34 diagnostic coder jobs found

Job Requirements Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. Principal Responsibilities And Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. Serves as a clinical coding subject matter expert,...

Clinical Coding Auditor Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems. Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. Serves as a clinical coding subject matter expert, and utilizes critical thinking to analyze and evaluate documentation issues with consultation from the medical and clinical staff, and clinical documentation specialists as needed. Audits ICD-10 diagnostic codes and CPT-4 procedure codes to outpatient, ambulatory surgery, and observation visits for the...

A prominent health data platform seeks experienced inpatient coders to join their remote team. Ideal candidates must possess exceptional attention to detail and a profound understanding of medical terminology. Responsibilities include assigning diagnostic codes, ensuring high coding accuracy, and mentoring junior coders. Preferred qualifications include at least 3 years of inpatient coding experience with relevant certifications. This role offers a flexible schedule, enabling you to contribute from your own workspace while shaping healthcare's future. #J-18808-Ljbffr

Why work at TidalHealth? Join a triple 'A' rated team where clinical excellence meets a coastal lifestyle. At TidalHealth, you'll be part of an award-winning network spanning Maryland and Delaware, recognized by the Leapfrog Hospital Safety Guide for our unwavering commitment to patient care. Whether your expertise lies in specialized clinical fields like neurosurgery, academic mentorship through our graduate medical programs, or the critical professional and support roles that keep our network thriving, we provide the tools and tuition assistance you need to excel. Coder-Outpatient Position Summary The Hospital Outpatient Coder accurately abstracts pertinent information from the patient record to apply the appropriate diagnostic and procedural codes to individual outpatient accounts for data submission/analysis and claims processing. This position adheres to the Official ICD-10 and CPT Coding Guidelines and the American Health Information Management Association...

Summary Who We Are: LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. 100% REMOTE, WITH QUARTERLY ONSITE MEETINGS. CANDIDATES MUST RESIDE IN MD, DC, PA, VA OR WVA. About the Role: Coordinates the daily billing activities of assigned areas. Works independently to maintain consistent workflow of all billing activities. Works collaboratively with the Professional Billing Office, physicians and third party payers. Provides and performs coding functions to optimize revenue enhancement. KEY RESPONSIBILITIES: Coordinates and monitors daily revenue cycle activities to optimize reimbursement opportunities. Works in conjunction with intradepartmental administration,...

Coder Financial Coordinator Who We Are: LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. 100% REMOTE, WITH QUARTERLY ONSITE MEETING. CANDIDATES MUST RESIDE IN MD, DC, PA, VA OR WVA About the Role: Coordinates the daily billing activities of assigned areas. Works independently to maintain consistent workflow of all billing activities. Works collaboratively with the Professional Billing Office, physicians and third party payers. Provides and performs coding functions to optimize revenue enhancement. KEY RESPONSIBILITIES: Coordinates and monitors daily revenue cycle activities to optimize reimbursement opportunities. Works in conjunction with intradepartmental administration,...

Job Description Job Description Performs functions such as reviewing documentation and selecting the appropriate procedure and / or diagnosis code to be entered in billing documents. Ensures that teaching physician requirements are met and are clearly reflected in the documentation; and other duties as assigned. ESSENTIAL FUNCTIONS Selects the appropriate procedural and diagnostic code based on provider documentation, utilizing HIPAA Standardized Code Set and applying CMS/payor guidelines. Ensures that teaching physician documentation and billing requirements are met and are clearly reflected. Review provider coding and provide training and feedback on coding questions and issues. Assists billing and collections staff with denials and charge correction requests as needed. Resolves coding TES edits. Continually refreshes and applies knowledge of government regulations as they relate to coding and billing Note: The intent of this list of primary duties is to provide a...

A prominent health data platform seeks experienced inpatient coders to join their remote team. Ideal candidates must possess exceptional attention to detail and a profound understanding of medical terminology. Responsibilities include assigning diagnostic codes, ensuring high coding accuracy, and mentoring junior coders. Preferred qualifications include at least 3 years of inpatient coding experience with relevant certifications. This role offers a flexible schedule, enabling you to contribute from your own workspace while shaping healthcare's future. #J-18808-Ljbffr

Auditing Team Lead Under direct supervision, the Auditing Team Lead provides day to day supervision and instruction of the auditors. The Auditing Team Lead oversees the internal and external auditing function and assists Director Inpatient Coding, Coding Audits, and Education in developing reports specific to audit findings and assists with implementing action plans. The Auditing Team Lead ensures internal audits are accurate, complete and reported on a timely basis and serves in an advisory and educator role for Coding Specialists. Principal Responsibilities and Tasks The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified. 1. Provides for day to day supervision and instruction for the auditors which includes audit assignments, problem solving, monitoring productivity and...

