93 other jobs found

Medical Claims Specialist This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. Job Duties/Responsibilities Maintains a thorough understanding and education of federal and state regulations and payer specific policies...

Cardiac Specialist Registered Nurse - CVOR At TriHealth, our corporate team thrives on a service-oriented mindset grounded in inclusivity, innovation, and collaboration. We cultivate a supportive culture where every team member is valued, empowered, and given a true sense of belonging. When you join us, you become part of a community that invests in your personal well-being and your professional future. You'll experience meaningful growth and development opportunities, excellent benefits, and a workplace where people actively support one another and share best practices every day. Here, your contributions matterand together, we make a lasting impact. Location: This is a work from home role that requires the team member to live in the Greater Cincinnati/Northern Kentucky area Schedule: Day Shift Job Overview: Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, APR-DRG's, SOI, ROM, POA indicators, discharge dispositions and...

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...

Coder II, Corporate Coding, Outpatient Ancillary Services, Full Time, First Shift Job Description Using established policies and procedures; the Certified Coder translates narrative descriptions of diseases, injuries, and medical procedures into numeric or alphanumeric codes needed for billing. The Certified Coder may code all types of inpatient, observation and outpatient cases (to include clinics, ancillary services, and ambulatory surgery, series, and emergency room cases) and may be called upon to code highly complex inpatient records (to include trauma, burns, open heart and transplant cases) based on experience and skill set. Responsibilities Reviews inpatients, ambulatory, observation, emergency and outpatient accounts to assign accurate ICD-10 and/or CPT codes and DRG’s. Interprets health record content to ensure that all diagnoses and procedures coded are supported by physician documentation. Maintains a coding accuracy rating of at least 95% on records assigned....

Job Description ***Medical Biller II - TriHealth Norwood*** At TriHealth, your expertise in medical billing directly supports our mission to deliver exceptional patient care. As a Medical Biller II, you'll be part of a collaborative, high-performing team that values accuracy, integrity, and continuous improvement. Your work ensures clean claims, timely reimbursement, and a smooth financial experience for our patients, and we recognize the importance of that impact. TriHealth offers career growth opportunities, a comprehensive benefits package, Apply today and grow your career with a team that truly values you. Location: TriHealth Norwood at 4685 Forest Avenue, Norwood, OH 45212 Work Schedule: Fulltime (80 hours bi-weekly) Day Shift No Weekend, No Holiday, No on Call Commitment Incentives & Benefits: TriHealth offers a comprehensive benefits package including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement....

Medical Biller II – TriHealth Norwood At TriHealth, your expertise in medical billing directly supports our mission to deliver exceptional patient care. As a Medical Biller II, you’ll be part of a collaborative, high‑performing team that values accuracy, integrity, and continuous improvement. Your work ensures clean claims, timely reimbursement, and a smooth financial experience for our patients, and we recognize the importance of that impact. TriHealth offers career growth opportunities, a comprehensive benefits package, Location TriHealth Norwood at 4685 Forest Avenue, Norwood, OH 45212 Work Schedule Fulltime (80 hours bi-weekly) Day Shift No Weekend, No Holiday, No on Call Commitment Incentives & Benefits TriHealth offers a comprehensive benefits package including medical, dental, vision, paid time off, retirement plans, and tuition reimbursement. Please view our benefits page: https://careers.trihealth.com/what-we-offer/benefits Job Requirements High School Diploma...

Job Description A client of Insight Global is seeking a Home Infusion Billing and Reimbursement Specialist to lead revenue cycle operations within a home infusion environment. This role is responsible for overseeing billing, collections, payment posting, and denial management while ensuring accuracy and compliance across reimbursement processes. This person will partner cross-functionally with operations, clinical teams, and leadership to improve cash collections, reduce reimbursement leakage, and optimize overall financial performance. Additionally, this individual will monitor key revenue cycle metrics, drive process improvements, and manage audits. Key Responsibilities: Lead billing and reimbursement operations including claims, collections, payment posting, and AR follow-up Oversee end-to-end revenue cycle processes (intake, authorization, billing, collections) Manage denials, underpayments, and appeals to maximize reimbursement Track key metrics...

