43 facility coding outpatient complex coder jobs found

Allied Health Professional Outpatient MRTs (Coders) Total Rewards: Review and abstract clinical data from the record for documentation of diagnoses and procedures to ensure it is adequate and appropriate to support the assigned codes. Code disease processes, patient injuries, and all procedures in a wide range of ambulatory settings and specialties. Directly consult with the clinical staff for clarification of conflicting, incomplete, or ambiguous clinical data in the health record. Abstract, assign, and sequence codes into encoder software to support medical necessity, resolve encoder edits, and ensure codes accurately reflect services rendered. Review provider health record documentation to ensure that it supports the diagnostic and procedural codes assigned and is consistent with required medical coding nomenclature. Query clinical staff with documentation requirements to support the coding process. Enter and correct information that has been rejected, when necessary....

Outpatient Coder (Remote) Full-time Work From Home Must have Surgical/OBS coding experience and documented billing edit experience Ob Summary As part of our hospital outpatient coding team, you will work outpatient coding quality and/or billing alerts/edits for hospital outpatient encounters (e.g., same day surgery, observation, wound care, emergency department, and/or diagnostic) to ensure complete and accurate code assignment. This is a great starting position for those wanting to move from production coding toward an outpatient coding quality review position. Job Responsibilities Verifying accuracy of assigned CPT codes for complex and/or error prone procedures, Verifying the diagnosis coding accuracy for complex and/or error prone encounters, Validating certain discharge dispositions, Reviewing charge and procedure mismatches, Reviewing codes with revenue integrity for NCD/LCD coverage, Reviewing invalid codes, code conflicts, and missing modifiers, Working with...

Summary Outpatient MRTs (Coder), dependent upon level, perform the full scope of outpatient coding including ambulatory surgical cases, diagnostic studies and procedures, outpatient encounters, and/or inpatient professional services. Outpatient duties consist of the performance of a comprehensive review of documentation within the health record to accurately assign ICD CM codes for diagnoses, CPT/HCPCS codes for surgeries, procedures and evaluation and management services. Responsibilities Total Rewards of a Allied Health Professional Outpatient MRTs (Coders): review and abstract clinical data from the record for documentation of diagnoses and procedures to ensure it is adequate and appropriate to support the assigned codes. code disease processes, patient injuries, and all procedures in a wide range of ambulatory settings and specialties. directly consult with the clinical staff for clarification of conflicting, incomplete, or ambiguous clinical data in the health record....

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. We're focused on improving the health of our members, enhancing our operational effectiveness and reinforcing our reputation for high - quality health services. As Senior Inpatient Medical Coder you will provide coding services directly to providers. You'll play a key part in healing the health system by making sure our high standards for...

Coder - Inpatient (Local or Remote with Experience) page is loaded## Coder - Inpatient (Local or Remote with Experience)locations: Business and Technology Centertime type: Full timeposted on: Posted Yesterdayjob requisition id: R19891We’ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas(R).Job Summary The Medical Coder is responsible for ICD-10 coding of diagnoses and procedures of inpatient/outpatient discharged patient records. Job Specific Responsibilities Daily assignments may include but are not limited to: • Apply diagnoses codes to in-patient, out-patient, and emergency services • Maintain knowledge of current laws and regulations related to insurance, Medicare, Medicaid, and DRG coding, sequencing, and CPT coding • Perform quality improvement reviews as assigned • All other assigned duties related to Health Information Management Inpatient Coder Duties: • Review and analyze...

Revenue Cycle Management is looking for a Medical Coder Auditor to join our team! Remote opportunity after 30-90 day in-person training SUMMARY The Medical Coder Auditor is responsible for reviewing coded encounters to ensure accuracy, compliance, and alignment with coding guidelines, payer rules, and organizational policies. This role provides feedback to coders, identifies trends in errors, and supports coding education and process improvement initiatives. ESSENTIAL FUNCTIONS: Conduct retrospective and prospective coding audits to ensure coding accuracy and compliance with regulations. Review coded documentation for completeness, accuracy, and adherence to ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS guidelines. Identify coding trends, error patterns, and compliance risks, and develop corrective action plans. Provide feedback and education to coders to improve accuracy and consistency. Collaborate with providers and clinical staff to clarify documentation as...