Schedule - Shift - Hours Full-time - Day shift - 8:00am-4:30pm Who We Are LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to “improve the health of people in the communities we serve.” Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. About the Role Coordinates the daily billing activities of assigned areas. Works independently to maintain consistent workflow of all billing activities. Works collaboratively with the Professional Billing Office, physicians and third party payers. Provides and performs coding functions to optimize revenue enhancement. Key Responsibilities Coordinates and monitors daily revenue cycle activities to optimize reimbursement opportunities. Works in conjunction with intradepartmental administration, physicians and other interdepartmental representatives to support...

Job Summary :Ensures all technical aspects of the assignment of diagnostic and procedure coding is carried out in accordance with established standards and is in compliance with CMS, NCQA, other regulatory agencies, third party payers and Kaiser Permanente policy.Function includes, but is not limited to working charge review work queues, other forms of charge submissions and querying providers to ensure the completeness and accuracy of coding of internal services performed.Essential Responsibilities :Responsible for reviewing primarily medical and ancillary type workques charge sessions within KP Health connect and applying coding principles for correct coding.Research, code, and / or data enter encounters that are supported by KPHC with the Charge capture tool.Review all other charge sessions submitted via paper encounters, physician in baskets and other various methods to ensure correct coding principles have been applied.Query providers for clarification of incomplete or...

HIM-INPATIENT CODER Baltimore, MD SINAI HOSPITAL HLTH INFORMATION MNG Full-time - Day shift - 8:00am-4:30pm ALLIED HEALTH $22.22-$39.12 Experience based 100% REMOTE OPPORTUNITY SIGN-ON BONUS ELIGIBLE $10,000 Eligible remote states: District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia Who We Are: LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve." Join us to advance health access, elevate patient experiences, and contribute to a system that values bold ideas and community-centered care. The Health Information Management Department supports the mission and goals of Sinai Hospital, Northwest Hospital, Carroll Hospital, Levindale and Grace Medical Center by providing appropriate and timely access to health information for continuity of patient care and other authorized requests. Key Responsibilities:...

Professional Fee Coding Auditor & Educator We are seeking an experienced Professional Fee Coding Auditor & Educator to partner with physicians and APPs on coding accuracy, documentation improvement, compliance, and provider education. Must currently possess both the CPC and CPMA certifications in order to be considered for the role. The Coding Auditor and Educator 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...

*Description* Risk Adjustment Coding Auditor The Impact you will have The Risk Adjustment Coding Auditor ensures the accuracy and completeness of coded clinical data to support compliant reporting and appropriate reimbursement across risk adjustment programs. The role strengthens organizational performance by identifying coding and documentation gaps, mitigating financial and regulatory risk, and improving data integrity. It provides subject matter expertise to support consistent application of coding standards and enables informed decision-making across the enterprise. Your Responsibilities Evaluates risk adjustment codes to ensure accuracy, consistency, and alignment with coding standards and best practices Protects patient records and audit information by ensuring compliance with HIPAA, privacy, security, and regulatory requirements Performs Retrospective and Prospective chart reviews to ensure accurate risk adjustment reporting Verifies and ensures the accuracy,...

Inpatient Coder - Full-Time With Benefits Supports, and is responsible for incorporating into job performance, the Frederick Health (FH) mission, vision, core values and customer service philosophy and adheres to the FH Compliance Program, including following all regulatory requirements and the FH Standards of Behavior. Codes and abstracts inpatient medical records of all types and, following a rigorous review of the clinical documentation, abstracts and assigns appropriate ICD-10-CM/PCS code sets and assigns the correct APR-DRG into the hospital information system. May also code other work types as assigned by the Coding Manager. Essential Functions: Determines the correct principal diagnosis, identifies and assigns co-morbidities and complications, secondary diagnoses, present on admission indicators for ICD-10-CM and MHACs (Maryland Hospital Acquired conditions), principal procedure codes and secondary procedure codes. Assigns the appropriate APR-DRG. Works in...

Coding Auditor And Educator (Remote) Employment Type: Full-Time Shift: Days Position Highlights: Competitive pay Additional benefits: tuition reimbursement, free parking, employee discounts Quality of life: flexible work schedules Advancement: professional growth within the organization Location: Holy Cross Health has two hospitals and four healthcare centers all a short driving distance from Washington DC and Baltimore, MD. Description: Monday-Friday The Professional Coding Auditor Educator performs medical record audits including but not limited to analysis of medical record documentation, validation of primary and secondary diagnoses and procedures; and ensuring proper assignment of diagnosis and procedure codes using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). Responsibilities: Monitors accuracy of centralized coders' charge capture and coding with proper ICD-10, CPTs, as well as proper modifiers, adhering to local...

