36 program manager certified coder jobs found

Inpatient Coding Support Specialist Under general supervision and according to established procedures, provides technical support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the department. On a daily basis, provides the Coding Manager with departmental statistics such as the monitoring/tracking of Inpatient coder productivity and uncoded figures. Works with the Coding Manager and Coding Educator to identify and resolve coding issues. Serves as the primary contact for outside departments for Inpatient coding related questions. Reports to the Director of Medical Records and the Coding Manager a list of aged accounts. Follow-up with the Medical Records Staff and/or Physician as necessary to obtain required documentation to code all accounts in a timely manner. Provides coding support as directed by the Coding Manager. Essential Functions Provides technical coding support to the Inpatient Coding Staff and coordinates daily workflow based on...

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...

JOB SUMMARY Under the direct supervision of Professional Coding and CDI Manager, The Professional Coder provides timely and accurate clinical and administration data to ensure optimal reimbursement for professional services performed at acute care, inpatient, outpatient, urgent care or physician offices to meet organizational needs. This position is responsible for ICD10CM diagnosis, CPT-4 coding and charge entry related to coding, documentation, billing and reimbursement issues. Works as a liaison between centralized billing staff, practice managers and office staff and may be required to meet with the office staff and physicians as needed. This position is responsible for the monitoring the quality of coding and stays current on professional coding changes, compliance issues, billing, documentation, reimbursement and interpretation of coding/documentation rules. Strives for superior performance by consistently providing a product or service to leadership and staff that is...

JOB SUMMARY The Health Information Management (HIM) Coder impacts Memorial's Healthcare quality initiatives and reimbursement through the assignment of the most accurate and optimal diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing. Under the direction of the Health Information Management (HIM) Coding and Clinical Documentation Integrity (CDI) Manager, this position will code and analyze physician documentation contained in health records (electronic, paper or hybrid) to determine the appropriate principal diagnosis, secondary diagnoses, and procedures codes to accurately capture MS-DRG assignment. Use the Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers in accordance with coding rules and regulations. The coding information is used to determine APC's (Ambulatory Payment Classification) for data quantitative analysis,...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Join Datavant, the leading data collaboration platform in healthcare dedicated to making health data secure, accessible, and actionable. Our mission is to provide vital data solutions for healthcare organizations including providers, health plans, researchers, and life sciences companies. Contribute to the future of healthcare by enabling advanced data connectivity and transformative change. What We Are Looking For: We seek experienced and credentialed inpatient coders to join our dynamic team. If you have a keen eye for detail and a solid understanding of medical terminology, this is your chance to make a meaningful impact while enjoying the flexibility of working remotely! Your Responsibilities Include: Assigning diagnostic and procedural codes using ICD-10-CM and ICD-10-PCS. Accurately sequencing and abstracting medical codes from patient records to ensure compliance and quality. Overseeing and auditing the work of Level 1 & 2 Coders, as needed....

Certified Coder - Billing Onsite - Royal Oak, MI About Sciometrix Sciometrix is a leading digital Health company looking for RN Case Manager Spanish. We are a leader in Telehealth -healthcare Virtual care Management. Our mission to engage patients to Deliver better outcomes. Sciometrix is known among customers, peers, and patients for clinical excellence, patient experiences, and provider satisfaction. Since the inception of our patient count, technological solutions have been evolving. We empower healthcare providers with advanced technology and human expertise, revolutionizing a patient's experience. Our propriety software and related technologies ensure HIPAA compliancy with cloud access. We have established HIPAA-compliant Clinicus, an artificial intelligence (AI) bot that monitors patients 24/7 and ensures fast response in their care management program. Clinicas watches each patient's vitals and alerts our licensed team when a patient's program progress or vitals are...

Job Summary Under general supervision and according to established procedures, provides technical support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the department. On a daily basis, provides the Coding Manager with departmental statistics such as the monitoring/tracking of Inpatient coder productivity and uncoded figures. Works with the Coding Manager and Coding Educator to identify and resolve coding issues. Serves as the primary contact for outside departments for Inpatient coding related questions. Reports to the Director of Medical Records and the Coding Manager a list of aged accounts. Follow-up with the Medical Records Staff and/or Physician as necessary to obtain required documentation to code all accounts in a timely manner. Provides coding support as directed by the Coding Manager. Essential Functions Provides technical coding support to the Inpatient Coding Staff and coordinates daily workflow based on the needs of the...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Siu Coder McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Position Overview: The Special Investigations...

Summary This position is located in the Health Information Management (HIM) section at the Battle Creek VA Medical Center. MRTs (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. These coding practitioners analyze and abstract patients' health records, and assign alpha-numeric codes for each diagnosis and procedure. Responsibilities Assigns codes to documented patient care encounters (outpatient and/or inpatient professional services) covering the full range of health care services provided by the VAMC. Patient encounters are often complicated and complex requiring extensive coding expertise. Applies advanced knowledge of medical terminology, anatomy & physiology, disease processes, treatment modalities, diagnostic tests, medications, procedures as well as the principles and practices of health services...

