19 nurse coder jobs found

Registered Nurse - Utilization Management/Coder RN Bienvivir All-Inclusive Senior Health ("Bienvivir") is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the provision of the Program of All-Inclusive Care for the Elderly ("PACE"). PACE is a unique managed care benefit for frail seniors (referred to as participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible. Bienvivir is currently accepting applications for the following position: REGISTERED NURSE - UTILIZATION MANAGEMENT / CODER The...

Job Description Job Description Our client is seeking an experienced RN Inpatient Coder in Fort Worth, TX to join their Payment Integrity and Clinical Appeals team. In this role, you will perform DRG validation, inpatient audits, and clinical appeals for pre and postpay claims in accordance with CMS guidelines and payer policies. The ideal candidate is a Registered Nurse with strong acute inpatient clinical experience and a background in hospital bill audits, DRG review, and appeals/denials, looking for a nonbedside RN role.This is a remote position; however, candidates must be available to work Monday through Friday, 8:00 AM - 5:00 PM Central Time (CST). Requirements: Active RN license required (unencumbered) Active Coding Certification e.g. CIC, CPC, CCS, etc. 1+ year experience in one or more of the following: RN Inpatient Coding or DRG Validation Hospital Bill Audit or Inpatient Claim Audit Clinical Appeals or Denials Management Payment Integrity or Healthcare...

Overview Bienvivir All-Inclusive Senior Health ("Bienvivir") is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the Program of All-Inclusive Care for the Elderly ("PACE"). PACE is a unique managed care benefit for frail seniors (participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible. Benefits for Full and Part-time Employees We pay 100% of the MEDICAL monthly premiums for Employee Only coverage. We pay 100% of the DENTAL monthly premiums for Employee Only coverage. We provide an...

Job Title PAM Health - Hospital Coding and Abstracting Position Job Description If you're looking for a schedule that fits your lifestyle, check out PAM Health - and ask us about our comprehensive benefits package! Some things that our hospital can offer YOU as a full-time employee: Medical benefits: EPO/HDHP/HSA options, including prescription coverage, Rx 'n Go, and Teladoc Comprehensive dental and vision benefits Employee Assistance Program, including counseling, legal, and financial service Flexible spending (FSA) and health savings (HSA) accounts Life and Disability insurance benefits Education/In-Service Opportunities including continuing education and tuition assistance Supplemental benefits: Accident, critical illness, cancer, pet, and identity theft protection insurance options Auto, Home, Cell Phone, and Gym Membership discount offerings Personal Travel Discounts Employee Bonus Referral Program 401(k) plans and discretionary employer match...

Nursing Supervisor (RN) – Medical Surgical Urology/Genitourinary – Full Time Days Bring your passion to Texas Health so we are Better + Together Work location: Texas Health Dallas, 8200 Walnut Hill Lane, Dallas Texas, 75231 Work hours: Full Time – Days (7A-7P) Medical Surgical Department Highlights 24-Bed Urology Inpatient Medical-Surgical Unit Self-scheduling with rotating weekend requirements Working with a Multi-Disciplinary Team Work with patients and provide life-saving care The opportunity to work with a diverse patient population What You Need Associate Degree in Nursing required; BSN preferred. Current RN licensure or compact licensure recognized by the Texas Board of Nursing upon hire required BCLS – prior to providing independent patient care and maintained quarterly required ACLS - Advanced Cardiac Life Support 90 Days Req And CPI – Crisis Prevention Intervention Training – within 90 days of hire 2-year experience as a registered...

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. Must always adhere to customer service expectations including in-person and virtual (via...

Overview Texas Oncology is looking for a Nurse Supervisor (RN) to join our team! This position will support the Dallas Medical City location. This is a full-time Monday-Friday 8:30am-5pm position with no weekends, call, or major holidays. Texas Oncology is the largest community oncology provider in the country and has approximately 600+ providers in 220+ sites across Texas and southeastern Oklahoma. Our founders pioneered community-based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today-at Texas Oncology, we use leading-edge technology and research to deliver high-quality, high-touch, evidence-based cancer care to help our patients achieve "More breakthroughs. More victories." ® in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an...

Senior Inpatient Coder At Houston Methodist, the Senior Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient, emergency room, therapy, and/or clinic encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. Location: Remote, must live in FL, GA, LA, TN, TX Qualifications: Associate's degree or higher in a Commission on Accreditation for Health Informatics and Information Management accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree Experience: Three years of relevant inpatient coding experience or successful completion of the Houston Methodist Senior Inpatient Coder Transition Program Licenses and Certifications Required: Must have one of the following: RHIT - Certified Health Information Technician (AHIMA), RHIA -...

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 Job Description These are 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...

