62 program manager certified coder jobs found

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $60,367.47 - $90,551.20 The Senior Hospital Coder is responsible for performing detailed coding quality audits, scheduled and random, on staff and providing thorough education and feedback, projects assigned by management, and special requests to review coding for external departments such as quality management and CDI. Responsible for monitoring and tracking trends of staff, bringing forward concerns to leadership regarding coding quality and productivity, completes duties as assigned by the Quality Manager. Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Senior Hospital Coder may be asked to assist with denials work, including researching and writing appeal letters. These individuals are highly skilled and considered experts in medical coding. Essential Duties and...

Overview Reviews and audits claims for billing, coding, services and other compliance or reimbursement issues. Assists with non-clinical aspects of the claims review process and acts as a coding resource. Provides training and support to Medical Care at Home Clinicians and staff to provide best practices of claims coding. Applies coding skills to various initiatives to ensure compliance in claims submissions. Works under moderate supervision. What We Provide Per Diem team members are eligible for some benefits and can access our extensive Employee Assistance Program that includes financial, legal, and mental health counseling programs as well as participate in a 403b retirement savings program. What You Will Do Reviews medical claims, records and other requested information for billing, coding and other compliance or reimbursement related issues; makes coding and documentation recommendations for adherence to risk adjustment models. Reviews medical documentation to ensure all...

Facility: Mercy Hospital of Buffalo Shift: Shift 1 Status: Full Time FTE: 1.000000 Bargaining Unit: CWA Local 1133 Exempt from Overtime: Exempt: No Work Schedule: Days Hours: 8:00am - 4:00pm - flexible start end times (manager approved) Summary: Codes primarily acute hospital inpatient, SNF, Rehab, for the purpose of accurate reimbursement, research and compliance with federal regulations. Coding of Ambulatory, ER / Urgent Care, Interventional Radiology and same day surgery records is performed on an as needed basis. Diagnoses and procedures are coded through review of the entire medical record, utilizing International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) and Current Procedure Terminology (CPT) classifications. Queries physician for further clarification when there is uncertainty in the documentation of the medical record. Analyzes and reviews records for completeness. Actively participates as a member of the...

Become a vital part of Datavant, the leading platform for secure, accessible, and actionable health data. Our mission is to enhance health data collaboration for healthcare providers, health plans, researchers, and life sciences organizations. Join us in transforming individual patient requests and advancing AI in healthcare! As a member of our team, you'll contribute to meaningful change in the healthcare landscape from the comfort of your own home. This fully remote position offers flexibility while allowing you to impact the future of healthcare. Key Responsibilities: Utilize ICD-10-CM and ICD-10-PCS codes to assign diagnostic and procedural codes accurately. Abstract and sequence medical codes from patient records, ensuring compliance and precision in documentation. Oversee and provide feedback on the work of Level 1 & 2 Coders when applicable. Identify opportunities for documentation improvement and collaborate with relevant stakeholders to...

Become a part of our caring community and help us put health first The Supervisor, Medical Referrals schedules and pre-registers patients for exams and procedures with specialists and providers outside of the primary care physician's office. The Supervisor, Medical Referrals gathers and communicates all relative information and preparation instructions to patient and referring providers. Required Qualifications Bachelor's Degree 4 - 6 years in a physician office, health care, or managed care environment Certified Medical Coder with one of the following active certifications and with a high degree of competency (CPC, CPC-H, or CPMA from AAPC; or CCA, CCSP, CCS from AHIMA) Strong experience in ICD-9, ICD-10 and CPT coding Prior management or supervisory experience Highly proficient with Microsoft Office products Valid driver's license and/or dependable transportation necessary Strong written and verbal communication skills; strong analytical, organizational and time...

Siu Coding Auditor Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselvesone that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our...

Job Description Job Description 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...

Position OverviewThe Inpatient Coder is responsible for reviewing and analyzing patient medical records to assign accurate ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes for hospital inpatient services. This role ensures compliance with official coding guidelines, regulatory requirements, and ethical standards to support proper billing, reimbursement, and data integrity. Primary Department, Division, or Unit: Coding Support Services, UHS Revenue Cycle Operations Primary Work Shift: Day Compensation Range: $22.97 - $34.46 per hour, depending on experience You will be eligible for benefits if you are hired into a regular position with at least 24 scheduled weekly hours. Job Responsibilities Essential functions are the core tasks, duties, and responsibilities performed with or without reasonable accommodation. Assigns accurate ICD‑10 diagnosis and procedure codes and groups to APR or MS‑DRG in accordance with established policies. Completes the...