Revenue Cycle Management is looking for a Medical Coder Lead to join our team! Remote opportunity after 30-90 day in-person training SUMMARY The Medical Coder Lead is responsible for serving as a subject matter expert in coding processes, providing advanced technical guidance, and ensuring coding accuracy, compliance, and productivity standards are met. The position supports coders and auditors through consultation, mentoring, and expertise on complex coding scenarios. ESSENTIAL FUNCTIONS: Serve as a resource and consultant for coders on complex or specialty coding scenarios. Review and provide guidance on challenging cases to ensure coding accuracy and compliance. Partner with auditors to resolve discrepancies and identify trends in coding errors. Provide mentoring and technical support to coders, promoting knowledge sharing and best practices. Assist in developing and updating coding procedures, guidelines, and reference materials. Collaborate with...

Full-time Description The remote Coder/Specialty Medical Bill Reviewer is responsible for reviewing, auditing, and data entry of medical bills for multiple states and lines of business within both Worker’s Compensation and Commercial Health arenas. This would include analysis for the fee schedule or usual and customary application, as well as PPO interface, while meeting contractual client requirements. Essential Job Functions: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts Analysis and review of 1 or more assigned states having fee schedules Utilize Fee Schedules, Online Documents, Client instructions, and other training material to properly review medical bills Review medical bills for compensability and relatedness to injury Reprice medical bills to Workers’ Compensation Fee Schedule and PPO Network Research usual and customary/fee schedule applications and system...

HIM Coder Analyst II-REMOTE within State of TX page is loaded## HIM Coder Analyst II-REMOTE within State of TXlocations: Fort Worth, TXtime type: Full timeposted on: Posted Todayjob requisition id: JR-110206**Location:**Medical Center - Fort Worth**Department:**HIM-Coding**Shift:**First Shift (United States of America)**Standard Weekly Hours:**40**Summary:**The HIM Coder Analyst II requires advanced knowledge of and skill in applying International Classification of Diseases and Procedures (ICD), and Current Procedural Terminology (CPT) code sets and associated Medicare/Medicaid rules and guidelines. Reviews and interprets patient medical record documentation to identify pertinent diagnoses and procedures and assigns ICD-10-CM and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for ambulatory surgery, special procedure, observation, emergency department, outpatient ancillary and clinic visit records. Primarily codes complex...

Description Summary Certified Medical Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key Responsibilities Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-10-CM coding classification system Selects and accurately records all appropriate records and data on assigned chart abstraction projects Ability to meet productivity and accuracy requirements Performs other duties as assigned Qualifications High School Diploma or GED required A certification in one of the...

At Palm Primary Care (PPC) our patients have the peace of mind knowing that their health and well-being are our primary concerns. We give our health plan clients the confidence that their members are well taken care of. With more than 24,000 at-risk members, we provide primary care and other services to seniors and families in our medical centers that are comfortable, convenient and staffed with caring professionals. Our activity and wellness facilities are filled with health plan members who know us for our distinct events and programs that cater to the communities we serve. Every day, we deliver on our promise to bring value based, quality healthcare to our patients.   Overview PPC is looking for a CDI/Certified Professional Coder who will demonstrate deep knowledge in Medical Risk Adjustment, HEDIS, CNS Coding guidelines, billing standards and regulations.  A teamwork person who will deliver a high standard of quality of work to drive improved business performance....

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. Position Purpose Codes, abstracts, and analyze inpatient and/or outpatient medical records using the most current International Classification of Diseases, Tenth Revision (ICD-10) for CMS risk adjustment purposes. Codes, abstracts and analyzes inpatient and/or outpatient medical records using International Classification of Diseases, Tenth Revision (ICD-10). Always coding to the highest level of specificity. Follows the Official ICD-10 guidelines for Coding and Reporting and has a complete understanding of these guidelines. Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines. Understands the impact of ICD-10 codes on the CMS HCC risk adjustment model....

Overview Who We Are We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community. Our Story We started out as a small operation in California. In May 1969, we acquired four hospitals, some additional care facilities and real estate for the future development of hospitals. Over the years, we've grown tremendously in size, scope and capability, building a home in new markets over time, and curating those homes to provide a compassionate environment for those entrusting us with their care. We have a rich history at Tenet. There are so many stories of compassionate care; so many 'firsts' in terms of medical innovation; so many examples of enhancing healthcare delivery and shaping a business that is truly centered around patients and community need. Tenet and our predecessors have enabled us to touch many...

Medical Coder Revenue Cycle Management is looking for a Medical Coder to join our team! Remote opportunity after in-person training SUMMARY 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, billing, and...

Medical Coder Opportunity Revenue Cycle Management is looking for a Medical Coder to join our team. Remote opportunity after 30-90 day in-person training. Summary: 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...