Coding Specialist Assigns ICD diagnosis and CPT procedure codes to assigned Outpatient work types. Employment Type: Full Time Weekly Scheduled Hours: Mon-Fri 7am-3:30pm Wage Range: $21.14-$31.70 Requirements: - High school diploma/GED, or higher education - Registered Health Info Tech (R-RHIT) required Preferred Requirements: - Registered Health Info Admin (R-RHIA) - Certified Coding Specialist (C-CCS) Coding: Based on clinical documentation, computerized encoding, accepted coding classification principals, and reference material, efficiently and accurately assigns appropriate ICD diagnosis codes CPT procedure codes and modifiers on assigned chart types. Verifies accuracy of completed fields. Maintains credentials and ongoing education in order to apply current policies and principals for accurate coding. Assigns appropriate ICD codes. Assigns appropriate CPT codes. Assigns appropriate Modifiers on APC accounts. Searches chart documentation for appropriate code...

Employment Opportunities Provides high level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments. Essential Functions: Knows, understands, incorporates, and demonstrates the Trinity...

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Risk Adjustment Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at...

Position Summary: At the direction of the assigned leadership, interprets business rules, federal and state guidelines and prepares specifications for all information systems, including benefiting and pricing requirements for claims processing. Develops and maintains reporting as needed by leadership and operational objectives. Assists in the enforcement of product, reporting and service controls and standards, deadlines, and schedules by creating and maintaining detailed development plans. Defines test scenarios, involved in testing, and approval of testing results for implementation to ensure business requirements are met. Responsible for change management that impact claims configuration for all systems. Essential Functions and Responsibilities: 1. Interprets business rules, Federal and State guidelines, including but not limited to outpatient coding to create rules for processing within systems to ensure requirements are met. 2. Responsible for auditing...

Risk Adjustment Coder McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Risk Adjustment Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Position Overview: The...

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a SIU Coder, to join in leading the organization forward. MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA). MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members. Learn more about McLaren Health Plan at...

Medical Coder Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future we provide the venue for individuals who have the desire and...

Description Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future - we provide the venue for individuals who...

Description Come grow with us. Yeo & Yeo Medical Billing & Consulting was established in 1998 as an affiliate of Yeo & Yeo to provide clients with medical billing and additional practice management solutions. We have devoted ourselves to helping clients maximize their reimbursement and assist in educating them with the ever-changing rules and guidelines of Medicare and other insurance carriers as well as CPT, HCPCS and ICD-10 coding. Yeo & Yeo Medical Billing & Consulting maintains a highly trained staff with experience in all areas of physician billing. Several Certified Professional Coders on staff assist in choosing proper diagnostic codes and procedure codes. Our billing specialists receive ongoing training specific to medical specialty. We continually train our staff by updating and maintaining their knowledge of insurance carrier trends and changes in billing rules and policies. Our people are our future - we provide the venue for individuals who...

Certified Professional Coder (Onsite) Team Bronson is compassionate, resilient and strong. We are driven by positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community. If you're ready for a rewarding new career, join Team Bronson and be part of the experience. The Professional Coder performs detailed review of provider documentation/dictation and performs research on code selection for validation of appropriate codes selected for surgically complex cases (e.g., Neurosurgery, Cardiothoracic Surgery). Provides codes for surgical cases for insurance authorization. Reviews work queues and/or posts charges into Practice Management System for provider hospital and office billing and complex surgical cases (e.g. Neurosurgery, Cardiothoracic Surgery). Employees providing direct patient care must demonstrate competencies specific to the population served. High school diploma or general education degree (GED) required....

CURRENT BRONSON EMPLOYEES - Please apply using the career worklet in Workday. This career site is for external applicants only. Love Where You Work! Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community. If you're ready for a rewarding new career, join Team Bronson and be part of the experience. Location BHG Bronson Healthcare Group 6901 Portage Road Title Certified Professional Coder (Onsite) The Professional Coder performs detailed review of provider documentation/dictation and performs research on code selection for validation of appropriate codes selected for surgically complex cases (e.g., Neurosurgery, Cardiothoracic Surgery). Provides codes for surgical cases for insurance authorization. Reviews work queues and/or posts charges into Practice Management System for provider hospital and office billing and...

Your Future Evolves Here Evolent is dedicated to transforming health care by partnering with health plans and providers to improve outcomes for individuals with complex and high-cost health conditions. We aim to bridge the gaps in the fragmented health care system, ensuring every person receives the compassionate care we would wish for our own loved ones. At Evolent, we prioritize work/life balance and provide the flexibility to allow our employees to tailor their work to fit their lives. We believe that the best work happens in an environment that supports personal well-being and encourages authenticity. This commitment to diversity and inclusion is at the heart of our organization. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Medical Coder - FWA Auditor plays a vital role in ensuring the accuracy of complex claim reviews, coding, and billing in alignment with the Plans' provider agreements and National Healthcare...

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...