6 outpatient professional coder jobs found

About the Job The Director of Reimbursement and Market Access is responsible for assisting the Senior Vice President of Reimbursement and Market Access by collaborating with life sciences clients to provide analysis and insight related to coding, reimbursement, practice management, and policy. This individual will leverage internal data sources and professional experience to effectively support clients in developing and implementing reimbursement and market access strategies for their drugs, devices and other healthcare technologies. Duties and Responsibilities Develop and implement coding and reimbursement strategies for new and existing drugs, biologics, medical devices, digital technologies and diagnostic tests Lead client project engagements by serving as the direct point of contact for clients and coordinating with project teams Evaluate drugs and technologies to assess the potential applicability of coding options (HCPCS, CPT, ICD-10-PCS, and ICD-10-CM)...

Job Title: Manager Location: System Business Office Department Name: HIM - Professional Req #: 0000207266 Status: Salaried Shift: Day Pay Range: $110,681.00 - $156,337.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The  System Professional Coding Provider Review and Education Manager  is responsible for onboarding, educating, and reviewing medical record documentation and coding processes of the Medical Group physicians, APNs and other billing providers across all medical centers within the RWJBH enterprise. This includes onboarding education, medical record reviews, targeted education to physician groups and individual physicians, annual and quarterly...

CPC Expertise in medical record review to abstract information required to support accurate coding. Ability to identify documentation deficiencies and properly query providers for proper code capture. Expertise in assigning accurate CPT, HCPCS Level II, and ICD-10-CM medical codes for diagnoses and procedures. Proficiency across a wide range of services, including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine. A sound knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture. CPB Proven knowledge of how to submit claims compliant with government regulations and private payer policies. Ability to follow up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. In-depth knowledge of...

Phoenix Behavioral Healthcare, LLC is seeking a highly skilled Executive   Director of Revenue Cycle Management (RCM) to oversee and optimize the full revenue cycle across multiple behavioral health facilities, clinics, laboratories, and E&M service lines. This onsite leadership role manages all aspects of RCM operations—including intake, UR/UM alignment, coding, billing, claims submission, collections, clinical documentation improvement, denial management, appeals, and compliance oversight. Key Responsibilities: Lead, manage, and optimize end-to-end revenue cycle operations for all Phoenix facilities Oversee billing and coding for inpatient, outpatient, lab, and professional services (UB-04 & CMS-1500) Direct UR/UM workflow integration to improve documentation quality and turnaround times Manage and mentor a full RCM support team (billers, coders, auditors, documentation trainers, compliance) Develop standardized...

The Certified Professional Medical Auditor is responsible for performing comprehensive audits of medical records, coding, and billing to ensure accuracy, compliance with federal and state regulations, and alignment with payer policies. This role helps protect the organization from financial risk, supports accurate reimbursement, and promotes high standards of documentation and clinical integrity. Key Responsibilities Perform prospective and retrospective audits of medical records, coding, and billing across assigned service lines (e.g., outpatient, inpatient, behavioral health, SUD/MH, lab). Verify that documentation supports ICD‑10‑CM, CPT, and HCPCS coding; identify under‑coding, over‑coding, unbundling, and other compliance risks. Review claims for adherence to Medicare/Medicaid, commercial payer, and regulatory guidelines; ensure compliance with NCCI edits and payer‑specific policies. Prepare clear, detailed audit reports summarizing findings,...