We are seeking an experienced Certified Medical Coder to join our team in an acute care setting. This opportunity begins with 1–2 weeks of onsite training (flexible per hiring manager) and transitions to a fully remote role once responsibilities are mastered. If you are a detail-oriented professional with a strong inpatient coding background and the ability to work independently, we encourage you to apply. Key Responsibilities: Perform accurate and compliant medical coding in an acute care setting, with a strong focus on Inpatient and Emergency Department (ED) cases Apply advanced knowledge of ICD-9-CM, ICD-10, and CPT-4 coding systems Utilize EPIC and 3M/HDS coding applications and encoder tools effectively Ensure adherence to official coding guidelines, payor-specific requirements, and federal billing regulations Review and analyze medical documentation thoroughly to ensure coding accuracy and optimal reimbursement Research and resolve complex coding scenarios and related...

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...

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...

We are seeking an experienced Certified Medical Coder to join our team in an acute care setting. This opportunity begins with 1–2 weeks of onsite training (flexible per hiring manager) and transitions to a fully remote role once responsibilities are mastered. If you are a detail-oriented professional with a strong inpatient coding background and the ability to work independently, we encourage you to apply. Key Responsibilities Perform accurate and compliant medical coding in an acute care setting, with a strong focus on Inpatient and Emergency Department (ED) cases Apply advanced knowledge of ICD-9-CM, ICD-10, and CPT-4 coding systems Utilize EPIC and 3M/HDS coding applications and encoder tools effectively Ensure adherence to official coding guidelines, payor-specific requirements, and federal billing regulations Review and analyze medical documentation thoroughly to ensure coding accuracy and optimal reimbursement Research and resolve complex coding scenarios and related...

Coder - Team Lead Remote, With Ability to Travel Frequently to Our Practices About Diana Health Diana Health is a network of modern women’s health practices working in partnership with hospitals to reimagine the maternity and women’s healthcare experience. We are restructuring the traditional approach to care to create an experience that is good for patients and good for providers. We do that by combining a tech-enabled, wellness-focused care program that women love with a clinical system that helps us drive continuous quality improvement and ensure work-life balance for our care team. We work with clients across all life stages to empower and support them to live happier, healthier, more fulfilling lives. With strong collaborative care teams; passionate administrators and a significant investment in operational support, Diana Health employees are well-supported to bring their very best to the work they love. Come join us! Role Description Under minimal direction, the Medical...

Job Description Job Description Hi, we're Oscar. We're hiring a Senior Analyst, SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role: The Senior Analyst, SIU Coding Auditor identifies and investigates aberrant behavior observed in medical claims data and member enrollment data. You will manage an investigative caseload from case identification through to resolution, including data mining, investigation planning, data analysis, sampling, medical records requests, audit interpretation, overpayment recovery, reporting to regulatory agencies and monitoring ongoing provider behavior. The Senior Analyst will meet metrics set forth related to caseload, turn around times, and other unit-wide goals....

Overview Hi, we\'re Oscar. We\'re hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About The Role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If...

Overview The Coder II reviews outpatient records and accurately assigns appropriate ICD-10-CM or CPT-4 codes according to established guidelines with 97% accuracy rate, while maintaining coding standards for productivity. This position reviews outpatient records and assigns codes according to outpatient rules. The Coder II may be responsible for ER Facility Charging, if applicable. This position follows up on outstanding unbilled accounts on a regular basis. This position does not have excessive re-bills. Responsibilities Reviews patient medical records and accurately assigns appropriate ICD-10-CM or CPT-4 codes according to established guidelines. Applies sequencing guidelines to coded data according to official coding rules. Reviews medical records to ensure appropriate documentation is there to support codes/ER charges assigned. Responsible for being knowledgeable of coding and diagnostic procedures, as well as remaining current about federal legislative changes that affect...

Overview Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura’s Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving...

