentation to ensure coding is supported and complete for billing submission. Apply proper modifiers, sequencing, and coding conventions appropriate to the setting (inpatient or outpatient). Ensure compliance with coding regulations, organizational policies, and HIPAA standards. Meet coding productivity and quality benchmarks. Collaborate with clinical,...

Fully Remote Lake Park Building Full time R180631 Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ’s and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately...

Coder II, CodingUS:TX:McAllen | Health Information Management | Full TimeThis is a mid-level, work from work position. Coder is responsible for:Analyzing provider documentationAssign and sequence ICD-10-CM, CPT®/HCPCS appropriatelyAppend billing modifiers when appropriateReconcile CPT(s)Resolves billing edits according to 3M Code editorParticipates in educational activities and attends staff meetings.Position Education/Qualifications:Coding credential from an accredited coding organization requiredCredentials from AHIMA, AAPC preferredExtensive knowledge of medical terminologyKnowledge of Coding GuidelinesKnowledge of CPT rules and regulationsKnowledge of NCCI policiesHighly reliableMust be a team player with good people skills and possess strong initiative to get daily work finished and processedMaintain productivity levelsJob Knowledge/Experience:Extensive experience in medical coding, medical terminology, and anatomy and physiology required; 3 year of coding experience...

Responsibilities POSITION SUMMARY: Performs the functions of all services of IP coding. Responsible and accountable for coding and DRG accuracy, timeliness of coding, and utilization of systems used to perform coding functions. Maintains relationship with Coding Manager/Supervisor, CDI team, Business Office and Case Management staff. Performs primary function of coding inpatient records, to include DRG assignment and validation. Maintains knowledge of outpatient coding and other areas to assist as needed. Utilizes the 3M Encoder to code and classify accurately all medical records according to ICD-10-CM/PCS. Responsible and accountable for maintaining performance skills. Qualifications QUALIFICATIONS: 1. Three to Five years coding experience required (Inpatient preferred) 2. Advanced training in medical coding (ICD10-CM/PCS, CPT and APC). 3. Medical terminology, anatomy and physiology required. 4. Computer skills. 5. Ability to read medical reports, interpret lab values pertinent...

Multispecialty CoderThe Multispecialty Coder will code for multispecialty surgery physicians primarily single path coding. Multi-specialty surgical coding experience, any trauma, urology, ENT, plastics, genSurg, OB/GYN, cardiovascular, interventional radiology, etc. Ability to extract data and apply appropriate ICD-10 diagnosis codes, along with CPT/HCPCS codes as defined for the service type, for coding, billing, internal and external reporting, research as required, and regulatory compliance. Under the direction of the coding manager—the coder should accurately code conditions and procedures as documented and in accordance with ICD-10-CM official guidelines for coding and reporting, CMS/MAC rules and the CPT rules established by the AMA, and any other official coding guidelines established for use with mandated standard code sets. The coder scope may involve reviewing coding related denials from payers and recommending the appropriate action to resolve the claim based on payer...

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement. This position may offer the opportunity to work from home, depending on experience and performance. Key Responsibilities: Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations. Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses. Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements. Review and verify accuracy of billing data within...

Position Description The Documentation and Coding Auditor supports the billing compliance program by helping prevent, detect, and respond to billing, coding, reimbursement, and documentation risks. This role conducts proactive monitoring, auditing, education and risk assessment activities while also responding to identified concerns, audit findings, regulatory changes, and reported compliance issues. Major/Essential Functions Plan and perform proactive compliance activities, including risk-based audits, pre-bill or concurrent reviews, data monitoring, targeted education, policy or template reviews, and department consultations. Identify and address billing compliance risks before issues escalate by using audit trends, payer updates, denial patterns, regulatory changes, stakeholder feedback, and risk assessment results. Partner with departments before new services, workflows, locations, provider groups, or documentation tools are implemented to assess and reduce...

Medical Dental CoderHarlingen Annex - Harlingen, TX 78550DescriptionThis position is vital in the health care delivery system in function with the fiscal aspect of the Clinic. Adhere to policies and procedures in conducting all clinical charges, payments, adjustments for proper billing and collections. Bills and submits claims to insurances/programs through AthenaOne EMR, follows up on claims statuses, resolves claim denials, submits appeals, post payments and adjustments, and manages collections. Great customer service and telephone etiquette, computer knowledge, professional appearance, attention to detail, able to multitask and work in a fast paced environment. Ability to work well under stress and maintain calm under pressure and work well with team members and willingness to cross-train. Functions as a member of a collaborative health care team to create and maintain a patient centered medical home.Essential Job FunctionsCommunication: Communicates with outside providers...