463 payment integrity coder jobs found

A healthcare organization is seeking a Coder Trainer I, fully remote, to develop and conduct training programs for the Payment Integrity department. This role involves conducting training needs analyses, developing training programs, and evaluating their effectiveness. Candidates should have a Bachelor's degree and at least 2 years of training experience in a healthcare environment. Competitive salary and a range of benefits including flexible work options are provided. #J-18808-Ljbffr

Overview Payment Integrity Nurse Coder RN III role at L.A. Care Health Plan . Responsibilities The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to include concept and cost avoidance development. This position trains and mentors Payment Integrity Nurse Coder, RN staff. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Performs quality audits to include validation of accuracy and completeness of ICD, Rev...

Payment Integrity Nurse Coder RN III (Job ID: 12330) Location: Los Angeles, 90017 Shift: Full Time Pay Range: $102,183.00 (Min.) – $132,838.00 (Mid.) – $163,492.00 (Max.) Job Description The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise and judgment in the application of medical and reimbursement policies within the claim adjudication process. The role involves medical record review for Payment Integrity and Utilization Management projects, serving as a subject‑matter expert (SME), performing quality audits, validating coding accuracy and completeness, and guiding Payment Integrity initiatives, including concept and cost avoidance development. Additionally, the position trains and mentors Payment Integrity Nurse Coder, RN staff, acting as a resource and mentor for fellow employees. Qualifications At least 8 years of clinical RN experience. At least 3 years of experience in utilization...

A prominent healthcare institution in Los Angeles is seeking a Payment Integrity Nurse Coder RN III to review medical records and provide expertise in claim adjudication. The role requires extensive knowledge of coding and healthcare reimbursement. Ideal candidates will have substantial RN experience in clinical settings and a strong background in utilization management or clinical coding. This position offers a full-time shift and great compensation along with the opportunity to mentor other staff members. #J-18808-Ljbffr

Payment Integrity Nurse Coder RN III Job Category: Clinical Department: Claims Integrity Location: Los Angeles, CA, US, 90017 Position Type: Full Time Requisition ID: 12330 Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding...

Overview At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. We are a leading authority in payment integrity solutions. The Outpatient Payment Integrity Coder Auditor is responsible for reviewing outpatient medical claims to ensure coding accuracy, compliance, and appropriate payment in accordance with CMS and payer-specific guidelines. This role supports the development and implementation of payment integrity initiatives by identifying coding and billing inaccuracies, trends, and potential cost savings opportunities across outpatient facility claims. The ideal candidate has advanced knowledge of outpatient coding, APC and EAPG payment methodologies, and clinical documentation requirements, with strong analytical and auditing skills. Responsibilities Perform detailed coding audits on outpatient facility claims to validate appropriate CPT/HCPCS, revenue codes, modifiers, and ICD-10 coding in accordance with CMS, NCCI, and...

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at...

Overview Introduction Do you want to join an organization that invests in you as an Inpatient Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Benefits Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and...

PRN Coder Analyst IV Marshall Health Network's Health Information Management department is seeking a PRN Coder Analyst IV. System Specific Duties and Responsibilities: Assign accurate diagnosis and procedure codes using ICD-10-CM/PCS, CPT, and/or HCPCS for reimbursement, compliance, and reporting purposes. Utilizes coding guidelines set up by government agencies dealing with the coding of health information. Demonstrates, promotes, and monitors for high standards of quality and productivity; focuses on quality results first. Maintains a standard of productivity that consistently meets or exceeds 98% of productivity. Maintains a standard or quality that consistently meets or exceeds 95% accuracy rate. Proficient to expert level knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS code sets. Proficient to expert level knowledge of MS-DRG and APR-DRG groupers and Medicare's inpatient prospective payment system (IPPS) and outpatient prospective payment system (OPPS)....

JOB SUMMARY The Health Information Management (HIM) Coder impacts Memorial's Healthcare quality initiatives and reimbursement through the assignment of the most accurate and optimal diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing. Under the direction of the Health Information Management (HIM) Coding and Clinical Documentation Integrity (CDI) Manager, this position will code and analyze physician documentation contained in health records (electronic, paper or hybrid) to determine the appropriate principal diagnosis, secondary diagnoses, and procedures codes to accurately capture MS-DRG assignment. Use the Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers in accordance with coding rules and regulations. The coding information is used to determine APC's (Ambulatory Payment Classification) for data quantitative analysis,...

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 a 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...

Inpatient Coder Opportunity Do you want to join an organization that invests in you as an Inpatient Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Parallon offers a total rewards package that supports the health, life, career, and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing. 401(k) Plan with a 100% match on 3% to 9% of pay...

Description Leidos, a global technology leader, is seeking a Combat Coder for our Sentinel program, supporting the United States Air Force in geographically distributed intelligence operations. Combat Coders directly support mission objectives by integrating data sources and interfaces quickly while being embedded with the user base. As a Combat Coder you will engage directly with our customers to build and modify all aspects of full-stack applications. Your contributions will move directly to production systems and get immediate feedback. You will be working with a small elite team of developers that focus on getting things done to support the mission. Join Leidos in our mission to enhance global security and efficiency through technology and innovation. Be part of a team that champions Integrity, Inclusion, Innovation, Agility, Collaboration, and Commitment. If you're ready to drive critical software deliveries, apply now to join Leidos as a Combat Coder for the...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Coding Team Member We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. At CHS, our coding team recognizes your individual talents, encourages professional development, and provides opportunity for career advancement. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 14 states, CHS is committed to helping people get well and live healthier. CHS operates 70 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Job Summary As a member of the 100% US Based HIM Central Services coding team, the Coder IP provides inpatient coding assistance for a set of HIM Central Services-supported CHS...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Coding Team Member We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. At CHS, our coding team recognizes your individual talents, encourages professional development, and provides opportunity for career advancement. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 14 states, CHS is committed to helping people get well and live healthier. CHS operates 70 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Job Summary As a member of the 100% US Based HIM Central Services coding team, the Coder IP provides inpatient coding assistance for a set of HIM Central Services-supported CHS...

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 a 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...

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 a 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...

Coder III Cardiology Job ID: R207422 Shift: 1st Full/Part Time: Full Time Pay Range: $28.05 $42.10 Location: Remote, WI Hours Per Week: 40 Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so you can live fully at and away from work, including: Compensation Base compensation within the position's pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses...

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 a 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...

Join Our Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Build the possibilities. Make an extraordinary impact. Title: DRG Coding Auditor This role enables associates to work virtually full-time, with the exception of 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. 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 an accommodation is granted as required by law. Alternate locations may be considered if candidates reside within a commuting distance from an office. The DRG Coding Auditor is...

Description Hourly Wage Estimate: $23.62 - $35.44 / hour Learn More About The benefits Offered For This Job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction Do you want to join an organization that invests in you as an Inpatient Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Benefits Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and...

Job Description Job Description Benefits: 401(k) matching Company parties 401(k) Dental insurance Health insurance Paid time off Vision insurance Job Details Position Title: Medical Biller / Coder Job Type: Full-Time Compensation: $55,000-$75,000 annually Location: In-office position - 81st & Mingo area, South Tulsa, OK Where accuracy, accountability, and healthcare operations come together! Please note this is an in-office position; remote work is not available. **Pre-employment screening required.** About the Role Our team at CCF Group is seeking an experienced Medical Biller/Coder to support the financial and operational integrity of our healthcare services. This role is essential to ensuring timely reimbursement, accurate claim submission, and compliance with payer requirements.We are looking for a detail-oriented professional with a strong billing background, who understands the full revenue cycle and can confidently work with insurance portals,...