28 credentialed coder jobs found

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. What We're Looking For We're looking for experienced and credentialed inpatient 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...

Description Codes outpatient charts and/or professional charts and abstracts all required data from records according to established procedures; including medical necessity for Medicare charts. Uses ICD-10 CM/PCS/CPT-4/chargemaster to code all diagnoses, operative procedures and physician procedures performed for outpatient procedures. Verifies/changes levels of care provided according to level of care guidelines. Captures all missing records and documentation, i.e. IV start/stop times, etc. Interacts with physicians and physician's offices regarding diagnoses or coding questions. Performs other work as needed to help within the department. Keeps current with coding practices and skills through in-services, seminars, workshops and current literature to increase coding knowledge. Reviews the entire medical record for identification of all documented conditions, diagnoses and procedures. Demonstrates the ability to read physicians handwriting and interpret...

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...

Certified Coder - Billing Onsite - Royal Oak, MI About Sciometrix Sciometrix is a leading digital Health company looking for RN Case Manager Spanish. We are a leader in Telehealth -healthcare Virtual care Management. Our mission to engage patients to Deliver better outcomes. Sciometrix is known among customers, peers, and patients for clinical excellence, patient experiences, and provider satisfaction. Since the inception of our patient count, technological solutions have been evolving. We empower healthcare providers with advanced technology and human expertise, revolutionizing a patient's experience. Our propriety software and related technologies ensure HIPAA compliancy with cloud access. We have established HIPAA-compliant Clinicus, an artificial intelligence (AI) bot that monitors patients 24/7 and ensures fast response in their care management program. Clinicas watches each patient's vitals and alerts our licensed team when a patient's program progress or vitals are...

Overview The Professional Coder provides timely and accurate clinical and administrative data to ensure optimal reimbursement for professional services performed at acute care, inpatient, outpatient, urgent care, or physician offices to meet organizational needs. This position is responsible for ICD10CM diagnosis, CPT‑4 coding, and charge entry related to coding, documentation, billing, and reimbursement issues. Works as a liaison between centralized billing staff, practice managers, and office staff and may be required to meet with office staff and physicians as needed. This position monitors the quality of coding and stays current on professional coding changes, compliance issues, billing, documentation, reimbursement, and interpretation of coding/documentation rules. Primary patient contact is only social. He/she demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision,...

Job Description Entry-Level Medical Coder / Billing Assistant We are seeking a motivated Entry-Level Medical Coder / Billing Assistant to join our administrative team. This role is an excellent entry point into the healthcare field for individuals interested in medical billing and coding , with plenty of room to grow your skills and career. After a successful training period, a hybrid work schedule may be available. Key Responsibilities Accurately code medical procedures and diagnoses for billing and insurance claims Prepare and submit claims to insurance companies and/or patients Enter, update, and maintain patient and billing data in practice management/EMR systems Track outstanding claims and follow up on unpaid or denied accounts Communicate with patients regarding balances, payment options, and payment plans Maintain strict confidentiality and comply with HIPAA and all applicable healthcare regulations Qualifications High school diploma...

Risk Adjustment Coder McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Risk Adjustment Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Position Overview: The...

Coding Specialist Assigns ICD diagnosis and CPT procedure codes to assigned Outpatient work types. Employment Type: Full Time Weekly Scheduled Hours: Mon-Fri 7am-3:30pm Wage Range: $21.14-$31.70 Requirements: - High school diploma/GED, or higher education - Registered Health Info Tech (R-RHIT) required Preferred Requirements: - Registered Health Info Admin (R-RHIA) - Certified Coding Specialist (C-CCS) Coding: Based on clinical documentation, computerized encoding, accepted coding classification principals, and reference material, efficiently and accurately assigns appropriate ICD diagnosis codes CPT procedure codes and modifiers on assigned chart types. Verifies accuracy of completed fields. Maintains credentials and ongoing education in order to apply current policies and principals for accurate coding. Assigns appropriate ICD codes. Assigns appropriate CPT codes. Assigns appropriate Modifiers on APC accounts. Searches chart documentation for appropriate code...