Job Description Job Description Job Title:Traveling Medical Scribe - Nephrology Location: Lubbock, Texas Company: Kidney and Blood Pressure Clinic Job Type: Full time Job Title_ Traveling Medical Scribe – Nephrology.pdf Job Title: Traveling Medical Scribe – Nephrology Location: Kidney and Blood Pressure Clinic of Lubbock (Travel to affiliated nephrology clinic sites within region) Employment Type: Full-Time Department: Nephrology Reports To: Lead Nephrologist / Office Manager Position Summary: The Traveling Medical Scribe supports nephrologists by accurately and efficiently documenting patient encounters, procedures, and care plans during clinic visits across multiple locations. This position plays a key role in maintaining high-quality documentation within the electronic health record (EHR) system and ensuring smooth coordination of care for patients with chronic kidney disease and related conditions. The ideal candidate is...

Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding....

Overview Coder - Full-time-Mesquite Specialty Hospital Mesquite Specialty Hospital in Mesquite, Texas (in the Dallas-Fort Worth area) is a long-term acute care hospital providing advanced medical care for patients with serious, prolonged illnesses or complex injuries. We specialize in treating patients who need extended hospitalization and intensive services - such as ventilator/respiratory care, cardiac monitoring, IV medication management, and complex wound care - in order to recover sufficiently before transitioning to home or a lower level of care. Mesquite Specialty Hospital offers an intimate, patient-focused setting with all private rooms and an expert team, including physicians, critical care nurses, respiratory therapists, and rehabilitation staff. Our caregivers approach each patient with compassion and dedication, developing individualized care plans that address both medical and rehabilitative needs. Joint Commission-accredited and honored for quality...

Overview Full‑time Monday‑Friday 8:30 am‑5 pm position with no weekends, call, or major holidays. Location: Dallas Medical City. Responsibilities Coordinate all activities related to nursing functions and patient care within budgetary constraints. Adhere to national and company standards and guidelines for specialty regulations. Supervise nursing staff providing professional nursing care to patients. Recognize physical, psychological, and spiritual aspects of care and support the US Oncology Compliance Program, including the Code of Ethics and Business Standards. Oversee clinical operations for all nursing clinical support activities. Ensure adequate staffing/FTEs for assigned clinics and maintain effective nursing staff coverage and operating costs within budgetary parameters. Ensure clinical operations and practice consistent with organizational objectives. Monitor and evaluate patient satisfaction and quality assurance measures. Coordinate, implement, and assist with staff...

Job Description We are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Think you've got what it takes? Job Duties & Responsibilities • Assess the treatment plan, clinical information, and medical necessity of all requested services • Utilizes established criteria to appropriately review billed services within established timeframe required. • Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. •...

Overview Texas Oncology is looking for a Nurse Supervisor (RN) to join our team! This position will support the Dallas Medical City location. This is a full‑time Monday‑Friday 8:30am-5pm position with no weekends, call, or major holidays. Texas Oncology is the largest community oncology provider in the country and has approximately 600+ providers in 220+ sites across Texas and southeastern Oklahoma. Our founders pioneered community‑based cancer care because they believed in making the best available cancer care accessible to all communities, allowing people to fight cancer at home with the critical support of family and friends nearby. Our mission is still the same today - at Texas Oncology , we use leading‑edge technology and research to deliver high‑quality, high‑touch, evidence‑based cancer care to help our patients achieve “More breakthroughs. More victories.” in their fight against cancer. Today, Texas Oncology treats half of all Texans diagnosed with cancer on an...

Medical Compliance Auditor We are searching for a Medical Compliance Auditor - someone who works well in a fast-paced setting. In this position, you will review and approve or deny medical claim appeals and perform clinical audits of medical records submitted in support of services billed by providers. This process includes clinical judgment, utilization review, application of product benefits, understanding of regulatory requirements for Medicaid managed care and fraud and abuse, and verification of medical necessity utilizing nationally recognized criteria. Job Duties & Responsibilities Assess the treatment plan, clinical information, and medical necessity of all requested services Utilizes established criteria to appropriately review billed services within established timeframe required. Consults with medical directors and clinical staff regarding patient's history and current care needs and whether services billed were appropriate. Refers case failing medical...

FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION Associate’s degree or higher in a Commission on Accreditation for Health Informatics and Information Management accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree EXPERIENCE Three years of relevant inpatient coding experience or successful completion of the Houston Methodist Senior Inpatient Coder Transition Program LICENSES AND CERTIFICATIONS Required Must have one of the following: • RHIT - Certified Health Information Technician (AHIMA) • RHIA - Registered Health Information Administrator (AHIMA) • CCS - Certified Coding Specialist (AHIMA) SKILLS AND ABILITIES Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the...

At Houston Methodist, the Senior Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient, emergency room, therapy, and/or clinic encounters based upon documentation within the electronic medical record while maintaining compliance with established rules and regulatory guidelines. FLSA STATUS Non-exempt QUALIFICATIONS EDUCATION Associate's degree or higher in a Commission on Accreditation for Health Informatics and Information Management accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree EXPERIENCE Three years of relevant inpatient coding experience or successful completion of the Houston Methodist Senior Inpatient Coder Transition Program LICENSES AND CERTIFICATIONS Required Must have one of the following:- RHIT - Certified Health Information Technician (AHIMA)- RHIA - Registered Health...

Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk‑adjusting conditions and supporting provider documentation improvement. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding. Advanced...