54 plan coder jobs found

Job Description Job Description Hi, we're Oscar. We're hiring a Senior Specialist, Coding Auditor to join our Payment Integrity. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: You will support issue resolution in the Oscar claim environment. You will be responsible for the end-to-end claims repayment quality, process improvement and supporting root cause analysis . You will report into the VP, Payment Integrity. Work Location: This is a remote position, open to candidates who reside in: Tempe, Arizona; Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; New York City, New York; Philadelphia, Pennsylvania; Salt Lake City, Utah. While your daily work will be completed from your...

Navajo Preference Employment Act TCRHCC is located within the Navajo Nation and, in accordance with Navajo Nation law and applicable federal law, has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy, applicants who are enrolled members of the Navajo Nation, Hopi Tribe, and San Juan Southern Paiute Tribe and who meet the necessary qualifications for this position will be given preference in hiring and employment for this position. Applicants who are legally married to an enrolled member of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe, who have resided within the territorial jurisdiction of the Navajo Nation or other federally-recognized American Indian Tribe for at least one continuous year immediately preceding the date of application, and who meet the necessary qualifications for this position will be given secondary preference. Applicants who are enrolled members of any other federally-recognized American Indian Tribe and...

Medical Coder, Tucson, AZ We are currently looking for a Medical Coder. This position is 100% Onsite and NOT Remote. Medical Coder Responsibilities: - Make sure that codes are assigned correctly and sequenced appropriately as per government and insurance regulations. - Comply with medical coding guidelines and policies. - Receive and review patients' charts and documents for verification and accuracy. - Follow up and clarifying any information that is not clear to other staff members. - Collect information made by the Physician from different sources to prepare monthly reports. - Implement strategic procedures and choosing strategies and evaluation methods that provide correct results. - Examine any medical malpractice that has been reported by analyzing and identifying the medical procedures, diagnoses or events that lead to the negligence. Medical Coder Qualifications: - A strong understanding of physiology, medical terms and anatomy. - Knowledge of federal,...

PLEASE NOTE - This position may require temporarily relocation to other TONHC Facilities: Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center. Position Summary: The Lead Medical Coder serves as a certified professional coder and assists the Medical Coding Office Manager with oversight of daily coding operations. Performs the full range of coding, assigns ICD, CPT, HCPCS, and medical inpatient codes; abstracts data from the record; performs chart analysis, research coding issues; peer reviews; and serves as a medical documentation and coding technical expert to TONHC providers. Scope of Work: This position is located within Tohono O'odham Nation Health Care (TONHC). The work involves performing specialized medical record tasks and resolving problems using established processes, coding conventions, and guidelines. Performance of duties reflects directly on patient care by recording services performed on the patient. The...

Become a part of our caring community Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator 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. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and...

Busy OB/GYN practice in Glendale is seeking a full-time Certified OB/GYN Coder to join our team. The ideal candidate will have 2-3 years of OB/GYN coding experience, experience with Athena EHR system, excellent attention to detail and the ability to work independently. Responsibilities Review and accurately code OB/GYN medical records, procedures, surgeries, and office visits using ICD-10-CM, CPT, and HCPCS codes Assign appropriate diagnosis and procedure codes for obstetric and gynecologic services Ensure coding compliance with federal regulations, insurance requirements, and organizational policies Maintain productivity and quality standards while meeting billing deadlines Stay current on coding updates, payer policies, and regulatory changes Collaborate with providers, billing staff, and management to improve reimbursement and compliance processes Benefits 401(k) and pension plan Health insurance Dental insurance Vision insurance Paid time off Life Insurance #J-18808-Ljbffr

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We’re Looking For We’re looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Job Description Job Description TTF is recruiting for an ONSITE Outpatient Coder for a well-respected healthcare organization in Central Phoenix. This is a full-time, Monday-Friday position offering a competitive salary range with the possibility of working remotely after training. Qualified candidates will have 3+ years’ experience Coding in an outpatient setting. Candidates must also have a CPC or CCS certification from AAPC.   Please send your resume to Chelle at CBodnar@ttfrecruit.com for consideration.   TTF is a search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health, consulting companies, and all other healthcare fields. We never charge a fee to candidates and all conversations are kept confidential. We would like to be your career consultant and look forward to working with you.   The TTF Coding and HIM Division partners with...