Toledo Clinic's Cardiology Department is seeking a full-time Coder/Medical Biller to work full-time (M-F, 8-5). Previous experience as a Coder in a medical office preferred.General Summary: Responsible for application of CPT and ICD-10 codes to all procedures performed for a given date of service for The Toledo Clinic, as well as tracking of patients seen and working all eCW claims for denials, errors.Principal Duties & Responsibilities: Example of Essential Duties:Codes visits utilizing the ICD-10 and CPT codes from patient visit documentation.Demographic registration/updates for all patients3)  Enters charges into claim entry in eCW4)  Monitors, submits, correct all claim activity5)  Create workflow processes to ensure accuracy and accountabilityOther Essential Duties May Include (but are not limited to):6)       Assists patients and/or insurance companies with billing and authorization questions.7)       Coordinate with providers to ensure all visits are accounted for...

Job Type Full-time Description Description: The Coder I is responsible to lead our billing team to obtain accurate reimbursement for our providers' claims. This is done through thoroughly reviewing, analyzing, and coding both diagnostic and procedural documentation used in the billing of charges for physician services. Responsibilities: Performs initial charge review to determine appropriate CPT and ICD-10 codes to be used in reporting physician services to third party payers. Interprets progress notes, operative reports, and charge documents to determine services provided and accurately assigns CPT and ICD-10 codes to these services. Provides coding education to client as required. Performs a comprehensive review of the record to assure all vital information such as patient identification, signatures, and dates are all present in the record. Evaluates the records for documentation consistency and adequacy. Ensures that the diagnosis(es) accurately reflects...

Anticipated End Date: 2026-09-25 Position Title DRG Coding Auditor Principal Job Description Location: This role enables associates to work virtually full-time , except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. How you'll make a difference Analyzes and audits claims by integrating advanced or convoluted medical chart coding principles (found in the Official Coding Guidelines, Coding Clinics, and the ICD-10 Alphabetic and Tabular Indices), complex clinical guidelines and...

Become a part of our caring community The 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 Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The 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 Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

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 other...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

MICROBIOLOGY MEDICAL LABORATORY SUPERVISOR Laboratory Licking Memorial Health Systems (LMHS) is a leading, non-profit healthcare organization, passionately dedicated to improving the health and well-being of our community. With a history dating back to 1898, LMHS remains a cornerstone of healthcare excellence, catering to the evolving needs of Licking County. Our cutting-edge facility provides a comprehensive spectrum of patient care services, from life-saving emergency medicine to the comforting embrace of home healthcare, with a unique range of specialized medical services, including cancer, heart health, maternity, and mental wellness. When you join the LMHS team, you become a vital part of your local community Hospital. Working at LMHS is not just a job, it is a unique opportunity to directly impact the health and well-being of your friends, family, and neighbors. You will be providing care in a place in which you are personally connected, where the impact of your work...

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Health Information Management Shift/schedule: Full Time (40 hrs/wk) GENERAL SUMMARY Works under the supervision of the HIM Manager (Operations & Auditing). The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting. Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately. Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines. Performs other duties as assigned....

Coder - Professional Functioning within the health system# mission, values, objectives, procedures and policies, the Coder - Professional codes all physician office medical records as assigned by reviewing the entire medical record to determine if the documentation supports the code assignment as well as reviewing the chart for any specific regulations such as medical necessity. Education: An associate#s degree or completion of a certified coding program is required. Licensure/Certification: Current CPC or AHIMA Certified Physician Coder is required. Will consider candidate who is actively enrolled in certification program. To retain position, if individual without a current certification is hired into a Coder - Professional position, s/he must successfully obtain certification within one year of hire. Experience: A minimum of two years of coding experience in a physician#s office or hospital setting is preferred. Skills: Must be knowledgeable in grouper mechanics,...

Medical Billing SpecialistHealth Partners of Western Ohio is an independent, non-profit and community-directed organization. We serve low-income areas and places without access to care. We're led by a volunteer Board of Directors. Most of our board members are also patients. Our mission is to eliminate gaps in health outcomes for all members of our community by providing access to quality, affordable, preventive and primary health care.Position Purpose:With knowledge of FQHC billing requirements, the Accounts Receivable Specialist prepares, submits, and follows up on insurance claims to the state Medicaid program to support an efficient and effective revenue cycle.Essential Functions and Basic Duties:Review insurance coverage and patient demographic information to ensure accuracy and completeness prior to billingPrepare, review, submit, and track insurance claims to Medicaid payers in accordance with FQHC, state, and federal billing requirementsProcess insurance reimbursements and...

