35 denials coder jobs found

Outpatient/Professional Lead Coder BJC is hiring for an Outpatient/Professional Lead Coder. We are looking for previous coding experience in ancillary or ED. This role is responsible for being a mentor for the coders on the team. At least one of the following certifications is required for this position: RHIA, RHIT, CCS, CCS-P, CPC, COC, or CCA. Open remotely to the following states: Alabama Iowa North Carolina Wisconsin Arkansas Kansas Ohio Florida Kentucky Oklahoma Georgia Louisiana South Carolina Illinois Mississippi Tennessee Indiana Missouri Texas Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health...

Medical 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). Medical Coders are responsible for review and submission of 64 encounters per day or 8 per hour related to evaluation & management, procedures, testing, monitoring and hospital services daily. Must be comfortable with discussing coding and guidelines with providers in a collaborative and professional manner. This position will assist with work que evaluation and update of pending encounter status and service lines. Will work with leadership on projects for coding as needed to assist with workflows. Medical coding of...

Professional Medical Coder I (Remote Position, Must Reside in South Carolina) Coding Full Time AM Shift 8a-5p, Mon-Fri Sign-On Bonus: $5,000.00 Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #1 in the Columbia metro area by U.S. News & World Report, Lexington Medical Center is the only hospital named one of the Best Places to Work in South Carolina and the first hospital in the state to achieve Magnet with Distinction status for excellence in nursing care. The 607-bed teaching hospital anchors a health care network that includes six community medical centers and employs more than 8,700 health care professionals. The network includes a cardiovascular program recognized by the American College of Cardiology as South Carolina's first HeartCARE CenterTM and an accredited Cancer Center of Excellence affiliated with MUSC Hollings Cancer Center for research and...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education. Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation...

Job Description Job Description Description: This is a PRN (pro re nata/as needed) position. Hours are not guaranteed and will vary based on the needs of the organization. Scheduling is at the discretion of management and may change. PRN employees are not eligible for benefits unless required by applicable law. Why you’ll want to work at nimble! Interested in becoming a part of a dynamic Coding team? This is a great opportunity to join a well-established and market-leading brand serving a high-growth end market while gaining valuable experience working closely with Executive leadership. As an organization, we are in high-growth mode through acquisition with a laser focus on positive culture building! Who we are: nimble solutions is a leading provider of revenue cycle management solutions for ambulatory surgery centers (ASCs), surgical clinics, surgical hospitals, and anesthesia groups. Our tech-enabled solutions allow surgical organizations to streamline...

Additional Information About the Role BJC is hiring for a Outpatient/Professional Lead Coder. We are looking for previous coding experience in ancillary or ED. This role is responsible for being a mentor for the coders on the team. At least one of the following certifications is required for this position: RHIA, RHIT, CCS, CCS-P, CPC, COC, or CCA. Open remotely to the following states: Alabama Iowa North Carolina Wisconsin Arkansas Kansas Ohio Florida Kentucky Oklahoma Georgia Louisiana South Carolina Illinois Mississippi Tennessee Indiana Missouri Texas Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health...

Sr Certified Medical Coder RN page is loaded## Sr Certified Medical Coder RNlocations: Remote-NYtime type: Full timeposted on: Posted Todayjob requisition id: 1616514You 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...

Job Description About the Role: Join our innovative healthcare information management team as a Lead Inpatient Medical Coder. This pivotal position is essential in connecting clinical data with technology, driving the development of advanced AI solutions for medical coding and billing. You will leverage your expertise to significantly influence our product development initiatives. Requirements and Qualifications: At least 3 years of extensive experience in inpatient medical coding within a hospital setting. Expertise in accurately identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and their modifiers from patient records. Comprehensive knowledge of the evidence requirements for precise coding. Hands-on experience with grouper software for MS-DRG and APR-DRG assignment. Excellent communication skills for effective collaboration with the billing department on coding-related matters. Up-to-date with the latest ICD-10-CM,...

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. Datavants bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Become a part of our caring community and help us put health first The Inpatient 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy...

Inpatient Coder II BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their...

Patient Account Representative And Certified Coder Saint Luke's in Kansas City is seeking a patient account representative and certified coder to join our team. You will perform a variety of functions related to managing accounts, coding, and charge reviews. Shift details: Monday- Friday flexible hours. Responsibilities include: Perform billing and collections to manage accounts receivable for the SLHS Physician Enterprise Central Billing Office (CBO) Focus on charge review edits and provide coding support to the Physician Enterprise CBO Charge review Account follow-up and reconciliation Resolving issues with payers Identifying and reporting trends in billing or collections This position requires a certified professional coder certification. Why Saint Luke's? We believe in creating a collaborative environment, while looking for innovative ways to improve. We offer competitive salaries and benefits packages to all eligible employees: Medical health plans Tuition...

Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice. BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay....

The Opportunity The Opportunity: Review medical record documentation of lower acuity inpatients to assign appropriate ICD-10-CM, ICD-10-PCS, and DRG codes for billing, internal and external reporting, research, and regulatory compliance. Ability to determine first listed diagnosis, secondary diagnoses, and surgical procedures. Analyze documentation and abstract pertinent data. Must maintain minimum quality and productivity standards. Preferred Certifications for role include: RHIA, RHIT and/or CCS Responsibilities Code procedures and diagnoses for inpatient accounts Assign present on admission indicators to diagnoses Query clinical providers when appropriate Abstract pertinent data Meet quality standards Meet productivity standards Communicate with CDI team Telecommute The Shifts 40 hours per week 8:00 AM to 5:00 PM core hours Why Saint Luke's? Evening and Weekend Shift Differential Saint Luke's offers competitive salaries and benefits packages to all eligible employees....

