101 plan coder jobs found

Description Job Summary The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider-coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring/auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Specific Duties Conducts audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD-10-CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Fl AHCA / Medicaid, and CMS regulatory requirements. Monitors professional fee...

Become a part of our caring community The Senior Market Consultation / Partnership Professional (Nurse Medical Coder) supports Clinical Support Team (CST) initiatives by promoting accurate, compliant, and complete documentation and coding practices that enhance the quality and measurement of programs across risk adjustment. Work assignments involve moderately complex to complex issues where analysis of clinical documentation, coding accuracy, and risk adjustment data requires evaluation of multiple variable factors. Key Responsibilities Perform detailed medical record reviews to ensure accurate ICD-10-CM coding, risk adjustment capture, and alignment with CMS-HCC (e.g., V24/V28) models Validate diagnosis coding and ensure documentation meets compliance standards Identify and escalate coding trends and documentation gaps Serve as a coding subject matter expert supporting CST workflows, including PDV, chart review prioritization, and provider outreach...

Job Description Job Description Description: Precision Healthcare Specialists is seeking an experienced and detail-oriented Certified Medical Coder to support our ENT & Allergy Specialists division. The Certified Medical Coder is responsible for accurately reviewing provider documentation and assigning appropriate diagnosis and procedure codes for otolaryngology, allergy, audiology, and related services. This role plays a critical part in ensuring coding accuracy, regulatory compliance, clean claim submission, and optimal reimbursement. The ideal candidate will possess strong knowledge of ICD-10, CPT, and HCPCS coding guidelines, have experience coding specialty physician services, and demonstrate exceptional attention to detail in a fast-paced healthcare environment. Essential Duties and Responsibilities Review and accurately code physician documentation, office visits, procedures, diagnostic testing, and surgical services. Assign ICD-10-CM, CPT, and HCPCS codes in...

Inpatient Medical Coder (Remote - Select States Only) The Inpatient Medical Coder is responsible for accurately coding hospital inpatient records using ICD-10-CM and ICD-10-PCS to support appropriate reimbursement, data integrity, and compliance with federal and state regulations. Candidates must reside in one of the following states: Maryland, Pennsylvania, Washington D.C., West Virginia, Virginia, Tennessee, Texas, North Carolina, South Carolina, Georgia, or Florida. Key Responsibilities Analyze inpatient medical records and assign accurate ICD-10-CM/PCS codes Ensure correct APR-DRG/MS-DRG, SOI, ROM, and POA assignment Review documentation and collaborate with clinical staff and CDI teams to resolve discrepancies Code and abstract records within established productivity and turnaround time standards Maintain high coding accuracy to prevent denials and compliance risk Communicate with billing and hospital departments regarding coding or registration...

Description The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider-coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Summary Conducts audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD-10-CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Fl AHCA / Medicaid, and CMS regulatory requirements. Monitors professional fee vendor‑coding services to...

Join The Team At PedIM Healthcare! Delivering exceptional care, together. PedIM Healthcare is the first private medical office of its kind in Citrus County – offering top-quality care for children, adults, and seniors all under one roof. We provide pediatric, adult internal medicine, family practice, geriatrics, women's care, medical weight-loss, sleep-medicine services and more. Our dedicated, community-focused team is committed to excellence, pride in service, and making a real difference for patients and families across Citrus County. Why Work With Us? A broad, multi-discipline practice where you can grow: pediatrics, internal medicine, weight-loss & sleep medicine specialties. A values-driven environment: we listen, we help, we understand—and we care. Community-oriented and recognized: voted "best of the best" in the region. Opportunity to make a meaningful impact by supporting patients over their full life span—from children to seniors. A workplace...

Job Description - Sr Compliance Auditor (301657) Job Description Sr Compliance Auditor - 301657 Description Job Summary The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider‑coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring / auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Specific Duties Conduct audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD‑10‑CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise...

Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address:...

Introduction Do you want to join an organization that invests in you as a Trauma Surgical Profee 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. Candidates with Trauma/Surgical Profee experience are strongly preferred. 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...

Become a part of our caring community The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 diagnosis codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Risk Adjustment Coder ensures coding is accurate and properly supported by clinical documentation within the health record. Reviewsmedical records toreport conditions that map toHCCs by reviewing medical record documentation and applying theappropriate ICD-10diagnosis codes. Followsstate and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. Works onprojects that may include making phone calls to providers. Works within broad guidelines with little...

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...

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...

Our promise to you Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 900 HOPE WAY City: ALTAMONTE SPRINGS State: Florida Postal Code:...

Our promise to you: Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family: Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address:...