Why work at TidalHealth? Join a triple 'A' rated team where clinical excellence meets a coastal lifestyle. At TidalHealth, you'll be part of an award-winning network spanning Maryland and Delaware, recognized by the Leapfrog Hospital Safety Guide for our unwavering commitment to patient care. Whether your expertise lies in specialized clinical fields like neurosurgery, academic mentorship through our graduate medical programs, or the critical professional and support roles that keep our network thriving, we provide the tools and tuition assistance you need to excel. PB Coding Auditor Position Summary The Coding Compliance Auditor conducts audits of provider documentation. The Auditor is responsible for data quality reviews on provider records to validate the Evaluation and Management (E/M) coding and surgical documentation for professional services. Audits provider records for accuracy of principal and secondary diagnosis and/or procedures and ensures compliance with all...

Performs functions such as reviewing documentation and selecting the appropriate procedure and / or diagnosis code to be entered in billing documents. Insures that teaching physician requirements are met and are clearly reflected in the documentation; and other duties as assigned. EDUCATION and/or EXPERIENCE * High school diploma or general education degree (GED) preferred * Certified Professional Coder certification required * Level and years of experience based on departmental needs * Extensive knowledge of CPT and ICD-10 coding * Knowledge of government regulations as they relate to teaching physician documentation and billing guidelines * Understanding of: the importance of compliance with all government, department, and contractual regulations regarding coding and billing; and provider requirements Total Rewards The referenced base salary range represents the low and high end of University of Maryland's Faculty Physician's Inc. salary range for this position. Some...

Overview Job Title: Coding Auditor and Educator (Remote) Employment Type: Full-Time Shift: Day Shift Responsibilities Monitors accuracy of centralized coders’ charge capture and coding with proper ICD-10, CPTs, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. Partners with leadership to improve HCC, high risk scoring, with provider and coder education. Conducts ongoing reviews of patient medical record documentation and procedural and diagnosis coding by each practitioner. Responsible for practitioner education in areas related to coding, documentation, and compliance. Works closely with leadership and the department to establish and modify the charge description master (CDM) methodology and pricing models to ensure accuracy and regulatory compliance. Reports to the Manager, Provider Revenue Operations. What You Will Need High school diploma or equivalent combination of education and experience Certified Professional Coder or...

CareFirst is looking for a Risk Adjustment Coding Specialist to support the CMS-HCC Medicare Advantage Risk Adjustment and HHS-Risk Adjustment Data Validation audit. This position requires an Associate's Degree in a related field and CCS certification upon hire. The role involves verifying diagnosis codes and maintaining coding guidelines. Candidates should have at least 3 years of relevant coding experience and be adaptable to various technology platforms. Position offers a hybrid work model, allowing some remote work. Salary ranges from $51,984 to $95,304 with a comprehensive benefits package. #J-18808-Ljbffr

About Us: At RELI Group, our work is grounded in purpose. We partner with government agencies to solve complex challenges, improve public health, strengthen national security, and make government services more effective and efficient. Our team of over 500 professionals brings deep expertise and a shared commitment to delivering meaningful outcomes. Behind every solution is a group of experts who care deeply about impact—whether we’re supporting data-driven decisions, modernizing systems or safeguarding critical programs. Job Overview We are seeking an experienced and detail-oriented Senior Medical Coder to support our Medicare Part C Risk Adjustment Data Validation (RADV) initiatives. The ideal candidate will have strong experience in ICD-9-CM/ICD-10-CM coding across various care settings, including inpatient, outpatient, and physician office encounters. The candidate will perform diagnosis coding, support intake reviews, conduct appeal responses, and contribute to quality...

RELI Group, Inc. is seeking an experienced Senior Medical Coder in Baltimore, MD. You will support Medicare Part C Risk Adjustment Data Validation initiatives, performing diagnosis coding across various care settings. The ideal candidate will have a minimum of five years of coding experience and be a certified coder. The role offers an annual salary range of $60,000 to $80,000 based on skills and experience. Join a team that values expertise and impact. #J-18808-Ljbffr

Become a part of our caring community Humana, a Fortune 100 Company, is looking for an experienced and Certified medical coding auditor to review inpatient hospital claims for proper reimbursement and resolve provider disputes. Your expertise will directly contribute to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, ensuring correct claims payment and appropriate diagnosis related group assignments. The Certified 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 goal is to ensure the accuracy and integrity of hospital claim payments. Responsibilities include the following: Review inpatient medical records and claims to ensure accurate coding and reimbursement Assign and validate ICD-10-CM, ICD-10-PCS, and DRG codes Audit coding quality and...

Become a part of our caring community 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. Where you Come In 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 of...