38 plan coder jobs found

At Suvida Healthcare, we are not just caregivers; we’re compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well‑being of an underserved community and their families. Our multi‑disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare‑eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service‑centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

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. We’re looking for experienced and credentialed outpatient 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 you to help shape the...

It's more than a career, it's a calling. WI-REMOTE Worker Type: Regular Job Summary: Coordinates, organizes and prioritizes the work flow activities for the coding area. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Leads and/or coordinates shift operations, work assignments and daily priorities of assigned activities, resources, and/or associates. Serves as a leader through modeling, mentoring and training assigned staff. Manages assigned charge review and coding-related claim work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plan follow-up steps. Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. Ensures all coded services meet appropriate Medicare, National Correct Coding...

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...

Humana seeks a Risk Adjustment Coder to conduct quality assurance coding of medical records, ensuring compliance with CMS standards. The role involves mapping conditions to Hierarchical Condition Categories (HCCs) using ICD-10 diagnosis codes. Required qualifications include certification from AAPC or AHIMA and the ability to work 40 hours weekly, with a focus on maintaining coding standards. Benefits include health insurance, a 401(k) plan, and paid time off. #J-18808-Ljbffr

Become a part of our caring community. Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will perform quarterly...

ThedaCare Coder (Clinic - III) The Coder (Clinic - III) performs coding review for surgical specialties for ThedaCare Physician Services to accurately reflect services rendered. Reviews and processes charges using industry standard methodologies (CPT, ICD-10-CM, HCPCS), abides by Standards of Ethical Coding (AAPC/AHIMA), and complies with official coding guidelines and other regulatory requirements. Audits medical record documentation and educates providers on documentation improvement opportunities and risks. Educates and trains new team members to department standards. Mentors and observes team members in department responsibilities. Upholds and demonstrates department expectations and accuracy in regards to coding responsibilities including payer denials and claim edits. Job Description: Schedule: Full time, benefit eligible 40 hrs/week Business hours (i.e 8:00am-5:00pm) Remote Position Preferred skill set and experience strong in surgical coding; Urology primarily to...

We’ve increased the wage range for this role as part of our ongoing commitment to competitive compensation and meaningful recognition of our employees’s skills and impact. Position eligible for $2,000 sign on bonus Discover. Achieve. Succeed. #BeHere This job is REMOTE. FTE: 1.000000 Standard Hours: 40.00 Shift: Shift 1 Shift Details: Flexible business hours. Holidays: Not required. Weekends: As needed. Job Summary The Inpatient Coder is responsible for reviewing and accurately coding inpatient medical records within a complex academic medical center environment, where cases often include high‑acuity, multidisciplinary, trauma, surgical, and research‑driven encounters. This role requires advanced proficiency in ICD‑10‑CM, ICD‑10‑PCS, and MS‑DRG/APR‑DRG assignment, along with a thorough understanding of official coding guidelines, documentation standards, and regulatory requirements to ensure accurate reimbursement and data integrity. The Inpatient Coder works independently...

Position Summary Applies CPT-4 and HCPCS codes to medical records for the cardiovascular lab and interventional radiology departments based on physicians’ documentation. Adheres to strict federal coding rules and guidelines, achieving 95% coding accuracy while meeting billing deadlines. Essential Responsibilities Code surgical procedures performed by cardiologists and interventional radiologists. Verify supplies used during procedures. Use encoders and other reference materials effectively. Maintain appropriate non‑leading queries to physicians. Abstract services from physician documentation and procedure logs. Reconcile monthly surgical logs. Manage multiple job tasks daily (WQs, emails, surgical logs, census, etc.). Prepare Excel analysis, including V‑Lookups and pivot tables. Gather and compile data systematically, document assumptions, and validate accuracy to resolve inconsistencies. Evaluate and implement charge requests with appropriate CPT/HCPCS codes, revenue codes, and...

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. We’re looking for experienced and credentialed outpatient 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 you to help shape the...

Position Summary Applies CPT-4 and HCPCS codes to medical records for the cardiovascular lab and interventional radiology departments based on physicians’ documentation. Adheres to strict federal coding rules and guidelines, achieving 95% coding accuracy while meeting billing deadlines. Essential Responsibilities Code surgical procedures performed by cardiologists and interventional radiologists. Verify supplies used during procedures. Use encoders and other reference materials effectively. Maintain appropriate non‑leading queries to physicians. Abstract services from physician documentation and procedure logs. Reconcile monthly surgical logs. Manage multiple job tasks daily (WQs, emails, surgical logs, census, etc.). Prepare Excel analysis, including V‑Lookups and pivot tables. Gather and compile data systematically, document assumptions, and validate accuracy to resolve inconsistencies. Evaluate and implement charge requests with appropriate CPT/HCPCS codes, revenue codes, and...

Become a part of our caring community. Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities You will deliver coding and documentation education to providers and clinic staff within IPA clinics. You will be a consultative resource and ongoing support for providers in assigned clinics. You will conduct documentation audits to identify gaps, trends, and opportunities for improvement. You will perform quarterly...

## Risk Adjustment CoderApplylocations: Remote Kentucky: Work at Home - Utah: Work at Home - Washington: Work at Home - Virginia: Work at Home - Texastime type: Full timeposted on: Posted Todayjob requisition id: R-421015# **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...

At Suvida Healthcare, we are not just caregivers; we’re compassionate advocates dedicated to enriching the lives of our cherished seniors. As a Team Member with us, you will embark on a fulfilling journey where your skills and empathy converge to make a meaningful impact on the well‑being of an underserved community and their families. Our multi‑disciplinary primary care program is built to address the physical, behavioral, social, and cultural needs of Medicare‑eligible Hispanic seniors. Celebrate diversity and inclusivity in a workplace that attracts, engages, values, rewards, and recognizes the unique needs and backgrounds of both our patients and our team. We believe that a rich tapestry of experiences, shared interests, and perspectives enhances the care we provide, making us a stronger, service‑centered, and more compassionate healthcare family and Employer of Choice! Will you join us Suvidanos , to help achieve our Higher Purpose? What Makes Us Unique We are an empowered...

