12 program manager certified coder jobs found

Job Summary Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Job Duties Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient severity and comply...

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 Details Sr. Coder Job Description Key Responsibilities: Coding Medical Records : Review patient medical records and assign appropriate codes using systems like ICD-10-CM, CPT, and HCPCS for diagnoses and procedures. Claims Processing: Prepare and submit claims to insurance companies, ensuring compliance with regulations and accuracy in coding to facilitate reimbursement. Collaboration: Work closely with healthcare providers, billing specialists, and other staff to clarify documentation and ensure accurate coding practices. Auditing and Compliance: Conduct audits of medical records to ensure coding accuracy and compliance with federal regulations and insurance standards. Training and Support: Provide training and support to healthcare staff on coding practices and documentation requirements. Required Qualifications Certification: Must hold a certification from recognized organizations such as AAPC (CPC) Experience: Typically requires a minimum of 2-3...

UPMC is hiring a full-time Certified Professional Coder to support their Women's Health Departments! This position is a remote position, but will be required to work onsite at an office location during our training period. Candidates must be located within a 60-mile radius of Pittsburgh or willing to relocate to the area. Our Women's Health decentralized coding team provides specialized coding support across multiple subspecialties, ensuring accurate and compliant claim submission for a diverse range of services. The team is experienced in handling complex subspecialty claims and coding scenarios unique to the Women's Health service line, including OB/GYN, Uro-gynecology, and Minimally Invasive Surgeries. With a focus on quality, collaboration, and operational efficiency, the team supports timely charge capture and revenue integrity across multiple practice locations across Western PA. The Certified Professional Coder supports Women's Health services by reviewing and releasing...

UPMC Corporate Revenue Cycle is hiring a Coder II to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. In this role, you will be handling same-day surgery and observation coding. Coding diagnosis & procedure codes ICD10 & CPT codes and charging for injections, infusions, hydrations, and reconciling NCCI edits. Responsibilities: Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD-10-CM, CPT and DSM IV codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed. Adhere to internal department policies and procedures to ensure efficient work...

UPMC Corporate Revenue Cycle is hiring a Coder II- Profee to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. This role will have the same responsibilities as a Coder I. The position will review all pertinent physician, nursing, and ancillary documentation. Depending on the type of service and place of service, you will determine the level of acuity, procedure(s) performed, billable supplies, and diagnosis to substantiate medical necessity. As well as review and sequence all codes to maximize reimbursement and address any potential bundling issues. The Coder II will apply modifiers as needed. The position will also handle LMRP/CCI edit and coding denial resolution. We are looking for coders with prior experience in ENT coding to join the team. If you are ready to take the next step in your coding career, look no further! Responsibilities: Utilize computer applications and resources essential...

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Assigns accurate diagnostic and procedure codes according to clinical documentation and official coding guidelines for outpatient hospital professional accounts Assigns CPT and ICD-10 codes to all orthopedic services Monitors assigned work schedules to...

Coder IPG - Full Time Job Category: Business Office / Patient Registration Requisition Number: CODER002173 Full-Time Indiana, PA 15701, USA Job Details Description Job Responsibilities Verify all documentation. Apply appropriate ICD-10 diagnosis codes and appropriate CPT codes. Enter any applicable charges to appropriate provider and place of service. Recognize the importance of appropriate use of ICD-10 and CPT codes for medical necessity. Understand the difference of each place of service and utilize the correct CPT that corresponds with it. Utilize all available resources. Answer any calls you may get in a courteous and pleasant manner, identifying yourself and the organization. Help caller with any questions or concerns they may have. Remain current regarding federal, state, hospital, interdepartmental and third-party carriers including managed care, HCFA rules and regulations. Adheres to current guidelines. Maintain the dignity of the patient...

Trauma Program Registrar The Trauma Program Registrar is responsible and accountable for the direction, coordination, and maintenance of the trauma registry and its data submission to the Pennsylvania Trauma Systems Foundation (PTSF). Minimum Requirements Education: Graduate of a Health Information Management Technology Program Will consider candidates with a degree in a healthcare related field Experience: 1 year full time experience for candidates who graduated from a Health Information Management Technology Program or degree in a healthcare related field Preference will be given to candidates with at least one of the following: Certified Specialist in Trauma Registries (CSTR) certification Previous trauma program abstraction experience Knowledge, Skills, Abilities: Knowledge of the clinical content of a medical record, including medical terminology, anatomy, physiology, pharmacology and disease processes Thorough and accurate data...

Job Details Compliance Auditor Job Description Compliance Auditor Under general supervision, using a unique combination of clinical expertise and billing knowledge, the Compliance Auditor monitors and improves the quality of clinical and financial documentation related to the provision of patient services. The Compliance Auditor will compare clinical and financial records to ensure that the documentation provided supports the patient charges listed. The Compliance Auditor will utilize our technology to codify and quantify findings to assist with reporting, monitoring and educating where appropriate. ESSENTIAL FUNCTIONS: • Performs audits of clinical documentation of physician, technical or specialty (e.g., Home Health, Hospice, Inpatient Rehab) billing and payment records and applicable industry standard billing codes by analyzing medical records, coding records and health system bills validating clinical documentation in conjunction with the bill; assessing the level...

Inpatient Coder One of the nation's largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. Growing steadily since its inception into an esteemed Fortune 500 corporation, UHS has approximately 99,000 employees and continues to grow through its subsidiaries. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. The Atlantic Region CBO is seeking a dynamic and talented Inpatient Coder for our Appeals department. This position performs the primary function of coding inpatient or outpatient records to include Ambulatory, ER and Miscellaneous Ancillary charges. Utilizes 3M Encoder to code and classify inpatient and/or outpatient records...

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.In addition, this role focuses on performing the following Health Information Management duties:Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information.An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a hands on environment.The majority of time is spent in the delivery of support services or activities, typically under supervision.An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education.Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or...