Profee coder jobs | Healthcare Careers

Full Time

MedReview Remote

Position Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. Collaborates with physician reviewers, as needed. Ability to prioritize and organize workload and complete tasks independently....

Contract

Contract 1099 Medical Biller/Credentialing – Home Infusion Therapy (Florida- IT Pumps)

DC Medical Billing Remote

Are you an experienced and motivated Medical Biller specializing in Home Infusion Therapy? The ideal candidate would have experience in billing for implanted pain pumps. We are seeking a skilled 1099 contractor with experience in billing for Florida-based home infusion services and in Payer credentialing. This is a remote contract position offering flexibility and competitive compensation. Expericence in Billing Key Responsibilities: Experience in credentialing and billing with CareCentrix BCBSFL- UB-04 Claim Submission: Efficiently and accurately prepare, review, and submit Home Infusion claims using the UB-04 and EDI Formats as required by payers. Payer Credentialing: assist with credentialing and re-credentialing processes with various commercial and government payers, specific to the state of Florida. A/R Management: Follow up on outstanding claims, denials, and appeals to ensure timely and maximum reimbursement. Compliance:...

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Full Time

Provider Coding Specialist- REMOTE

Tidelands Health Remote

Provider Coding Specialist Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day. A Brief Overview Under the supervision of the Coding Supervisor, the Provider Coding Specialist is responsible for analyzing and assigning ICD-10-CM diagnostic codes, CPT, and HCPCS codes to professional surgical patient accounts, based on the medical information provided and consistent with regulatory guidance and best practices in the industry and Organization policy and procedure. Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify documentation to ensure accurate code assignment. Organizes and prioritizes...

Full Time

Outpatient/Professional Vascular Coder - REMOTE

Centra Remote

Centra is seeking a detail-oriented and motivated Vascular Outpatient Coder to join our dynamic healthcare team. In this vital role, you will be responsible for accurately translating clinical documentation into precise medical codes to ensure proper billing, reimbursement, and compliance. Your expertise will support our commitment to delivering exceptional vascular outpatient care while maintaining the highest standards of medical coding integrity. This position offers an exciting opportunity to contribute to a fast-paced environment where your skills directly impact patient outcomes and organizational success. This is a fully remote - Monday-Friday, day shift role. The Outpatient Specialty Medical Coder is responsible for coding outpatient records, Facility, and/or Professional, for the purpose of reimbursement in compliance with federal, state, and regulatory agencies’ guidelines using the most current taxonomic and classification systems. Performs coding, charge entry, and...

Full Time

RCM AR Specialist

Allergy Partners PLLC Remote (Asheville, NC, USA)

POSITION: RCM AR Specialist RESPONSIBLE TO: RCM Supervisor, AR Collections JOB SUMMARY: Follows up on Claim Denials and overdue insurance balances using Explanation of Benefits (EOB) documents and reports. RCM AR Specialist are assigned specific book of business based on Financial Class and Payers. Work to support the field related to claim denials. RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO, THE FOLLOWING: Daily Duties Follows up on denied claims and no response within a timely manner. Submits appeals related to contract rate variances with a discrepancy in allowed amounts; notifies Supervisor of payers for which this is a consistent problem. Submit Medical Records when requested by the payer for claims processing determination. Monitor and review Payer correspondence from the lockbox and faxes. Monitor, review, and respond to Hub (field) communication inquiries within the 48-hour requirement. Account Follow-Up Using data from the...

Full Time

Pathology Coder

APS Medical Billing Remote

Pathology Coder APS Medical Billing, located in Toledo, Ohio, is seeking certified professional coders with experience to become part of our progressive team. This position works with clients to ensure proper documentation for charge capture and remains current with industry guidelines. Requirements Demonstrated ICD-10-CM proficiency Demonstrated understanding of the CPT guidelines for separate procedures, bundling and add-on-codes Experience in abstracting medical records for accurate CPT code assignments Experience in surgical pathology preferred Experience in reviewing, resolving and preventing coding denials Understanding and application of CMS initiatives including NCCI Edits, MIPS and NCD/LCD polices Competitive wages; benefit package (Health, Health Savings Account, Dental, Vision, Personal Health Care Advisor, EAP, Life, 401k, Paid Holidays, Vacation & Earned Time Off (ETO). We are an Equal Opportunity Employer...

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Full Time

INPATIENT CODING EDUCATION ANALYST

UW Medicine Remote

UW Medicine Enterprise Records and Health Information has an outstanding opportunity for an INPATIENT CODING EDUCATION ANALYSTS. WORK SCHEDULE 100% FTE Mondays - Fridays 100% Remote POSITION HIGHLIGHTS Performs daily activities related to auditing, education and training of one or more content areas ERHI has coding oversight for. Serve as an expert in Inpatient coding, respond to general coding questions (ICD, DRG, CPT and HCPCS), engage in the development and/or implementation of audit/monitoring plans, participate in the development and/or delivery of educational and outreach materials, report on unit activities, maintain unit records, monitor regulatory developments, and help develop Coding program policies and procedure. DEPARTMENT DESCRIPTION Enterprise Records and Health Information (ERHI) is a Shared Service Department that supports all aspects of the patient medical record from governance, integrity, documentation timeliness, completion, clinical...

7 profee coder jobs found