Job Description Job Description Who We Are At Copa Health, we are committed to People First, fostering a culture of compassion, innovation, and impact. We support individuals and families across Arizona through high-quality behavioral health and integrated care services while also investing in the growth and well-being of our team.    Why Join Copa Health? At Copa Health, we prioritize the growth, well-being, and satisfaction of our team members. When you join our team, you’ll receive: Competitive salary and comprehensive benefits package Personalized Health Coverage – Receive a monthly, tax-free contribution to select the medical plan that works best for you, with guidance and support through our ICHRA program Dental and Vision Coverage to complement your health plan Generous PTO – up to 3 weeks in your first year, plus an additional wellness day to recharge 10 paid holidays annually Wellness Program, including access to mental health resources Tuition...

Are you a detail-oriented Certified Medical Coder who takes pride in accuracy and contributing to quality patient care? We#re looking for someone just like you to join our growing healthcare family at Valleywise Health.As a key member of our team, you#ll play a vital role in ensuring that patient services are accurately coded and reimbursed, helping our clinical teams continue to deliver excellent care.You#ll be surrounded by a supportive team, gain access to ongoing professional development, and have a direct impact on our hospital#s mission to serve the community with compassion and integrity.If you#re a certified medical coder who values accuracy, efficiency, and being part of a healthcare team that truly makes a difference - we want to hear from you! Why You#ll Love Working With Us :# Meaningful Impact :We value you! Accurate medical coding is more than just numbers - it#s about ensuring the integrity of patient care, supporting proper reimbursement, and safeguarding the...

Medical Claims Coder, Tucson, AZ Under general supervision from the Director of Operations, the responsibility of Medical Claims Coder consists of processing claim data and adjudicating medical and inpatient claims received from all provider types and lines of business. Review and resolve rejected and/or denied claims. Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor copays, deductibles, insurance verification, and authorizations. Analyze incoming and outgoing revenue sources and measure different financial cycles on behalf of Customers. Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote. Medical Claims Coder Responsibilities: Submit claims and encounters in a timely manner. Review and resolve rejected, pended, and/or denied claims within expected timeframes. Coordinate claim adjustments with the customer. Identify revenue cycle issues...

TriWest Healthcare Alliance is seeking a skilled coding expert to conduct retrospective medical claims reviews under the guidance of a supervisor. Your role will include coding validation for inpatient claims and ensuring compliance with established guidelines. Applicants should possess a high school diploma, relevant coding certifications, and a minimum of five years of coding experience. This position allows remote work, with extensive benefits including health coverage and a 401(k) plan. #J-18808-Ljbffr

A healthcare data collaboration platform is seeking experienced inpatient coders to join their remote team. The role requires attention to detail, proficiency in medical coding, and strong communication skills. Candidates should have at least 3 years of inpatient coding experience and preferred certifications (CCS, RHIT, RHIA). The position offers a flexible schedule and includes benefits such as a 401k savings plan and comprehensive training. Pay ranges from $32 to $42 per hour based on experience and qualifications. #J-18808-Ljbffr

Centauri Health Solutions, Inc. in Tempe, Arizona, is seeking a skilled Risk Adjustment Coder to enhance healthcare data quality. This role requires certified professionals who can perform accurate coding and documentation improvements, working primarily with Medicaid lines. Candidates must possess a minimum of 3 years of coding experience with relevant credentials like CRC or CPC. The job offers comprehensive benefits, including medical coverage and a 401(k) plan with company match. #J-18808-Ljbffr

Our client is seeking an experienced Quality Assurance Coder/Auditor in Phoenix, AZ on a Hybrid basis. This opportunity will transition from a 6-month contract to direct hire position while being trained as a replacement by a seasoned employee. The Quality Assurance Coder/Auditor will develop a risk mitigation and provider education program. The Quality Assurance Coder/Auditor will perform risk mitigation analysis using available vendor tools to identify at-risk single occurrence of HCCs and OIG targets. Schedule 40 hours a week (plus any additional hours as requested or as needed to meet business requirements). Hybrid 1 day a week in office setting, remainder of week is remote Key Responsibilities Comprehensive understanding of HCC Coding rules, regulations and methodology Review medical records and supporting documentation, determine completeness and accuracy of medical records and supporting documentation, identify and eliminate barriers to correct coding, and recommend best...