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...

Why ThedaCare? Living A Life Inspired! Our new vision at ThedaCare is bold, ambitious, and ignited by a shared passion to provide outstanding care. We are inspired to reinvent health care by becoming a proactive partner in health, enriching the lives of all and creating value in everything we do. Each of us are called to take action in delivering higher standards of care, lower costs and a healthier future for our patients, our families, our communities and our world. At ThedaCare, our team members are empowered to be the catalyst of change through our values of compassion, excellence, leadership, innovation, and agility. A career means much more than excellent compensation and benefits. Our team members are supported by continued opportunities for learning and development, accessible and transparent leadership, and a commitment to work/life balance. If you're interested in joining a health care system that is changing the face of care and well-being in our community, we...

A healthcare facility in Dodgeville, WI is seeking a Medical Coding Team Lead to supervise and support a coding team. This full-time role involves mentoring coders, ensuring compliance with coding standards, and collaborating with healthcare providers. Requires an associate degree in Health Information Technology and relevant coding certifications. Benefits include comprehensive health packages, paid time off accruement from day one, and a retirement plan with matching dollars. #J-18808-Ljbffr

Job Details Job Location: GLHP Remote - MADISON, WI 53713 Position Type: Full Time Salary Range: $65,000.00 - $75,000.00 Job Shift: Day Oasis Specialist/ICD-10 Coder Remote Position General Purpose Responsible for the organization, development and monitoring and management of the Quality Assessment and Performance Improvement (QAPI) program for Interim Healthcare. Responsible for coordinating the QAPI program for home care and hospice operations. Essential Functions Will complete all proper ICD-10 coding and review all OASIS assessments Locks down all SOC, Recerts, follow-up, discharges, and ROC OASIS and POCs Manage the submission of OASIS and HIS/HOPE assessments for all agencies, ensuring timely submission within 30 days Foster a professional environment that supports employee development and achievement of organizational goals through training and educational resources Utilize QAPI Plus (Centralized/Electronic QAPI Program) for data trending for the development of patient...

Job Title :Endovascular / Cardiology Coder (Remote)Company :GetixHealthEmployment Type :Full-Time (FTE)Pay Range :$28.00 - $29.00 per hour ( based on experience ) Quarterly Bonus EligibleWork Environment :Reliable high-speed internet is required and Candidates must successfully complete an internet speed test prior to hirePosition Summary :The Endovascular / Cardiology Coder is responsible for reviewing clinical documentation and assigning accurate ICD-10-CM, CPT, HCPCS, and modifier codes for complex endovascular and cardiology procedures.This role requires strong specialty expertise, attention to detail, and adherence to regulatory and client-specific guidelines.Essential Duties & ResponsibilitiesReview electronic health record (EHR) documentation and abstract accurate ICD-10-CM, CPT, HCPCS, and modifier codesDetermine appropriate code selection and sequencing in compliance with AMA, CMS, and client-specific guidelinesSubmit provider queries when documentation clarification...

Current Madison College employees must apply to the internal career site by logging into Workday Job Posting Date: January 29, 2025 Application Deadline: Salary Information: Salary depends upon workload. Department: School of Health Science_OTA, MA, MC, OptTech, TM&Rad_PT Faculty Job Description: Madison College is recruiting a pool of highly motivated and qualified candidates to teach part time courses for the Medical Coding Specialist program. Applications will be accepted on a continuous basis for the 2025-2026 academic school year. If you possess the aspiration to help others succeed, this is an opportunity for you to positively impact the community and lives of our students. Madison College is a first-choice institution that offers exceptional educational opportunities to our students providing high-demand skills for professional and academic growth. Madison College's dedication to promoting equity, inclusion and diversity is reflected in our...

Medical Coding Specialist II This is a full-time, 1.0 FTE position that is 100% remote. Shifts will be flexible and will be discussed during the interview. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states. Approved Remote Work States Listing Be part of something remarkable Join the #1 hospital in Wisconsin! We are seeking a Medical Coding Specialist II to: Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local Coverage...

Medical Coding Specialist II - Orthopedics Outpatient, Multi Specialty Middleton, WI, United States (Remote) Job Description Work Schedule: This is a full-time, 1.0 FTE position that is 100% remote. Shifts will be flexible and will be discussed during the interview. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. To be eligible to work remotely, you must be in an approved remote work state for UW Health. We’re included a link below to view the full list of approved remote work states. We are seeking a Medical Coding Specialist II to: Utilize available encoder, grouper software, and other coding resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS including specialty specific codes and Evaluation and Management (E&M) codes. Maintain an understanding and apply knowledge of National Correct Coding Initiatives (NCCI), Local...

Major Responsibilities: Assumes responsibility for the day-to-day operations of the department including providing work direction, expertise, and guidance to the staff. Oversees the clinical laboratory testing, evaluation of results, and the proficiency of testing. Actively participates in projects to meet strategic initiatives including implementation and development of quantitative outcomes. Monitors budget compliance. Analyzes laboratory fiscal needs, and departmental performance and takes action to address variances. Collaborates and implements performance improvement processes to optimize teammate engagement, and physician and patient satisfaction. Ensures quality, regulatory, accreditation, compliance and competency standards are met. Ensures compliance with current policies, procedures, and standardization and/or consolidation decisions. Coordinates orientation, training, and competency...