52 outpatient complex coder jobs found

Job Type 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...

Job Title Under direct supervision, responsible for conducting review of inpatient and outpatient coding, assuring coding compliance with federal regulations, and maintains up-to-date coding guidelines and coding policy changes. Performs all tasks required to facilitate medical billing to include abstracting complex patient related data from medical records and coding of diagnoses and procedures using the ICD-10 and CPT classification systems. This position will be a hybrid position working remote and/or on campus. Candidate being considered would need to live within commuting distance of UT Health San Antonio. Upon hire candidate will be required to be onsite for orientation and training. Transition to remote work is contingent on meeting productivity and quality standards as determined by supervisor. Remote Coders may be required to occasionally attend on campus training and meetings. Responsibilities Reviews, interprets, and assigns diagnostic and procedural codes based...

Professional Coder II What we do here changes the world. UTHealth Houston is Texas' resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That's where you come in. Once you join us you won't want to leave. It's because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you'd expect from a top healthcare organization (benefits, insurance, etc.), plus: 100% paid medical premiums for our full-time employees Generous time off (holidays, preventative leave day, both vacation and sick time all of which equates to around 37-38 days per year) The longer you stay, the more vacation you'll accrue! Longevity Pay (Monthly payments after two years of service) Build your future with our awesome retirement/pension plan! We take care of our employees! As a world-renowned institution, our employees' wellbeing is important to us. We offer work/life services such as... Free financial...

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 Lead 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 clinical...

Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women Children’s Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription...

Who We Are JPS Health Network is a $950 million, tax‑supported healthcare system in North Texas. Licensed for 582 beds, the network features over 25 locations across Tarrant County, with John Peter Smith Hospital a Level I Trauma Center, Tarrant County's only psychiatric emergency center, and the largest hospital‑based family medical residency program in the nation. The health network employs more than 7,200 people. Acclaim Multispecialty Group Acclaim Multispecialty Group is the medical practice group featuring over 300 providers serving JPS Health Network. Specialties range from primary care to general surgery and trauma. The Acclaim Multispecialty Group formed around a common set of incentives and expectations supporting the operational, financial, and clinical performance outcomes of the network. Our goal is to provide high quality, compassionate clinical care for every patient, every time. Why JPS? We're More Than a Hospital. We're 7,200 Of The Most Dedicated People You...

Location :Medical Center - Fort WorthDepartment :HIM-CodingShift :First Shift (United States of America)Standard Weekly Hours :40Summary :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 ambulatory surgery and observation visit medical records.Identifies and abstracts specified information from the patient medical record and enters data into the electronic health record system for billing and use in all...

Location: Medical Center - Fort Worth Department: HIM-Coding Shift: First Shift (United States of America) Standard Weekly Hours: 40 Summary: The HIM Coder Analyst III requires superior 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-9-CM, ICD-10-CM/PCS and CPT 4 codes accurately and timely to the highest level of specificity based upon physician documentation for inpatient, observation and outpatient ambulatory procedures/treatment room records. Validates the coded data to one or more Diagnosis Related Groupers (DRG) validates the Present on Admission (POA) indicators for accuracy. Primarily codes more complex and difficult inpatient medical records. Identifies and abstracts specified...

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 ambulatory surgery and observation visit medical records. Identifies and abstracts specified information from the patient medical record and enters data into the electronic health record system for...

Position Summary: The Professional Coder II is responsible for reviewing medical documentation provided by physicians or other health care professionals to validate or assign and sequence CPT/HCPCS, ICD-10CM, and modifiers for both clinic and hospital based professional encounters. The Coder applies coding conventions in accordance with official coding and regulatory guidelines, third-party payer policies, and departmental procedures. This role is responsible for inpatient/outpatient E/M encounters including office or hospital outpatient procedures, radiology and emergency department visits. Position Key Accountabilities: Resolves edits and assigns diagnosis and procedure codes. Responsible for reviewing encounters in the coding work queue in a timely manner and resolving all coding related edits. Reviews medical record and accurately assigns and sequences CPT, ICD-10CM, and HCPCS codes/modifiers ensuring compliance with all applicable guidelines. Approves and...

$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...

About Us Community Health Choice, Inc. (Community) is a non-profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 Members with the following programs: • Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women • Children's Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR • Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions. • Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits,...

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Healthcare isn't just changing. It's growing more complex every day. ICD-10 Coding replaces ICD-9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and Healthcare organizations continue to adapt, and we are vital part of their evolution. And that's what fueled these exciting new opportunities. Who are we? Optum360 . We're a dynamic new partnership formed...