Description Welcome to Pathways Health Partners, the Accountable Care Organization (ACO) that's leading the charge in helping independent providers transition to Value-Based Care. What We Do: Medicare REACH ACO: We're at the forefront of Medicare innovation. Medicare Advantage MSO: Providing top-notch services to our Medicare Advantage patients. Commercial MSO: Managing care for approximately 16,000 patients across North-West/Central Florida. Where We Operate: From The Villages to St. Petersburg, and across to Mount Dora, we've got you covered! Our Services: Hospital Medicine Group: Delivering exceptional care in hospitals. Affiliated Medical Practices: Managing several top-tier medical practices. Insurance Agency: Offering comprehensive insurance solutions. Join us on our journey to better health and value-based care! Job Summary The HCC Risk Coder plays a vital role in coordinating and supporting retrospective and concurrent chart reviews while...

Vaco is hiring for a Medical Coder in Jacksonville, Florida. The role requires a hybrid work environment with a one‑day‑in‑office commitment per week. Overview The Medical Coder is responsible for reviewing medical records and assigning the correct diagnosis and procedure codes. The coder must ensure coding accuracy, compliance, and that the documentation in the patient's chart supports the coding. Responsibilities Review physician documentation and assign the correct ICD‑10, CPT, and/or HCPCS codes. Ensure coding is accurate and follows all required coding guidelines. Review medical records to gather the information needed for coding. Ask for clarification when physician documentation is incomplete, unclear, or does not support the code. Stay current on coding guidelines, payer requirements, and reimbursement rules. Maintain coding accuracy and meet productivity expectations. Follow company policies, procedures, HIPAA, and compliance guidelines. Attend coding meetings...

Vaco is hiring for a Medical Coder in Jacksonville, Florida. This is a hybrid work environment requiring a commitment of one day per week in the office. The Medical Coder is responsible for reviewing medical records and assigning the correct diagnosis and procedure codes, ensuring coding is accurate, compliant, and supported by the documentation in the patient’s chart. Main Responsibilities Review physician documentation and assign the correct ICD‑10, CPT, and/or HCPCS codes. Ensure coding accuracy and adherence to coding guidelines. Gather information from medical records for coding. Request clarification when documentation is incomplete or unclear. Stay current on coding guidelines, payer requirements, and reimbursement rules. Maintain coding accuracy and meet productivity expectations. Follow company policies, procedures, HIPAA, and compliance guidelines. Attend coding meetings and complete continuing education as required. Maintain active coding certification....

Physician Coding Auditor The Physician Coding Auditor performs coding related audits to monitor professional coding to ensure optimal efficiency and follow the controlling compliance guidelines with governmental and private payers. The Physician Coding Auditor is responsible for analyzing Physician and Coder charges for Surgical, procedural and E/M based coding. Orlando Health is committed to providing benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible, so that you can be present for your passions. "Orlando Health Is Your Best Place to Work" is not just something we say, it's our promise to you. Orlando Health proudly embraces and honors the individuality of our team members. By sharing different ideas and perspectives and working together as a team, we are better able to relate to, care for...

Certified Medical Coder Are you a skilled and detail-oriented Certified Medical Coder seeking an exciting opportunity to join Quest National Services, a thriving medical billing company? We are looking for a dedicated individual to join our dynamic team at our Downtown Orlando office. If you have a passion for accuracy, teamwork, and growth opportunities, we want to hear from you! Job Description Utilize your expertise as a Certified Medical Coder to accurately assign appropriate medical codes to diagnoses, procedures, and services, ensuring compliance with all relevant coding guidelines and regulations. Review medical documentation and superbills to extract essential information required for proper coding. Work collaboratively with medical providers and billing specialists at Quest National Services to clarify coding questions, resolve discrepancies, and optimize claim accuracy. Stay updated with the latest coding guidelines, industry changes, and regulations to...

Certified Medical Coder II - Surgical Coder - $2000 sign on bonus Hybrid - Remote. Hourly Salary plus monthly bonus! As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking, tight-knit...

Review E/M services under 2021+ guidelines MUST RESIDE IN TEXAS AND HAVE CODING AND AUDITING EXPERIENCE. Counter Affidavit as well as Testimony experience is preferred. Requirements We are seeking an experienced CPC certified medical coder to perform coding audits, utilization reviews, audits and more. We are looking for someone who can provide litigation support including deposition and testimony services when needed. The ideal candidate must have strong Texas based coding experience and a thorough understanding of medical necessity, documentation compliance, and payer audit defense. Counter Affidavit experience is preferred. Responsibilities Perform detailed medical coding audits (ICD-10-CM, CPT, HCPCS) Conduct utilization reviews to determine medical necessity and documentation compliance Review and prepare demand packages and audit response materials Analyze records for payer disputes and recoupmentsPrepare written audit findings and defensible reports Provide expert...

Hospital Inpatient Coder Remote, Florida resident required As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment...

It's rewarding to be on a team of people that truly believe in making an impact! We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us. Job Summary The Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. The Risk Adjustment Coder is required to follow procedures and documentation policies regarding claim/encounter information and provide appropriate support to justify their recommendations. Duties & Responsibilities Essential Duties & Responsibilities Review medical record information to identify all appropriate coding based on CMS HCC categories Prepare the medical charts and track patient information via Excel spreadsheets. Complete...

As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking, tight-knit community of more than 4,000 dedicated employees fosters an environment of care and compassion. Each member plays a vital...