39 outpatient complex coder jobs found

Description: Investigates complex healthcare claims flagged by third-party referrals, tips, or external allegations prior to payment. This role combines advanced clinical coding expertise (ICD-10, CPT, HCPCS) with investigative scrutiny. The auditor reviews medical records to verify that documented services match the billed codes, adhere to medical necessity guidelines, and comply with state, federal, and contractual coding regulations. Key responsibilities: Allegation Triaging & Investigation: Analyze incoming third-party referrals, compliance tips, and external fraud allegations to identify specific billing patterns, suspect providers, or unbundled services. Identify potential fraud, waste, abuse, billing irregularities, and patterns of non-compliance through medical record review and claims analysis. Pre-Payment Clinical Review: Perform comprehensive clinical and technical reviews of high-dollar or highly complex medical records before a claim is finalized for payment....

Insight Hospital and Medical Center Chicago At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full-service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world-class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago team that provides patient care second to none! Position Purpose Provides high level technical competency and subject matter expertise analyzing physician/provider documentation contained in assigned Complex Outpatient (CO) and/or Inpatient health records to determine the principal diagnosis, secondary diagnoses,...

Job Title: Pre-Payment Clinical Auditor (RN/Coder) Contract Duration: 6 months, possible extension Work Arrangement: Remote Summary Investigates complex healthcare claims flagged by third-party referrals, tips, or external allegations prior to payment. This role combines advanced clinical coding expertise (ICD-10, CPT, HCPCS) with investigative scrutiny. The auditor reviews medical records to verify that documented services match the billed codes, adhere to medical necessity guidelines, and comply with state, federal, and contractual coding regulations. Key Responsibilities Allegation Triaging & Investigation: Analyze incoming third-party referrals, compliance tips, and external fraud allegations to identify specific billing patterns, suspect providers, or unbundled services. Identify potential fraud, waste, abuse, billing irregularities, and patterns of non-compliance through medical record review and claims analysis. Pre-Payment Clinical Review: Perform comprehensive...

Outpatient Coder II, HB Coding, Full-time, Days (Remote - Must reside in IL, IN, IA, WI, MO - Sign-on bonus eligible) Full-time Job Shift: Day Job (1st) Compensation: USD 30 - USD 40.5 - hourly Company Description At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better? Job Description Required: 3-4 years of coding experience in an acute healthcare setting RHIT, RHIA or CCS credentialed The Outpatient Coder II reflects the mission, vision, and...

About Ensemble Thank you for considering a career at Ensemble!Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!O.N.E Purpose:Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation....

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognise that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation. Striving...

Thank you for considering a career at Ensemble! Ensemble is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognise that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference! O.N.E Purpose: Customer Obsession: Consistently provide exceptional experiences for our clients, patients, and colleagues by understanding their needs and exceeding their expectations. Embracing New Ideas: Continuously innovate by embracing emerging technology and fostering a culture of creativity and experimentation....

Jamison Professional Services, Inc. (“Jamison”) is currently seeking a qualified and motivated candidate for the position of Certified Inpatient/Outpatient Medical Coder. Job Title: Certified Inpatient/Outpatient Medical Coder (Medical Records Technician) Candidates must hold at least one current certification from AHIMA or AAPC, including: Registered Health Information Technician - RHIT Certified Coding Specialist - CCS Certified Coding Specialist–Physician Based - CCS-P Registered Health Information Administrator - RHIA Certified Professional Coder - CPC Candidates must provide documentation verifying their current certification. DESCRIPTION OF SERVICES: The Medical Records Technicians - Inpatient/Outpatient Coders will provide remote medical coding services in support of a federal healthcare client. The selected candidates will perform inpatient and outpatient medical records coding, coding validation, documentation review, provider queries, and...

Jamison Professional Services, Inc. (“Jamison”) is currently seeking a qualified and motivated candidate for the position of Certified Inpatient/Outpatient Medical Coder. Job Title: Certified Inpatient/Outpatient Medical Coder (Medical Records Technician) Candidates must hold at least one current certification from AHIMA or AAPC, including: Registered Health Information Technician - RHIT Certified Coding Specialist - CCS Certified Coding Specialist–Physician Based - CCS-P Registered Health Information Administrator - RHIA Certified Professional Coder - CPC Candidates must provide documentation verifying their current certification. DESCRIPTION OF SERVICES: The Medical Records Technicians - Inpatient/Outpatient Coders will provide remote medical coding services in support of a federal healthcare client. The selected candidates will perform inpatient and outpatient medical records coding, coding validation, documentation review, provider queries, and...