Medical Coder Auditor Revenue Cycle Management is looking for a Medical Coder Auditor to join our team. Remote opportunity after 30-90 day in-person training. SUMMARY: The Medical Coder Auditor is responsible for reviewing coded encounters to ensure accuracy, compliance, and alignment with coding guidelines, payer rules, and organizational policies. This role provides feedback to coders, identifies trends in errors, and supports coding education and process improvement initiatives. ESSENTIAL FUNCTIONS: Conduct retrospective and prospective coding audits to ensure coding accuracy and compliance with regulations. Review coded documentation for completeness, accuracy, and adherence to ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS guidelines. Identify coding trends, error patterns, and compliance risks and develop corrective action plans. Provide feedback and education to coders to improve accuracy and consistency. Collaborate with providers and clinical staff to clarify...

Certified Medical Coder Certified Medical Coder role is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10-CM, HCPCS, and CPT coding and compliance with Risk Adjustment requirements. Key Responsibilities Follows CMS Risk Adjustment guidelines and has a complete understanding of their real-world application Reviews submitted medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission Codes all diagnoses and services accurately and completely, from the medical record in accordance with the ICD-10-CM coding classification system Selects and accurately records all appropriate records and data on assigned chart abstraction projects Ability to meet productivity and accuracy requirements Performs other duties as assigned Qualifications High School Diploma or GED required A certification in one of the following is required: Certified...

Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: • Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Medical Coder US Heart and Vascular is in need of a Medical Coder to join our team at Houston Cardiovascular Associates in Houston, TX The Professional Fee Medical Coder, Level 3 reviews medical documentation that physicians or other healthcare professionals complete to validate, assign, and sequence CPT/HCPCS, ICD-10CM, and modifiers for clinic and hospital-based professional encounters. The Coder applies coding conventions per official coding and regulatory guidelines, third-party payer policies, and departmental procedures. This role is responsible for complex surgical coding in the inpatient and outpatient settings. May also be assigned E/M encounters, ancillary diagnostic procedures, and other inpatient and outpatient visits. Reviews encounter in a timely manner and resolves all coding-related edits. Reviews medical records and accurately assigns and sequences CPT, ICD-10CM, and HCPCS codes/modifiers, ensuring compliance with all applicable guidelines. Generates...

Job Title PAM Health - and ask us about our comprehensive benefits package! Job Description This position has responsibility for performing coding and abstracting of both inpatient and outpatient medical records in accordance with ICD-10-CM and CPT coding rules, guidelines, and conventions following hospital and PAM Health system procedures. The ICD-10-CM codes will accurately reflect the reason for admission, extent of care received, and level of severity of illness. Qualifications Education and Training: 1. High school diploma or its equivalent is required. 2. Coding, medical terminology, Anatomy/Physiology courses preferred. 3. Certification as one of the following is preferred: a. Certified Coding Specialist (CCS) b. Certified Coding Specialist-Physician based (CCS-P) c. Certified Professional Coder (CPC) d. Certified Professional Coder Apprentice (CPC-A) e. Certified Billing and Coding Specialist (CBCS) f. Certified Coding Associate required (CCA) g. Registered...

Sr Health Information Management Coder Dallas, Texas Job Title: Senior Health Information Management Coder Location: Dallas, Texas Job Type: Full-Time Apply Job details Sr Health Information Management Coder Location: Dallas, Texas Salary: $80,000 to $86,000 FullTime,Permanent Are you passionate about ensuring accurate and efficient coding for healthcare records? Here's an exciting opportunity for you! Verovian Nursing Recruitment Agency is seeking a dedicated and experienced Senior Health Information Management Coder in Dallas, Texas. As a Senior HIM Coder, you will play a vital role in the review and coding of medical records, ensuring compliance with all relevant regulations and optimizing the reimbursement process for the healthcare facility. If you're intrigued by the prospect of this role, we encourage you to apply for this fulfilling opportunity to become an essential part of a healthcare team that is renowned for its expertise and...

Data Quality Auditor Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Job Responsibilities/Duties: Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or MS-DRG assignment. Adheres to...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from patient medical...

Job Description Job Description Job Summary: Conducts data quality audits of inpatient admissions and outpatient encounters to validate coding assignment complies with the official coding guidelines as supported by clinical documentation in health records. Validates abstracted data elements that are integral to appropriate payment methodology. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc.   Job Responsibilities/Duties: · Chart Analysis IP, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to validate abstracted data including but limited to discharge disposition which impacts facility reimbursement and/or...