Certified Medical Coder- Remote We are seeking a Certified Medical Coder- Remote to join our team. We are deeply rooted in the communities we serve, which means that our patients are often our family, friends, and neighbors, and it is special to be able to care for them. As one of the top healthcare systems, we are committed to your ongoing growth and development. After work, you will find things to do in every season, including beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment. Why work as a Coder Abstractor? Remote work schedule Our dynamic work environment includes many opportunities for growth and development Our efforts directly impact patient satisfaction and outcomes Our employees work in positive, supportive, and compassionate environments built on our organizational values. Skills At least 1 years recent coding experience including coding surgical cases preferred. Experienced in coding hospital inpatient and...

Genesis OB/GYN in Glendale is seeking a full-time Certified OB/GYN Coder to enhance our team. The successful candidate will review and accurately code OB/GYN medical records and procedures while ensuring compliance with regulations. An ideal applicant has 2-3 years of OB/GYN coding experience and proficiency with Athena EHR. Benefits include health insurance, a 401(k) plan, paid time off, and more. Join us to contribute to improving reimbursement and compliance processes. #J-18808-Ljbffr

ED / Observation Coder (Full Time) Unlock your potential for professional development! We are hiring an ED / Observation Coder to join our Imaging Services Team! Located in northwest Arizona, Kingman has a mild climate with stunning Arizona sunsets! In the shadows of beautiful mountain ranges and nearby lakes, Kingman is an outdoor enthusiasts' paradise with abundant sunshine and is a great community to live, work and play! Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. The ED / Observation Coder oversees assigned departments' charging through software systems. Benefits (Full Time Employees): We offer you an excellent total compensation package, including a competitive salary, comprehensive benefits, and growth opportunities: Exceptional Colleagues Join us and you'll be a part of a culture where we support...

Medical Claims Coder, Tucson, AZ The Medical Claims Coder needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medical Claims Coder consists of processing claim data and adjudicating medical and inpatient claims received from all provider types and lines of business. Review and resolve rejected and/or denied claims. Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor copays, deductibles, insurance verification, and authorizations. Analyze incoming and outgoing revenue sources and measure different financial cycles on behalf of customers. Maximize...

Medical Claims Coder, Tucson, AZ The Medical Claims Coder needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medical Claims Coder consists of processing claim data and adjudicating medical and inpatient claims received from all provider types and lines of business. Review and resolve rejected and/or denied claims. Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor copays, deductibles, insurance verification, and authorizations. Analyze incoming and outgoing revenue sources and measure different financial cycles on behalf of customers. Maximize...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

About the job Certified Medical Coder- Remote We are seeking a Certified Medical Coder- Remote to join our team. Weare deeply rooted in the communities we serve, which means that ourpatients are often our family, friends, and neighbors, and it is specialto be able to care for them. As one of the top healthcare systems, weare committed to your ongoing growth and development. After work, youwill find things to do in every season, including beaches, outdoorrecreation, unique restaurants, world-class wineries, arts andentertainment. Why work as a Coder Abstractor ? Our dynamic work environment includes many opportunities for growth and development Our efforts directly impact patient satisfaction and outcomes Our employees work in positive, supportive, and compassionate environments built on our organizational values. SKILLS At least 1 years recent coding experience including coding surgical cases preferred. Experienced in coding hospital inpatient and outpatient E/M services....

Summary Join the Indian Health Service and make a meaningful impact in Native communities. In this role, you will support vital healthcare operations that ensure patients receive timely, high-quality care. If you're looking for a rewarding career where your work directly supports patient services and community well-being, we encourage you to apply. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021). Learn more about this agency Duties Help All Grade levels MAY NOT be available at all locations. Total Compensation Package - Check out IHS's outstanding total compensation package for this job: Medical Records Technician Total Compensation | Pay (ihs.gov) Reviews medical records for completeness, including required identifiers, signatures, dates, and reports associated with services rendered. Evaluates documentation for accuracy, consistency, medical necessity, and appropriate modifier usage; verifies that final...