What we do here changes the world. UTHealth Houston is Texas’ resource for healthcare education, innovation, scientific discovery, and excellence in patient care. That’s where you come in. Once you join us you won't want to leave. It’s because we reward our team for the excellent service they provide. Our total rewards package includes the benefits you’d expect from a top healthcare organization (benefits, insurance, etc.), plus: 100% paid medical premiums for our full‑time employees Generous time off (holidays, preventative leave day, both vacation and sick time – all of which equates to around 37-38 days per year) The longer you stay, the more vacation you’ll accrue! Longevity Pay (Monthly payments after two years of service) Build your future with our awesome retirement/pension plan! We take care of our employees! As a world-renowned institution, our employees’ wellbeing is important to us. We offer work/life services such as: Free financial and legal counseling Free...

Overview 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) code sets 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 ambulatory surgery and observation visit medical records. Identifies and abstracts specified information from the patient medical record and enters data into the electronic health record 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...

An established industry player is seeking a Senior Outpatient Coder to ensure accurate coding for outpatient encounters. This role involves working with complex medical records and collaborating with healthcare professionals to maintain high standards of coding quality. The ideal candidate will have a strong background in ICD-10-CM and CPT coding, along with experience in utilizing electronic health record systems. Join a forward-thinking organization that values initiative and continuous improvement, and contribute to enhancing the quality of healthcare data management. #J-18808-Ljbffr

Community Health Choice, Inc. (Community) is a non‑profit managed care organization (MCO), licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 94 hospitals, Community serves over 400,000 members with the following programs: Medicaid State of Texas Access Reform (STAR) program for low‑income children and pregnant women Children’s Health Insurance Program (CHIP) for the children of low‑income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre‑existing conditions. Community Health Choice (HMO D‑SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription...

Job Description Job Description Hiring for a Medical Billing Specialist in San Antonio, TX. This will be fully on-site! Pay rate: $20-25/hr (based on experience) Schedule (full time option):  Monday-Friday 7:30am-4:30 Schedule (part-time options):  16-24 Hours a week 3-5 days a week or Monday-Friday 4-5 hours a day (i.e 12:00pm-5:00pm) Responsibilities:   Review clinical documentation to ensure the appropriate coding (CPT codes, diagnosis codes, modifiers, etc) Ensure all codes meet federal, state, and insurance-specific guidelines  Communicate with payers via portals or phone to resolve outstanding payment issues  Post insurance and patient payments accurately to the practice management system  Maintain strict adherence to HIPAA regulations regarding patient data privacy Audit medical records regularly to ensure proper coding & documentation supports the service billed Must Haves: Experience: Minimum 1 year of experience in outpatient billing, Vascular is...

Certified Professional Coder Think of yourself as someone who will provide world-class service to our customers or clients in an accurate, efficient, and respectful manner on every call as measured by different performance metrics, so not everyone can qualify for this role. We make sure we get the best of the best, after all, we are a ridiculously good company so we make sure our employees are top-notch. So come on, now we need your full concentration because it's time to imagine what it's like being a Certified Professional Coder. As a Certified Professional Coder you will... Audit charts to ensure accurate ICD-10 CM and CPT code assignment as well as documentation integrity to prevent claim denials. Use critical and logical thinking skills in chart-auditing based on the guidance set forth by the client. Uphold netiquette and professionalism in any interaction with the TaskUs team, other vendors and the client. Job Summary: The CPC will be responsible for reviewing...

At Houston Methodist, the Senior Outpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to day surgery and observation 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 or higher degree in a Comission on Accreditation for Health Informatics and Information Managment 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 outpatient coding experience or successful completion of the Houston Methodist Senior Outpatient Coder Transition Program LICENSES AND CERTIFICATIONS Required Must have one of the following:-RHIT - Certified Health Information Technician (AHIMA)-RHIA - Registered Health Information...

At Houston Methodist, the Lead Outpatient Coder position is responsible for providing administrative support to the department while ensuring diagnostic and procedure codes are assigned accurately to outpatient encounters based upon documentation within the electronic medical record and maintaining compliance with established rules and regulatory guidelines. This position serves as the liaison between management, staff and physicians for routine matters, resolving questions and issues. Duties may be varied and may include many of the following: organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of staff performance, develop and implement quality improvement activities, train and mentor staff, provide feedback on staff performance and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. FLSA STATUS Non-exempt...

At Houston Methodist, the Inpatient Coder position is responsible for ensuring diagnostic and procedure codes are assigned accurately to inpatient 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 CAHIIM accredited program or additional two years of experience (in addition to the minimum experience requirements listed below) in lieu of degree EXPERIENCE One year of relevant inpatient coding experience or successful completion of the Houston Methodist Coding Apprentice Program or Outpatient to 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)...