28 plan coder jobs found

HIM Coder II – Billings Clinic Main Campus Location: Billings, Montana Shift: Day Employment Status: Full-Time (.75 or greater) Hours per Pay Period: 80 hours every two weeks (Non-Exempt) Starting Wage (DOE): $21.70 - $27.12 Position Summary: Responsible for coding and abstracting diagnoses and procedures from patient charts using ICD-CM, ICD PCS and/or CPT-4/HCPCS codes for statistical and reimbursement purposes for all Billings Clinic inpatient and outpatient services. Also audits or assigns CPT and E&M codes to clinic encounters, captures primary and secondary ICD-CM diagnoses, adds HCPCS modifiers, and verifies units of service for pharmacy items and supplies. Actively queries physicians for clarification, provides coding education, and serves as an on‑site resource for providers and staff. Calculates MSDRG and APR-DRG, ensuring adherence to all internal and regulatory compliance policies and procedures governing medical records coding, billing, and...

You’ll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. Billings Clinic has been in the top 1% of hospitals internationally for receiving Magnet® Recognition consecutively since 2006. And you’ll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere, and a culture that values kindness, safety and courage. This is an incredible place to learn and grow. Billings, Montana, is a friendly college community in the Rocky Mountains with great schools and abundant family activities. Amazing outdoor recreation is just minutes from home. Four seasons of sunshine! You can make a difference here. About Us Billings Clinic is a community‑owned, not‑for‑profit, Physician‑led health system based in Billings with more than 4,700 employees, including over 550 physicians and non‑physician providers. Our integrated organization consists of a...

Billings Clinic in Billings, Montana is looking for a HIM Coder II to annotate patient charts using ICD-CM, CPT-4, and HCPCS codes for statistical and reimbursement purposes. The coder must ensure compliance with medical records coding policies and provide educational feedback to medical providers. Qualifications include a minimum of high school education and two years of coding experience, alongside required certifications. The position comes with extensive benefits like medical coverage and a retirement plan. #J-18808-Ljbffr

Scheduled Hours 40 Position Summary Performs advanced coding and appeal activities; investigates payer issues; responsible for timely filing of appeals to insurance companies; handles charge corrections. Primary Duties & Responsibilities Responsible for appealing claims denied by third‑party payers. Creates appropriate letters and compiles documentation to substantiate the validity of claims. Investigates and problem‑solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with physicians and other clinical staff as needed to provide documentation feedback and to develop appeals. Researches payer policies and processes. Review clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient’s conditions and treatment. Works with coders and IBC staff on medical terminology and policy interpretation as required. Codes...

QA Nurse / Coder (RN) As a QA Nurse / Coder, you will ensure the accuracy, completeness, and regulatory compliance of Home Health documentationparticularly OASIS assessments, the Home Health Plan of Care (485), and face-to-face encounter noteswhile properly sequencing diagnoses according to federal/state standards and agency policy. Core responsibilities include: Review OASIS forms and Plans of Care for appropriateness, completeness, and compliance. Assign and sequence ICD?10 codes in line with current home health coding guidelines. Ensure consistency and compliance of face-to-face encounter documentation with OASIS and care plans. Conduct additional clinical record audits and OASIS reviews as assigned. Stay current on Medicare reimbursement policies, home health regulations, and compliance requirements. Maintain relevant certifications (HCS?D, HCS?O or COS?C). Participate in quality assurance and performance-improvement efforts. Coordinate with physicians, facilities,...

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. Reviews medical records to report conditions that map to HCCs by reviewing medical record documentation and applying the appropriate ICD-10 diagnosis codes. Follows state and federal regulations as well as internal policies and guidelines while analyzing coding information and medical records. Works on projects that may include making phone calls to providers. Works within broad guidelines with...

Become a part of our caring community The Medical Coding Auditor 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. The Medical Coding Auditor audits medical charts and records for compliance with federal coding regulations. provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Essential Functions You will verify and ensure the accuracy, completeness, specificity, and appropriateness of medical record documentation based on a patient's documented medical conditions You will confirm appropriate diagnosis and procedure code assignment, following all applicable coding guidelines You will use electronic tools (i.e., spreadsheets-web-based) that have been created based on the CMS-HCC model and established coding guidelines...