Ceris Certified Coder I Ceris is seeking a certified coder. The Ceris certified coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role. Essential functions and responsibilities: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations to referring office Communicates claim status with referring office Reads and comprehends all medical reports Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Complies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program ("IIPP"), as well as, maintains HIPAA compliance Knowledge and skills: Ability to learn rapidly to develop knowledge and understanding of...

Ambulatory Surgery Center (ASC) Cardiology Coder MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent customer service. MedHQ, LLC, is a 2022 Becker's Top 150 Places to Work in Healthcare company. We believe our quality of service begins with our quality of team member. We offer exceptional benefits and working environments to exceptional employees. Position Summary The Ambulatory Surgery Center (ASC) Cardiology Coder is responsible for accurately reviewing,...

Additional Information About the Role BJC is hiring for an Inpatient II. We are looking for 2-5 years of experience. Must be have one of the following certifications: CCS, RHIA, or RHIT Elgible states for remote: Alabama Iowa North Carolina Wisconsin Arkansas Kansas Ohio Florida Kentucky Oklahoma Georgia Louisiana South Carolina Illinois Mississippi Tennessee Indiana Missouri Texas Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness,...

The Coder is responsible for assigning diagnostic and procedural codes to patient charts using ICD-10-CM, ICD-10-PCS or any other designated coding classification system in accordance with coding rules and regulations. The coder will abstract required clinical information. This position requires a thorough knowledge of medical terminology, disease processes, pharmacology, Medicare's Inpatient Prospective Payment System (IPPS), Official Coding Guidelines for ICD-10-CM and ICD-10-PCS codes, and documentation requirements for correct and accurate coding. It is the coder's responsibility to submit physician queries when clarification of documentation is needed. Coders must also be able to collaborate with others in the organization including the CDI team, Medical Staff, and other clinicians to ensure the record accurately documents the services provided. Coder will be asked to attend Performance improvement meetings and physician documentation education meetings when needed. A Level II...

Datavant is a leading data platform company revolutionizing health data exchange. Our mission is to ensure that every healthcare decision is made with the right data, delivered timely and in the appropriate format. Powered by the most extensive health data network in the U.S., our platform guarantees secure, accessible, and usable data to enhance health decisions. We are proud to be trusted by the foremost life sciences organizations, government bodies, and healthcare providers. By joining our team, you will be part of a high-performing and values-driven culture. Together, we are addressing some of healthcare's most challenging issues with innovative technology solutions. We embrace a diverse array of professional and personal experiences among our team members as we pursue our ambitious goals for healthcare. What We're Seeking We are on the lookout for seasoned and certified inpatient coders to join our team. The perfect candidate will have exceptional attention to...

A leading health data exchange firm seeks experienced outpatient coders to join their remote team in Jefferson City, Missouri. Candidates should have AHIMA or AAPC certifications and at least two years of coding experience. Responsibilities include reviewing medical records and maintaining coding accuracy. The position offers a flexible schedule, comprehensive training, and employee benefits including medical, dental, and retirement plans. Compensation ranges from $20 to $35 per hour, reflecting the skills and responsibilities of the role. #J-18808-Ljbffr

POSITION TITLE: Compliance Auditor REPORTS TO: Director of Compliance CLASSIFICATION: Non-Exempt POSITION SUMMARY: The Compliance Auditor is responsible for developing and executing audit plans based on research and regulatory guidelines and conducting internal and external audits of departments and their policies. They review programs, records, and systems to ensure adherence to regulations and to support an effective compliance program that prevents illegal, unethical, or improper conduct at the health center. Additionally, they compile and present audit findings to department leadership, assist in implementing procedural changes to resolve compliance issues, and may be reassigned duties as needed for accommodation or staffing reasons. ESSENTIAL FUNCTIONS: The following information is considered the definition of essential functions, but does not restrict the tasks that may be assigned. The Compliance Auditor may be reassigned duties and responsibilities...

The Compliance Auditor is responsible for developing and managing an annual audit plan based on measured risk assessments. This individual will complete compliance audits which includes Developing audit tools and methodologies, conducting entrance conference to explain the audit purpose, scope, and applicable laws/standards. It also includes obtaining the necessary information and data to conduct the audit, including reviewing records and reports. Analyzing the information to determine if it meets the standard and drafting detailed written reports that explain the standards and the audit findings. Including recommendations of corrective action and continued monitoring and presenting the findings/recommendations at an exit conference. Successful Candidate will have: Identify applicable laws, standards, and program requirements, including Department of Mental Health licensure and certification requirements, Health Resources and Service Administration (HRSA) requirements, and...

Become a part of our caring community and help us put health first The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g., ICD‑10‑CM, CPT, HCPCS). The role requires interpretation and independent determination of the appropriate courses of action, contributing to overall cost reduction by increasing the accuracy of provider contract payments in our payer systems and ensuring correct claims payment for appropriate CPT/HCPCS code assignments. The Auditor analyzes, enters and manipulates database data, responds to or clarifies internal requests for medical information, understands departmental, segment and organizational strategy and operating objectives, and follows established guidelines and procedures while making decisions in ambiguous situations. Where you come in The Medical Coding Auditor reviews medical claims submitted against medical records to ensure correct coding guidelines are met (e.g.,...

A leading healthcare data company is seeking an Inpatient Auditing Specialist with 3-5 years of experience at a Trauma Level 1 facility. This fully remote role involves conducting outpatient coding audits, providing coder education, and assisting with compliance assessments. Candidates should possess an associate or bachelor’s degree from an AHIMA-certified program, with preferred credentials such as CCS, RHIT, or RHIA. Competitive pay ranges from $35 to $45 per hour, alongside great benefits including medical and dental coverage. #J-18808-Ljbffr