16 hcc coder jobs found

A consulting company is searching for a Sr. Associate with expertise in coding, revenue cycle, and clinical operations. This role focuses on complex investigations, compliance evaluation, and project management within healthcare disputes. The ideal candidate must be CRC certified with a strong grasp of clinical terminology and health regulations. Excellent communication skills and proficiency in Excel, Word, and PowerPoint are essential. The position offers a salary range from $85,000 to $200,000, depending on experience and location. #J-18808-Ljbffr

Medical Coder II This position has a deep understanding of disease process, A&P and pharmacology and acts as a key collaborator with Providers and Clinical areas to ensure the medical record accurately reflects the patient's service. Position Highlights: Position: Medical Coder II Location: Warrenville, IL Full Time/Part Time: Full Time Hours: Monday-Friday, day shift What you will do: Assigns diagnostic and procedure codes for compliant physician reimbursement and for both evaluation/ management, preventive (HCC risk adjustment) and surgical services under general supervision. Communicates daily regularly with physicians and staff to resolve discrepancies with patient records and coding selections. Performs provider audits on E/M (evaluation/management) services and HCC review on Medicare/Medicare Advantage preventive services and educates providers as needed. Trains physicians and other staff regarding documentation, billing and coding, and documentation....

A health care advisory firm is seeking a Sr. Associate to analyze medical records and ensure compliance with coding standards. The ideal candidate will be certified in Risk Adjustment Coding and have at least five years of experience in HCC/Risk Adjustment methodologies. Strong communication skills and proficiency in Excel are essential. This role offers a hybrid work environment. Salary range is between $85,000 to $200,000 based on qualifications and experience. #J-18808-Ljbffr

Ankura is a team of excellence founded on innovation and growth.**Practice Overview:**Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura’s Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura’s health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Endeavor Health is seeking an Ambulatory Risk Adjustment Coding Specialist in Skokie, IL. This full-time role involves reviewing and coding HCC codes accurately, collaborating with clinical documentation specialists, and ensuring compliance with CMS documentation requirements. Candidates should possess at least 2 years of relevant experience and a high school diploma, along with a CRC certification to be obtained within 6 months of hiring. The position offers competitive pay and a range of benefits including tuition reimbursement and retirement options. #J-18808-Ljbffr

Carle Inclusion Connection Group in Champaign, IL, is seeking a HIM Certified Coder responsible for accurate and timely coding of hospital encounters. Candidates must possess certifications such as CIC, CCS, or similar, along with a High School Diploma. The role requires knowledge of ICD-10-CM, CPT, and HCPC codes, and demands strong communication and collaborative skills. This position offers a compensation range of $23.58 to $39.38 per hour, with a comprehensive benefits package. #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

Overview The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. HIM Certified Coder is also responsible for understanding and applying coding knowledge to resolve billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters. Qualifications Certifications: Certified Inpatient Coder (CIC) – American Academy of Professional Coders (AAPC); Certified Coding Specialist – Physician-Based (CCS‑P) – American Health Information Management Association (AHIMA); Certified Coding...

HIM Certified Coder The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. HIM Certified Coder is also responsible for understanding and applying coding knowledge to resolve billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters. Qualifications Certifications: Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC); Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC); Certified Inpatient Coder (CIC) -...

We are seeking experienced and highly accurate Value-Based Coders to join a project dedicated to in-home health assessments for Medicare Advantage and other value-based programs.This role is 100% remote and ideal for coders who are confident working independently, detail-oriented, and committed to quality and compliance.As a contractor, you'll have the independence to manage your own schedule while contributing to meaningful work that truly makes a difference.As part of the coding team, you will review clinical documentation from in-home visits and assign complete and compliant ICD-10-CM diagnosis codes that reflect the full spectrum of each patient's health.This includes :Risk adjustment (HCC) diagnoses aligned with CMS-HCC and HHS-HCC models.Social Determinants of Health (SDOH) codes.Medication-related Z codes, such as long-term drug therapy and treatment monitoring.All other clinically relevant diagnoses supported by documentation.Your accuracy directly supports the integrity of...

This position has the primary function of coordinating and supporting the Deputy Chief Compliance Officer with administrative, analytical, and program coordination activities. This position will provide support related to compliance auditing activities and programs, assisting with developing and coordinating the Compliance Audit Plan, supporting proactive and reactive audits of professional fee billings in clinic and facility settings, including federally qualified health centers. Proactively support audit activities related to billing and coding risks to the SOM, identifying and calculating potential overpayments based on audit results, participating in the repayment process if necessary, reviewing research billing compliance issues and assisting the Deputy Chief Compliance Officer in designing and managing a comprehensive billing/auditing program.  The position supports compliance-related activities by gathering information, coordinating documentation reviews, monitoring...

Gibson-Area-Hospital- is seeking a Medical Coder responsible for transforming healthcare services into universal codes. This role requires knowledge of CPT, ICD-10, and HCPC codes, with a current CPC or CCS certification. The ideal candidate will have at least 2 years of medical coding experience and strong analytical skills. Responsibilities include ensuring accurate coding, following up with providers, and reprocessing denials. The position is office-based in Gibson City, Illinois, with clear expectations of professional communication and teamwork. #J-18808-Ljbffr

GENERAL SUMMARYThe PFS Medical Coder is responsible for the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The coder is responsible for assigning and verifying the correct codes are used to describe the type of service(s) the patient received. The Coder will ensure the codes are applied correctly during the medical billing process, which includes removing the information from the documentation, assigning the appropriate codes, and creating a claim to be paid by the insurance carriers. Coders will work with the hospital, clinics, and physician offices as needed to provide personalized, professional healthcare services to the residents of the Communities we serve.PRINCIPLE DUTIES AND RESPONSIBILITIES1. Assign codes to diagnosis and procedures, using ICD-10, CPT, and HCPS codes.2. Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations.3. Knowledge and...

PFS - Coder I FT Gibson City, IL 60936 Overview Salary Range $21.00 - $32.00 Hourly Position Type Full Time Description General Summary The PFS Medical Coder is responsible for the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. The coder is responsible for assigning and verifying the correct codes are used to describe the type of service(s) the patient received. The Coder will ensure the codes are applied correctly during the medical billing process, which includes removing the information from the documentation, assigning the appropriate codes, and creating a claim to be paid by the insurance carriers. Coders will work with the hospital, clinics, and physician offices as needed to provide personalized, professional healthcare services to the residents of the Communities we serve. Principle Duties And Responsibilities Assign codes to diagnosis and procedures, using ICD-10, CPT, and...