Join to apply for the Coder lll - Inpatient Coder role at Insight Health Systems . 3 weeks ago. Be among the first 25 applicants. Insight Health Systems provided pay range This range is provided by Insight Health Systems. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range $31.00/hr - $36.00/hr At Insight Hospital and Medical Center Chicago, we believe there is a better way to provide quality healthcare while achieving health equity. Our Chicago location looks forward to working closely with our neighbors and residents, to build a full‑service community hospital in the Bronzeville area of Chicago; creating a comprehensive plan to increase services and meet community needs. With a growing team that is dedicated to delivering world‑class service to everyone we meet, it is our mission to deliver the most compassionate, loving, expert, and impactful care in the world to our patients. Be a part of the Insight Chicago...

Medical Coder (Remote) - Contract Opportunity Job ID: 297083 Location: Remote Facility: Hopedale Medical Complex Employment Type: Contract Duration: 13 Weeks Schedule: Day Shift Start Date: ASAP (Quick Start Available) Position Summary Hopedale Medical Complex is seeking an experienced Medical Coder to join its team on a contract basis. This remote opportunity is ideal for a coding professional with strong experience across multiple healthcare service lines and a commitment to coding accuracy, compliance, and revenue cycle integrity. The Medical Coder will be responsible for reviewing clinical documentation and assigning accurate diagnostic and procedural codes for a variety of patient encounters within a Critical Access Hospital environment. This position plays a key role in supporting compliant billing practices, reimbursement accuracy, and regulatory requirements. Key Responsibilities Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes based on...

Certified Inpatient/Outpatient Medical Coder - RemoteJamison Professional Services, Inc. ("Jamison") is currently seeking a qualified and motivated candidate for the position of Certified Inpatient/Outpatient Medical Coder (Medical Records Technician).Candidates must hold at least one current certification from AHIMA or AAPC, including:Registered Health Information Technician - RHITCertified Coding Specialist - CCSCertified Coding Specialist–Physician Based - CCS-PRegistered Health Information Administrator - RHIACertified Professional Coder - CPCCandidates must provide documentation verifying their current certification. The Medical Records Technicians - Inpatient/Outpatient Coders will provide remote medical coding services in support of a federal healthcare client. The selected candidates will perform inpatient and outpatient medical records coding, coding validation, documentation review, provider queries, and related health information management functions. The work will...

Company Description At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better health care, no matter where you work within the Northwestern Medicine system. We pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, our goal is to take care of our employees. Ready to join our quest for better? Job Description Required:3-4 years of coding experience in an acute healthcare settingRHIT, RHIA or CCS credentialed The Outpatient Coder II reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation...

Who You Are You are a detail-oriented, experienced medical coder who understands that accurate coding is the foundation of a healthy revenue cycle. You bring strong outpatient coding expertise and a sharp eye for documentation - catching what others miss and knowing exactly how to translate a clinical encounter into a clean, compliant claim. You communicate confidently with providers and teammates, and you know how to make complex coding questions easier to understand. You thrive in a remote environment where you can take ownership of your work, manage competing priorities, and keep things moving. Most importantly, you care about getting it right - for our providers, our patients, and the business. Who You Are You are a detail-oriented, experienced medical coder who understands that accurate coding is the foundation of a healthy revenue cycle. You bring strong outpatient coding expertise and a sharp eye for documentation - catching what others miss and knowing exactly how to...

Description Required: 3-4 years of coding experience in an acute healthcare setting RHIT, RHIA or CCS credentialed The Outpatient Coder II reflects the mission, vision, and values of NM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. Follows ICD-10-CM Official Guidelines for Coding and Reporting, Coding Clinics, interprets ICD-10-CM coding conventions and instructional notes to select appropriate diagnoses with a minimum of 95% accuracy. Meets established minimum coding productivity per departmental protocol and guidelines. The Outpatient Coder IIis the coding and reimbursement expert with ICD-10-CM diagnosis coding, HCPCS and CPT codes and modifiers. The focus is on complex outpatient encounters that include Observation stays, Same Day Surgery, Surgery Center, and Outpatient in a bed. Should have more in-depth knowledge of...

Job Summary We are seeking an experienced and certified Medical Coder - Inpatient & Outpatient to join our Health Information Management/Revenue Cycle team.The Medical Coder is responsible for accurately reviewing and coding inpatient and outpatient hospital medical records in accordance with official coding guidelines, CMS requirements, payer regulations, and hospital policies.This position plays an essential role in ensuring coding accuracy, regulatory compliance, timely reimbursement, and the integrity of clinical and financial data.The successful candidate will demonstrate strong knowledge of hospital coding, medical terminology, anatomy and physiology, reimbursement methodologies, and regulatory requirements.Essential Duties and Responsibilities Review inpatient and outpatient medical records and accurately assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes based on assigned account type. Assign and validate appropriate MS-DRG/APR-DRG, APC, Present on Admission (POA),...

