38 professional coder associate jobs found

Job Opportunity It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Summary: Performs periodic and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Audits specified number of records per coder as defined in the system coding audit plan. Prepares audit reports that are issued to key stakeholders, as appropriate. Develops corrective action plans to address opportunities for coding, billing and documentation improvement. Identifies trends and educational opportunities. Prepares and presents educational programs related to coding. Assists in the management of the coding and billing auditing and monitoring program to address high risk compliance areas. Performs other duties as assigned. EDUCATION Bachelor's degree in business, healthcare or related field, or equivalent years of experience and education EXPERIENCE Three...

Job Description Job Description Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation in the medical record utilizing knowledge of anatomy, physiology, medical terminology, and pathology. Review the discharge summary, history and physical, physician progress notes, consultation reports, radiology, laboratory, pathology, operative records, emergency room record to accurately assign diagnosis and / or procedure. Determine diagnoses that were treated, monitored, and evaluated and procedures done during the episode of care and assign appropriate codes. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations. Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG, APC or payment tier under the Prospective Payment system to guarantee accurate reimbursement. Review coding for accuracy and...

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...

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 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...

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Qualifications: Ideal candidate has experience with inpatient coding and auditing. RHIT, RHIA, and CCS are preferred certifications. ? Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. * Candidates to reside in MO, IL, OK, or WI (additional states my be considered) Job Summary: Performs periodic and ongoing audits of claims to ensure accuracy of coding and billing, and sufficiency of supporting documentation. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Audits specified number of records per coder as defined in the system coding audit plan. Prepares audit reports that are issued to key stakeholders, as appropriate. Develops corrective action plans to...

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 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 with medical terminology and policy interpretation as required. Codes evaluation and management...

Hiring Department University Physicians Job Description #upjobs 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 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...

Certified Professional Coder, Outpatient Billing Full Time Corporate 3 days ago Requisition ID: 4107 Salary Range: $27.00 To $35.00 Hourly Position Summary This role is responsible for ensuring accurate, compliant, and complete coding of professional outpatient encounters in a high-volume urgent care environment. This role reviews provider documentation, validates and corrects CPT® and ICD-10-CM code selection, queries providers for missing or unclear documentation, and ensures all claims meet CCI, payer, and outpatient coding requirements prior to billing. This role also plays a key role in supporting provider coding and documentation audits and manual coding activities required during system downtime or special operational needs. Key Responsibilities Documentation Review & Coding Validation Review clinical documentation to confirm all services rendered are documented completely and accurately prior to billing. Validate provider-selected CPT® and ICD-10-CM codes to...

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...

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...

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...

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....

Position Summary Position reviews medical record documentation to determine appropriate billing codes and necessary documentation. 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 patients conditions and treatment. Evaluates and assigns CPT codes and ICD-9 diagnosis codes. Meets with physicians to review documentation, resolve coding issues, secure signatures of all unsigned dates of service, and tag files for follow up. Acts as lead person and assists coders with IBC staff on 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 the billing process. Working Conditions Job Location: Normal office environment. Physical Effort: Typically sitting at a desk or table. Equipment: Office equipment....

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided, to ensure correct coding guidelines are met (e.g., ICD-10-CM, CPT, HCPCS). The Medical Coding Auditor's work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor contributes to overall cost reduction, by increasing the accuracy of provider contract payments in our payer systems, and by ensuring correct claims payment for appropriate CPT/ HCPCS code assignments. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed....

Your job is more than a job. Join LCMC Health, and you’ll find that our everyday makes it easy to live your extraordinary. Essential Function Apply the appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes and determine the MS‑DRG and APR‑DRG assignments for inpatient records across multiple specialties (cardiology, cardiothoracic surgery, trauma, orthopedics, general medicine and surgery, pediatrics, obstetrics, newborns, etc.). Apply ICD-10 diagnostic and CPT procedure codes for ambulatory records across multiple specialties (family medicine, internal medicine, cardiology [IR], cardiothoracic surgery, interventional radiology, trauma, orthopedics, general surgery, urology, gynecology, etc.). Navigate patient health records and other computer systems accurately to determine diagnosis, procedures, MS‑DRGs, APCs, and required modifiers. Validate charges by comparing charges with health‑record documentation as necessary. Communicate effectively with clinical staff,...

Job Description Job Description Description: BASIC FUNCTION: JOB DESCRIPTION DEPARTMENT: Finance JOB TITLE: MEDICAL CODING SPECIALIST Responsible for correctly coding healthcare claims, in order to obtain reimbursement from insurance companies and government health care programs. All employees of FCHC must ensure service standards are delivered, including: FCHC Core • Demonstrates a commitment to FCHC mission and vision. • Demonstrates a positive attitude towards patients, employees, role, and the health center. • Demonstrates FCHC core values (accountability, courtesy, excellence, flexibility, integrity, respect). Customer Service and Professionalism • Smiles and makes appropriate contact, greets individuals upon entry into building and space. • Is customer service oriented to both internal (colleagues) and external (patients, clients, vendors, etc.) Customers. Treats patients, customers and colleagues with dignity and respect. •...

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...

Coding Specialist 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 with medical terminology and policy interpretation as required. Codes evaluation and...

Inpatient Coding Position Accurately assigns ICD-10 codes to diagnoses and CPT codes to procedures respectively for reimbursement integrity and research purposes. Medical terminology, anatomy and physiology required. Minimum of 3-5 years previous inpatient coding experience in an acute care setting. Certification as RHIA, RHIT, CCS, CCS-P, CPC, CPC-H required. Keyboard/typing, minimum 45 wpm. High School Diploma or equivalent required. Active CCS/CPC required. Associates Degree and/or 3-5 years experience in inpatient coding a must.

Summary The Harris House Foundation is a residential treatment program for alcohol and drug addiction. For over 50 years, we have helped people recover their lives from drug and alcohol addiction. We advocate a recovery with responsibility program that empowers clients to take control of their treatment and recovery process. The Medical Billing Specialist is responsible for covering all aspects of billing and collecting on client accounts in this contract position. Job Responsibilities Create and submit insurance claims for reimbursement in an accurate and timely manner. Process client payments, including charging credit cards, setting up payment arrangements, and following up on outstanding balances. Research and resolve claim issues, denials, and discrepancies to ensure proper reimbursement. Maintain effective communication with third party insurance carriers to resolve issues that impede cash flow. Monitor and report on key metrics such as aged receivables, collections, days...