Location: Portsmouth, Ohio, United StatesCompany: Southern Ohio Medical CenterPosted: 2026-06-20Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process." Department: Health Information Management Shift/schedule: Full Time (40 hrs/wk), Remote GENERAL SUMMARYWorks under the supervision of the Health Information Reimbursement Manager. The primary job function of the HIM Coder Level I are to assign correct, ICD-10 and CPT codes to established diagnoses and procedures to outpatient (emergency room, same-day surgery, interventional radiology, observation and/or Urgent Care Center) and/or limited inpatient records. In some instances, may audit OP and /or IP records for charging accuracy. May be asked to add or delete charges for optimal reimbursement as well as compliance following coding and governmental guidelines. The level one coder has mastered a maximum of 2 work types. Performs other duties as assigned....

Certified Coder, Specialty Coding Position: Certified Coder - Specialty Coding. Contract Type: Full-Time Days. Employer: Summa Health System. Location: US:OH:Akron 1077 Gorge Blvd, Summit, Akron, OH 44310, US. Salary: $22.61/hr - $27.14/hr. Post Date: 07/28/2026 Responsible for all aspects of coding review, billing data entry, reprocessing of coding denials (including follow-up and coding denial queues), reconciling services provided at the hospital, and maintaining regulations requirements. Uses coding knowledge to make sure that the appropriate code was used given the support of the charge to be posted. Ensures that work is done accurately, timely, and in compliance with federal, state, and payer specific regulations. Supports the coordination of care through Patient-Centered Medical Home methodologies, as applicable. Formal Education Required High school diploma or equivalent Completion of a formal medical coding training program Current coding certification required. CCA, CCS...

Join Our Team as a Medical Billing Specialist! At One Health Ohio, we believe in fostering a positive work environment that prioritizes our team and our patients. Enjoy competitive benefits and a supportive workplace where your contributions truly matter! Do you have prior billing experience in dental or medical settings? Are you looking for a role that blends your billing expertise with a clinical touch? If so, we could be the perfect next step in your career journey. Benefits Include: Affordable Health, Vision, Dental, and Life Insurance 401(K) with dollar-for-dollar matching (up to 4%) Generous Paid Time Off (PTO) Paid Holidays Essential Job Functions: Prepares and submits clean claims to various insurance companies either electronically or by paper. Answers questions from patients, clerical staff, and insurance companies. Identifies and resolves patient billing complaints. Prepares, reviews, and sends patient statements. Evaluates patient's...

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization's operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. JOB DUTIES/RESPONSIBILITIES Duty 1: Maintains a thorough understanding and education of federal and state regulations and payer...

Medical Billing SpecialistEstablished in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation's largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.Hourly Range: $23.5577 to $32.9808 USDThe Medical Billing Specialist reports to the Revenue Cycle Manager and is responsible for various tasks to ensure efficient billing, follow up, payment processing, and patient communication activities to maximize revenue. Essential functions of the job include,...

Cardiology Department Coder/Medical Biller Toledo Clinic's Cardiology Department is seeking a full-time Coder/Medical Biller to work full-time (M-F, 8-5). Previous experience as a Coder in a medical office preferred. General Summary: Responsible for application of CPT and ICD-10 codes to all procedures performed for a given date of service for The Toledo Clinic, as well as tracking of patients seen and working all eCW claims for denials, errors. Principal Duties & Responsibilities: Example of Essential Duties: Codes visits utilizing the ICD-10 and CPT codes from patient visit documentation. Demographic registration/updates for all patients Enters charges into claim entry in eCW Monitors, submits, correct all claim activity Create workflow processes to ensure accuracy and accountability Other Essential Duties May Include (but are not limited to): Assists patients and/or insurance companies with billing and authorization questions. Coordinate with...

1 week ago Be among the first 25 applicants This range is provided by Insight Global. Your actual pay will be based on your skills and experience talk with your recruiter to learn more. Base pay range $50,000.00/yr - $55,000.00/yr Direct message the job poster from Insight Global Professional Recruiter at Insight Global QUALIFICATIONS: Associates Degree or 3-5 years related experience or equivalent combination of education and experience specifically dealing with Medicare and Medicaid Experience collecting unpaid payor transactions and researching discrepancies. POSITION SUMMARY: Maintains accounts receivable records and processes invoice transactions for Medicaid and other insurance payors, performing follow-up efforts to secure payment for services delivered. ESSENTIAL DUTIES: Maintains the sponsor file in the Agency Accounts Receivable System (HSIS) to ensure proper billing to client payor sources. Performs collection activities to follow up...