Washington University in St. Louis is seeking a coding specialist to ensure adherence to proper billing codes and documentation. Responsibilities include reviewing medical records, collaborating with physicians, and maintaining accurate coding standards. The ideal candidate will have relevant coding certifications and knowledge of ICD-10 and CPT coding. Benefits include competitive health insurance, generous vacation, and a defined contribution retirement plan. #J-18808-Ljbffr

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...

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...

Certified Medical Biller & Coder Kidney Associates of Kansas City is seeking a detail-oriented and experienced Medical Biller & Certified Medical Coder to join our team. This role plays a vital part across the entire revenue cycle-from coding and claim submission through payment posting and follow-up-ensuring accuracy, compliance, and optimal reimbursement. Position Details Full-time schedule: Monday–Thursday: 8:30 AM – 5:00 PM Friday: 8:30 AM – 4:30 PM Hybrid work option: 3 days onsite / 2 days remote (after training) Must reside in the Kansas City area Key Responsibilities Review medical codes (ICD-10, CPT, HCPCS) for accuracy prior to claim submission Perform internal coding audits to ensure accuracy and compliance with regulations and payer requirements Submit claims to insurance carriers in a timely manner Post payments and reconcile accounts Perform claims follow-up, including denials, corrections, appeals, and resubmissions...

Overview Position Summary: Scheduled Hours 40. Reviews medical record documentation to determine appropriate billing codes and necessary documentation. Responsibilities Review documentation in the record to identify all pertinent facts necessary to select comprehensive diagnoses and procedures that fully describe patient conditions and treatment. Evaluate and manage codes, selecting appropriate CPT codes and assigning diagnoses to appropriate ICD-10 codes. Meet with physicians to review documentation, resolve coding issues, secure signatures of all unsigned dates of service, and tag files for follow‑up. Act as lead person and assist coders with IBC staff with medical terminology and policy interpretation as required. Assist with efforts to increase physician awareness of documentation requirements. Prepare case reports and initiate follow‑up for billing processes. Perform other duties as assigned. Required Qualifications Certified Coding Associate (CCA) – AHIMA Certified Coding...

COMPANY OVERVIEW Health Partners Management Group, Inc (HPMG) is a government contracting company in Poplar Bluff, Missouri. HPMG currently bidding on a contract with the Federal Government for several coding positions. You would be a W-2 employee for HPMG and NOT a government employee. SUMMARY Responsible for assignment of accurate ICD codes for diagnoses and procedures. Medical Severity - Diagnostic Related Group (MS-DRG) is automatically assigned by the grouper software for inpatient stays. Inpatient coders may also be responsible for the assignment of accurate ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities from medical record documentation (paper or electronic) for inpatient professional services (a.k.a., rounds or IBWA encounters). Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities. MANDATORY KNOWLEDGE AND SKILLS Position requires...

Position Summary Position reviews medical record documentation to determine appropriate billing codes and necessary documentation. Scheduled Hours 40 hours per week. Job Description Primary Duties & Responsibilities: Reviews the documentation in the record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment. Codes evaluation and management to appropriate CPT code and codes diagnosis to appropriate ICD-9 code. Meets with physicians to review documentation, resolve coding and secure signature of all unsigned dates of service, tagging files for follow up. Acts as lead person and assists coders with IBC staff with medical terminology and policy interpretation as required. Assists with efforts to increase physician awareness of documentation requirements. Prepares case reports and initiates follow-up for billing process. Working Conditions Normal office environment....

Job Summary As a Profee Coder, you will be responsible for reviewing and coding clinical notes and operative reports for a minimum of one specialty. You will provide feedback and documentation advice to the physician, practice management, and other coders. You will also work with the denials team to resolve coding-related denials. You will be a key promoter of Central Coding and responsible for setting the tone of the Coding Physician Service Center as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs. What you will do in this role: Reviews and codes clinical notes and operative reports for assigned specialty/specialties. Coordinates and reconciles multiple schedules to ensure complete charge capture. Charge entry of codes into billing system in a timely manner. Work in conjunction with A/R team on follow up and resolution of coding related denials and rejections, including recommendation of new/updated coding edits....

St. Luke’s Hospital St. Luke’s Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship, St. Luke’s Hospital has been recognized for “Outstanding Patient Experience” by HealthGrades. Position Summary The Coding Specialist III will abstract clinical data from inpatient records to facilitate reimbursement and data collection activities. It involves abstracting pertinent information to assign ICD-10-CM and HCPCS codes in compliance with all regulatory mandates and outpatient reporting requirements, and accurately entering this information into the hospital’s abstracting software. The role promotes teamwork with all members of the healthcare team and...