JOB SUMMARY : Under the Supervision of the Revenue Cycle Manager is responsible for managing the full billing cycle for work related and no fault injuries, ensuring accurate submission of claims to insurance carriers, employers, or state boards. Responsible for pursuing outstanding accounts and resolving denials to maximize reimbursement while adhering to regulations and HIPAA compliance. DUTIES & RESPONSIBILITIES : 1. Prepare, review, and submit claims to workers' compensation/No Fault, ensuring accurate carrier/claim information. 2. Responsible for aggressive follow-up of unpaid/denied claims through the use of payer web sites, portals, and other mechanisms as directed by management. 3. Responsible for specific Worker's Compensation and No Fault payer rules, guidelines and billing procedures in order to accomplish follow-up activity. 4. Responsible for review and correction of denied claims in accordance with Federal and payer specific rules and regulations....

Coder - Inpatient As an Inpatient Coder, your strong attention to detail is crucial when reviewing and accurately coding medical records. Responsibilities: Coding. Code a variety of records within established productivity guidelines with at least 95% accuracy on a consistent basis; group and assign DRGs and appropriate E/M levels with at least 95% accuracy on a consistent basis Abstraction. Abstract ER provider assignment into an abstracting system with at least 99% accuracy on a consistent basis; abstract other required information accurately including discharge dispositions, SPARCS data, physician names and procedure dates Quality Assurance. Accurately assign the facility charge for emergency room and observation records; identify errors and process accounts for corrections; correct errors identified through various auditing processes; manage problematic workflow edits and other technical issues to ensure timely resolution Required Qualifications: One of the...

Job Description Job Description Job Title : Coder Analyst Inpatient Location : New York Hire Type : Temp to Hire Pay Range : $26.44 - $39.66/hour Work Type : Full-time Work Model : Remote Work Schedule : Monday – Friday, 8am – 5pm Recruiter Contact : Luisa Beato, LBeato@imaginestaffing.net Nature & Scope: Positional Overview The Imagine Group is recruiting for a Coder Analyst Inpatient on behalf of our client, a leading not-for-profit healthcare system, providing a comprehensive network of hospitals, outpatient services, rehabilitation, home care, and long-term care to patients throughout Western New York. The organization is committed to delivering compassionate, patient-centered care across a full spectrum of medical specialties while fostering a mission-driven culture of quality, dignity, and community service. In this role, you will be responsible for accurately reviewing and assigning diagnostic and procedural codes for inpatient medical...

Connecticut Institute for Communities, Inc. Description: Connecticut Institute For Communities, Inc. (CIFC) Center seeks a full-time (1.0 FTE) temporary to permanent Medical Billing Specialist. High volume, community health center Billing Department position will perform manual and electronic billing to all insurances and patient statements, using computerized patient management billing software. This position is responsible for acquiring information for claims processing and posting payments and EOB denials. To assure timely reimbursement to the Center and manage the accounts receivable, the Specialist will review and research past due accounts, follow-up on unpaid claims and re-bill if necessary, and make calls to insurers on unpaid accounts. Communication with patients and assisting with other Center administrative duties may be required occasionally. Essential Job Responsibilities: 1. Responsible for working with colleagues (ie: providers, front desk) to resolve...

Professional Coder page is loaded## Professional Coderlocations: 1275 Broadway Albany, NY 12204time type: Full timeposted on: Posted Todayjob requisition id: 67330Department/Unit:Health Information ManagementWork Shift:Day (United States of America)Salary Range:$55,895.80 - $83,843.71The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote.**Essential Duties and Responsibilities*** Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines.* Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes.* Understands National Correct Coding Initiative (NCCI) edits and...

Connecticut Institute for Communities, Inc. Description: Connecticut Institute For Communities, Inc. (CIFC) Center seeks a full-time (1.0 FTE) temporary to permanent Medical Billing Specialist. High volume, community health center Billing Department position will perform manual and electronic billing to all insurances and patient statements, using computerized patient management billing software. This position is responsible for acquiring information for claims processing and posting payments and EOB denials. To assure timely reimbursement to the Center and manage the accounts receivable, the Specialist will review and research past due accounts, follow-up on unpaid claims and re-bill if necessary, and make calls to insurers on unpaid accounts. Communication with patients and assisting with other Center administrative duties may be required occasionally. Essential Job Responsibilities: 1. Responsible for working with colleagues (ie: providers, front desk) to resolve...