Business (Non-Clinical) As an integral member of the HAP Medical Policy Team, the Project Coordinator will be responsible for research and guidance on coding such as CPT, HCPCS, ICD used in the development and maintenance of Benefit Administration Manual policies and HAP's coverage tool (Master Tiering Database) as well as actively participate in various HAP code-related committees and ad hoc projects. Principal Duties and Responsibilities: Conduct research for development and update of codes for Benefit Administration Manual policies and the Master Tiering Database, requests by the Utilization Management Committee and HAP code-related committees, and other issues such as new technology. Maintain organized documentation of findings from research as well as proposed resolutions. Research all types of codes (e.g., CPT, HCPCS, ICD) including new codes, existing codes, additions and deletions of codes, use of modifiers, and revenue codes to be compliant with Medicare rules and...

Job Description Job Description Description: CPC-As are not being considered at this time. We're coding rebels with a cause. KODE is a health-tech company developed by medical coders for medical coders looking to change the way things are done in the industry. Our company may be young but we're growing rapidly. That also means we're not buried in outdated policies and bureaucracies.Coders play a critical role in healthcare, but have you ever felt like you're just a cog in the machine? At KODE there are no cogs, there are people. We aren't looking for a coder to fill an open position simply. We're looking for a new teammate passionate about professional coding who wants to join our collective mission to be awesome.We're serious about two things: coding and treating you like the professional you are. If this intrigues you, please keep reading. About this Role We're looking for a Facility Inpatient Coder to join our company! Responsibilities: Review medical records...

Professional Surgical Coder Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD-10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders in new specialties. Remote Position Summary: Responsible for charge capture process...

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Risk Adjustment Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at...

Overview The Health Information Management Coder Inpatient Level 2 provides timely and accurate clinical and administration data to ensure optimal reimbursement for inpatient, rehab and/or skilled nursing coding to support the facility needs. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adheres to current coding rules, regulations and requirements for inpatient coding, DRG/APR-DRG assignment, rehab coding, skilled care coding, CMG assignment,...

Overview The Professional Coder provides timely and accurate clinical and administration data to ensure optimal reimbursement for professional services performed at acute care, inpatient, outpatient, urgent care or physician offices to meet organizational needs. This position is responsible for ICD10CM diagnosis, CPT-4 coding and charge entry related to coding, documentation, billing and reimbursement issues. Works as a liaison between centralized billing staff, practice managers and office staff and may be required to meet with the office staff and physicians as needed. This position is responsible for the monitoring the quality of coding and stays current on professional coding changes, compliance issues, billing, documentation, reimbursement and interpretation of coding/documentation rules. Primary patient contact is only social. He/she demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards...

Employment Type: Full time Shift: Day Shift Description: Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD-10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/ clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders in new specialties. Position Summary:...

Certified Medical Biller/Coder & Revenue Cycle Manager Submissions from recruiters, staffing agencies, or third-party contractors will not be considered. Overview: Focus Clinic is seeking a full-time Certified Medical Biller/Coder & Credentialing Specialist who is organized, proactive, and mission-driven. This is an in-person role in Wyoming, MI, working Monday-Thursday (32 hours/week). You will serve as the comprehensive revenue cycle manager for a rapidly growing clinic, with duties including coding, billing, patient balance follow-up, and compassionate financial guidance for families. The ideal candidate can confidently manage both insurance-billed and cash-pay services, streamline front-desk processes, and help families understand their out-of-pocket expenses with warmth and clarity. Key Responsibilities: Medical Coding Accurately code services using CPT/ICD-10 (and modifiers as appropriate) across Focus Clinic's multidisciplinary offerings (medical...