Job Title Clinical Documentation Specialist Job Description This position is responsible for reviewing clinical documentation and applying the correct coding and modifiers for clinical services performed in office and/or hospital setting an may include surgical and non-surgical procedural services. This position ensures that the documentation supports the levels or types of service billed, ensures the documentation is compliant with regulatory regulations, provider documentation guidelines, and CPT documentation and CMS coding guidelines. Principal Responsibilities Responsible for reviewing and analyzing documentation present in the medical record for professional services related to clinic, inpatient and/or outpatient services. Verifying and coding of the diagnosis, evaluation and management, procedures or other codes required for the completeness and accuracy of the record. Codes and/or reviews encounters to identify first-listed diagnosis, co-morbidities, complications,...

Hospital Outpatient Coding Specialist Expected pay for this position is $21.71-$31.48. Actual pay will be determined by experience, skills and internal equity. MDH Benefits package includes: Medical, Dental, Vision 457B and employer match for FT Employees Company paid STD and LTD Job Summary: Codes and abstracts hospital outpatient medical records, including but not limited to, emergency department encounters, outpatient surgical services, observation services, rehabilitation services, infusion, and other hospital outpatient visits, for reimbursement, data reporting, research, and compliance with applicable coding guidelines and regulatory requirements. Assigns appropriate ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS codes based on provider documentation and applicable coding guidelines. Reviews medical records for completeness, accuracy, and appropriate code assignment; identifies documentation deficiencies and coding discrepancies; and coordinates follow-up or...

Revenue Cycle SpecialistIndustry: Healthcare / Medical BillingLocation (city, state): Chicago, ILAssignment Type: Contract-to-HirePay: $24–$26 per hour, depending on experience and qualificationsWork Schedule: Monday–Friday, 9:00 AM–5:00 PM (40 hours per week). Occasional Saturday coverage may be required with advance notice.Benefits: This position is eligible for medical, dental, vision, and 401(k).About The Company:Our client is an established healthcare organization providing outpatient medical services. The organization prioritizes quality patient care, efficient financial operations, and teamwork. This opportunity offers the chance to work alongside a collaborative team while supporting billing accuracy, reimbursement, and overall revenue cycle performance.Job Description:We are seeking a detail-oriented Revenue Cycle Specialist to manage various aspects of medical billing and reimbursement for an outpatient healthcare setting. This role involves insurance verification, claims...

Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: PB Revenue Integrity Work Type: Full Time (Total FTE 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits). Pay Range: $27.47 - $43.27 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary: This position is responsible for overseeing the billing, coding guidelines and entire charge capture process for physicians including research charges for Rush...

Job Description Location: Chicago, Illinois Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: PB Revenue Integrity Work Type: Full Time (Total FTE 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits). Pay Range: $27.47 - $43.27 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary: This position is responsible for overseeing the billing, coding guidelines and entire charge capture process for physicians including research charges for Rush...

Job Description Job Description Horizon Health  is a Critical Access, Rural Health Facility comprised of 25-inpatient beds located in Paris, IL & a multitude of outpatient clinic settings including Family Practice and Specialty Clinics in Paris and surrounding cities. We have been serving residents of Edgar County since 1968 though community education, emergency services, and outpatient care. As we continue to expand our services & locations, our community has grown far beyond Paris. Our rich history and strong community support pave the way for the future of healthcare as we serve you—our family, friends, and neighbors. Position Summary: Codes and/or bills the patient's medical record using pertinent information according to departmental and Horizon Health policy and procedures. Uses the healthcare coding systems to accurately assign codes to patient accounts and may require entering billing entries. Essential Functions: Data entry for the facility...

Job TitleClinical Documentation SpecialistJob DescriptionThis position is responsible for reviewing clinical documentation and applying the correct coding and modifiers for clinical services performed in office and/or hospital setting an may include surgical and non-surgical procedural services. This position ensures that the documentation supports the levels or types of service billed, ensures the documentation is compliant with regulatory regulations, provider documentation guidelines, and CPT documentation and CMS coding guidelines.Principal ResponsibilitiesResponsible for reviewing and analyzing documentation present in the medical record for professional services related to clinic, inpatient and/or outpatient services.Verifying and coding of the diagnosis, evaluation and management, procedures or other codes required for the completeness and accuracy of the record.Codes and/or reviews encounters to identify first-listed diagnosis, co-morbidities, complications, therapeutic and...

Inpatient Medical Coder (CCS certified) Assignment Details: 100% REMOTE Position Type: W2 Regular Employment At least 5 years of IP PCS Coding experience, required At least 3 years OP, preferred CCS certificate is required. Schedule: Weekdays, full-time hours Shift: Regular day shift hours System Experience: Cerner | Power Chart | 3M | EPIC Start Date: Immediately To be considered, IP and/or OP assessment test will be required to complete and pass a coding assessment test. Summary IP/OP Coding Specialist demonstrates proficiency in coding all types of inpatient and outpatient accounts. Utilizes International Classification of Disease (ICD-10-CM and PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Responsibilities: 1. Examines the complete medical record to accurately determine the principal & secondary diagnoses, procedures, and complications. 2....