Professional coder 3 jobs | Healthcare Careers

Full Time

Gainwell Technologies Remote (USA)

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary: We are seeking a talented individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to validate the conditions that were documented in the medical record, the ICD-10-CM/PCS code assignments and determine the accuracy of DRG assignment that is clinically supported as defined by review methodologies specific to the...

Full Time

DRG (Coding) Reviewer/Auditor

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:...

Full Time

Professional Medical Coder I & II

Lexington Health West Columbia, SC, USA

Job Summary Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from medical records for complete and accurate statistical documentation. Minimum Qualifications Minimum Education: High School Diploma or Equivalent Minimum Years of Experience: 3 Years of Professional Coding Experience Covering Multiple Clinical and/or Surgical Specialties (Combination of Surgical, E/M, or other coding experience as approved by Director), which they Successfully Met Quality and Productivity Standards Substitutable Education & Experience (Optional): None. Required Certifications/Licensure: Active AAPC or AHIMA Coding Credential Required Training: Experience working with CPT, ICD diagnosis coding; Experience with CCI edits; Experience with Medicare LCDs and NCDs; Understanding of state and federal regulations as well as payor...

Full Time

Compliance & Coding Audit Specialist (SOME FLEXIBILITY ON REMOTE WORK OPTION; 5 days per week; 8:00a-4:30p; Mon-Fri)

University Health Hybrid

Help safeguard accuracy, integrity, and regulatory compliance across our organization. We are seeking a skilled Compliance & Coding Audit Specialist to support the Corporate Compliance Program through detailed auditing, monitoring, and provider education related to coding, billing, and clinical documentation practices. What You’ll Do Conduct ongoing coding, billing, and documentation audits to ensure compliance with hospital policies and federal and state regulations Interpret medical records and related documentation using advanced coding knowledge to assess accuracy and risk Execute compliance audit assignments with a high degree of independence, confidentiality, and professional judgment Analyze findings, prepare audit documentation, and identify trends or improvement opportunities Present audit results directly to physicians and providers, delivering clear feedback and education on documentation and coding best practices...

Full Time

Professional Coder

SGMC Health Remote (WV, USA)

JOB LOCATION: Remote (Considering applicants residing in Georgia, Florida, Ohio, North Carolina, South Carolina, West Virginia, Utah, Arizona, and Missouri.) DEPARTMENT: REVENUE CYCLE MEDICAL GROUP, SGMC Health SCHEDULE: Full Time, 8 HR Day Shift, 8-5 Abstracts ICD-10 and CPT codes for Diagnosis and Procedures on professional services. Reviews and analyzes medical records verifying and coding the diagnosis, evaluation and management service, minor procedures, or other codes required for the completeness and accuracy of the record. Additionally, will code and/or review principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, any applicable supply, medication, and injectable drugs. Maintains communication with Management, Practice Manager, and Provider to ensure timely notification of identified documentation issues. Interact with other team members of the revenue cycle and provider clinics. Responsible for continuing education of...

Full Time

Risk Adjustment Coder

Gonzaba Medical Group San Antonio, TX, USA

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation. Supervisory Responsibilities: This position has no supervisory responsibilities. General Requirements: All duties performed will be done accurately and in a timely manner. 1. Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. 2. Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. 3. Must...

Full Time

Medical Billing Specialist

Concord OB/GYN Associates, PC Hybrid (Concord, MA, USA)

Overview: The Billing Specialist works collaboratively with the Billing Manager to support all functions of the billing department, ensuring the maximization of receivables and maintaining optimal cash flow. This role requires advanced knowledge of OB/GYN coding and billing practices. The Billing Specialist is responsible for maintaining compliance with office policies, procedures, and all applicable regulatory requirements. The ideal candidate demonstrates a friendly and professional demeanor, strong interpersonal skills, and the ability to remain composed during high-pressure situations. This role requires the ability to work independently, apply critical thinking to resolve complex billing issues, and manage sensitive financial conversations with patients in a respectful and understanding manner. Key Responsibilities: Support the daily operations of the billing department, including medical and surgical coding and billing for both hospital and office...

Full Time Part Time

Behavioral Health Billing Specialist (Mid and Senior Level)

JotPsych Remote (USA)

IMPORTANT: To submit your application, please click "Apply" to view our full job description, then submit the form listed under "Application Process". We're looking forward to receiving your application! INTRODUCTION: JotPsych is hiring a Behavioral Health Billing Specialist at both the middle and senior level to own the end-to-end billing lifecycle for a dedicated set of JotBill customers—behavioral health and psychiatry practices that depend on us to get their claims submitted accurately and paid promptly. This is a high-ownership, execution-focused role. You'll run the billing independently—managing the full claim lifecycle with a high standard of accuracy and follow-through. You'll thrive here if you: Are comfortable owning multiple accounts end-to-end, without needing someone to review your work at every step Get satisfaction from resolving a denial that's been sitting open—and then identifying why it happened so it doesn't happen again Are...

UM

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...

Full Time

Coding Education Specialist

University of Colorado Medicine Remote

University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado. We are seeking 2 motivated Coding Education Specialists with an emphasis in Pathology/Interventional Radiology and Anesthesia/Radiation Oncology. This job can be performed 100% remotely and out of state candidates will be considered. The Coding Education Specialist will primarily be responsible for supporting and leading ongoing education to existing coding staff,...

Full Time

Lead Coding Specialist, Day Shift, Medical Coding

Adventist Healthcare Gaithersburg, MD, USA

Adventist HealthCare seeks to hire an experienced Lead Coding Specialist for our Medical Coding Department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing. As a Lead Coding Specialist, you will: Conduct reviews to validate I-10-CM diagnosis codes and PCS procedure codes for inpatient bill hold related to PSI, PPC & other reimbursement conventions to be resolved prior to final coded data. Manages daily DNFB and DNFC reports and work queues for un-coded or outstanding records. Under the direction of the coding manager, the coding specialist lead should be proficient in communicating with the coding team. Oversees coding corrections, abstracts elements for HSCRC submissions, and ensures coding compliance with coding standards. Liaison between coding and other departments, managing coding-related tasks and denials. Provides mentoring support to coders on coding...

12 professional coder 3 jobs found