GENERAL SUMMARY: As an integral member of the HAP Medical Policy Team, the Project Coordinator will be responsible for research and guidance on coding such as CPT, HCPCS, ICD used in the development and maintenance of Benefit Administration Manual policies and HAP’s coverage tool (Master Tiering Database) as well as actively participate in various HAP code-related committees and ad hoc projects. PRINCIPLE DUTIES AND RESPONSIBILITIES: Conduct research for development and update of codes for Benefit Administration Manual policies and the Master Tiering Database, requests by the Utilization Management Committee and HAP code-related committees, and other issues such as new technology. Maintain organized documentation of findings from research as well as proposed resolutions. Research all types of codes (e.g., CPT, HCPCS, ICD) including new codes, existing codes, additions and deletions of codes, use of modifiers, and revenue codes to be compliant with Medicare rules and...

Certified Home Health Coder & QA Specialist Become a part of the Hope At Home Family! We currently have a position available for a Certified Home Health Coder & QA Specialist. Position Summary: Certified Home Health Coder & QA Specialist is required to have PDGM, Oasis D1 experience, and Kinnser software knowledge. Home Health Coder is responsible for coding using ICD-10 all diagnoses and applicable procedures of skilled service visits. The position is also responsible for reviewing OASIS and abstracting visit data for billing and data collection purposes. Responsibilities: Codes records using ICD-10-CM and coding guidelines. Reviews OASIS. Observes and reports unusual patterns in data collection and/or lack of adequate documentation for code assignments. Review documentation and provide ICD-10 coding recommendations based on current coding and Oasis guidelines. Performs other related duties as requested by the Home Health Supervision. Must be...

Coder - Hospital Inpatient Services - Revenue Cycle Mid Service Days - 40hrs/wk (remote) Requisition #:req11231 Shift:Days FTE status:1 On-call:No Weekends:No General Summary:The Coder for Hospital Services, under the direction of the HIM Director, is responsible to accurately and completely code inpatient and outpatient conditions and procedures by reviewing clinical documentation and diagnostic results, as appropriate, to extract data for billing, internal and external reporting, research and regulatory compliance as documented in the ICD-9-CM and/or ICD-10-CM Official Guidelines for Coding and Reporting.Requirements:RHIT, RHIA, CCS, CCS-P, CPC or other professional HIM coding certificate.Coding software and basic computer software experience.Effective communication and listening skills.Ability to contribute to team efforts.Essential Functions and Responsibilities:Code all diagnoses, treatments, and procedures by translating physician and nursing documentation according to the...

Employment Opportunities Provides high level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments. Essential Functions: Knows, understands, incorporates, and demonstrates the Trinity...

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...

ASSOCIATE DIRECTOR Ross Education Holdings, Inc. Warren, MI - Campus based position Schedule: Full Time - Monday-Friday (3) days 8-5 and (2) afternoons 11-8 We are looking for a Medical Assistant with 3+ years of MA experience, an Associate's Degree or higher, and preferably some management experience to take your career to the next level. Apply with confidence knowing a human will read your resume. Come find your "WHY" at Ross Education! Ross Educations non-profit secondary education centers are working to provide all students with the tools to become much needed health care professionals. Ross is more than a place to work - we're a community built on shared values. As part of our team, you'll be asked to embody and uphold the Core Values that guide everything we do: Be Humble, Be Kind, Be a Good Steward, Embrace Accountability, Lead Responsibly and Deliver an Exceptional Student Experience If these principles resonate with you and you're looking to...

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Risk Adjustment Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at...

A healthcare organization is seeking a Coder Senior Medical Records to provide technical support and coordinate daily workflow for the Inpatient Coding Staff. The ideal candidate will resolve coding issues and analyze patient records, assigning proper codes. Requirements include an Associate's degree in Medical Information Technology and 2+ years of coding experience. Preferred credentials include RHIA or CCS. This full-time position is based in Sterling Heights, MI offering a comprehensive benefits package. #J-18808-Ljbffr