Billings Clinic is seeking a HIM Specialty Coder II in Billings Township, Michigan. The role entails accurately reviewing and coding patient medical records to ensure proper billing and compliance. Candidates must have a high school diploma or GED, coding experience across various specialties, and relevant coding certifications. This full-time position offers a competitive salary ranging from $23.92 to $29.90 per hour, depending on experience, and provides a comprehensive benefits package including medical and retirement plans. #J-18808-Ljbffr

Hiring Department University Physicians Job Description #upjobs This position is a dual post linked to Job ID 59697 -MCS and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made to...

Billing - Medical Biller BASIC PURPOSE OF THE JOB Under the supervision of the Business Office Manager, this position is responsible for completing billing projects and submitting bills in a timely manner, reporting weekly on the status of a project, and meeting the goals as outlined. Reviews patient accounts for complete and accurate preparation of patients' charges in all clinical areas, Responsible for all fiscal aspects of patient accounts and preparing accounts for billing to ensure maximum payment on a timely basis. Ensures protection of hospital's financial position. Works with patient/health insurance providers to determine coverage and benefit limits. Advises patients of procedure costs and alternative sources of funding. Relies on experience and judgment to plan and accomplish goals. Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards. Provides...

Associate Director, Medical Science Liaison At Insmed, every moment and every patient counts and so does every person who joins in. As a global biopharmaceutical company dedicated to transforming the lives of patients with serious and rare diseases, you'll be part of a community that prioritizes the human experience, celebrates curiosity, and values every person's contributions to meaningful progress. That commitment has earned us recognition as Science magazine's No. 1 Top Employer for five consecutive years, certification as a Great Place to Work in the U.S., and a place on The Sunday Times Best Places to Work list in the UK. For patients, for each other, and for the future of science, we're in. Are you? About the Role: We're looking for an Associate Director, Medical Science Liaison on the Field Medical team to cover the St. Louis, MO and Indianapolis, IN territories and to help us expand what's possible for patients with serious diseases. Reporting to the Regional...

St. Luke’s Hospital St. Luke’s Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship, St. Luke’s Hospital has been recognized for “Outstanding Patient Experience” by HealthGrades. Position Summary The Coding Specialist III will abstract clinical data from inpatient records to facilitate reimbursement and data collection activities. It involves abstracting pertinent information to assign ICD-10-CM and HCPCS codes in compliance with all regulatory mandates and outpatient reporting requirements, and accurately entering this information into the hospital’s abstracting software. The role promotes teamwork with all members of the healthcare team and...

Opportunities At Change Healthcare Opportunities at Change Healthcare, part of the Optum family of businesses. We are transforming the health care system through innovative technology and analytics. Find opportunities to make a difference in a variety of career areas as we all play a role in accelerating health care transformation. Help us deliver cutting-edge solutions for patients, hospitals and insurance companies, resulting in healthier communities. Use your talents to improve the health outcomes of millions of people and discover the meaning behind: Caring. Connecting. Growing Together. Job Description: The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours:...

Hiring Department University Physicians Job Description This position is a dual post linked to Job ID 59698 - MCS-C and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records to identify potential problems with coding and reimbursement, such as edits, denials, and appeal letters. Act as liaison between third-party payers and assigned departments to coordinate all aspects of professional coding. Provide assistance to faculty, residents, and department staff in standards of medical record documentation and coding. Assist in the presentation of training sessions for faculty, residents, and staff to inform them of changes made to Medicare billing, federal laws and regulations, and other specific standards...

GENERAL DESCRIPTION This position will primarily handle insurance claim submissions, payment posting, and researching claim rejects/denials. This position must have a thorough knowledge of government, commercial, HMO, PPO, and other types of insurance billing guidelines. ESSENTIAL JOB FUNCTIONS Submits claims to government and commercial payers according to timely filing requirements. Posts payments and remittance advices in appropriate database(s). Tracks and collects aging accounts receivables. Research claim denials & clearinghouse edits. Completes requests for medical information and other related correspondence. Identifies and analyzes open claims and corrects billing errors. Re-submits claims to insurance carriers as appropriate. Monitors all past due accounts for payment. Contributes to a cohesive departmental unit. Maintains regular and predictable attendance. REQUIRED SKILLS High School Diploma...