11 program manager certified coder jobs found

We are looking for a Medical Coder (Behavioral Health, E/M) to help define how automated and human-in-the-loop coding works at scale. In this role, you will serve as an internal authority on behavioral health E/M coding , partnering closely with Brellium's Customer Success, Product, and Engineering teams. You will help ensure that coding recommendations are accurate, defensible, and aligned with payer expectations — balancing appropriate revenue capture with audit-safe compliance. This is a highly impactful role for an experienced coder who enjoys shaping policy, improving systems, and applying clinical coding expertise in a modern, technology-driven environment. What You'll Do Own Coding Quality & Compliance Review and validate E/M coding for behavioral health encounters in a pre-bill workflow Ensure coding decisions align with documentation, payer guidance, and compliance best practices Define clear standards for when revenue capture is appropriate vs when...

SUMMARY/OBJECTIVE: The Revenue Cycle Management Manager is responsible for all duties listed below. The position requires coordination with clients, executive staff and RCM staff for the revenue cycle management performance reporting.   ESSENTIAL FUNCTIONS: Core duties and responsibilities include the following. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Other duties may be assigned. 1. LEAD AND SUPERVISE REVENUE CYCLE STAFF Provide day‑to‑day leadership, coaching, and performance oversight for billing, coding, collections, and reimbursement teams. Ensure staff adhere to organizational policies, regulatory requirements, and best practices across the full revenue cycle. 2. Monitor and Report Staff Productivity Develop, track, and analyze productivity metrics for all revenue cycle functions. Prepare regular performance dashboards and present findings AND SUGGESTIONS for improvement to...

The position will be responsible for developing and establishing the guidelines/policies/procedures for the program, determine proper staffing, preparing, and maintaining relevant guidelines for billing to each insurance carrier, coaching and training the staff, tracking and trending for the continued development of the rules in Encoda, and developing creative solutions for any challenges. Pay will be based on years of experience  QUALIFICATIONS AND EXPERIENCE: •       Previous Medical Billing experience preferred. Preference for those with a minimum of eighteen months experience. •       Comfortable using email and interacting with Internet applications •       Knowledge of practice management and Mircrosoft processing software •       Proven understanding of Explanation of Benefits forms, claim forms and the insurance billing process •       Working knowledge of managed care, commercial insurance, Medicare, and Medicaid...

A Day in the Life of a CRMG Coder II Under general supervision, reviews medical record documentation to abstract demographic data and assign diagnoses, procedures, and modifiers for statistical classification and reimbursement purposes. Performs various  coding  assignments under the direction of  Coding  Management. Utilizes software applications and electronic  coding  references to perform  coding  related tasks. Why Work at Cheyenne Regional? Employer Sponsored Medical, Dental, and Vision Plans 403(b) and 457(b) retirement options with 4% employer match Life Insurance Short Term and Long-Term Disability Insurance Employer Sponsored Wellness Program Employee Assistance Program ANCC Magnet Hospital 21 PTO days per year (increases with tenure) Tuition Reimbursement Program Dedicated Loan Forgiveness Advisory Service Here is What You Will Be Doing: Interprets clinical information documented within medical records. Assigns...

Director, Billing Compliance  Dana-Farber Cancer Institute  Boston, MA  Full Time  Overview Reporting to the VP, Chief Compliance Officer with a dotted line reporting relationship to the VP, Revenue Performance Management, the Director of Billing Compliance is a strategic leader and subject matter expert responsible for ensuring the integrity, accuracy, and compliance of billing practices across the organization. The Director provides constructive oversight and mentorship to the Billing Compliance team. This role leads the development and execution of a robust billing compliance program focused on hospital technical and professional fee billing in compliance with internal policies and state, federal and local rules. The Director serves as a key 'second line of defense' in support of accurate and compliant operational processes. The Director works as a cross functional leader, partnering with clinical, administrative, and financial teams and participating in...

Billing Compliance Reviewer  Dana-Farber Cancer Institute  Boston, MA  Full Time Overview Reporting to the Director of Billing Compliance, the Billing Compliance Reviewer plans and executes risk-based audits, analyzes documentation and coding for medical necessity and regulatory adherence, and recommends corrective actions to mitigate compliance risk. The role evaluates the accuracy and integrity of hospital and professional billing practices to ensure compliance with federal and state regulations, payer requirements, national coding guidelines, and internal policies. The Billing Compliance Reviewer is responsible for developing clear findings, collaborating with clinical and administrative stakeholders to resolve issues, and supporting continuous improvement in charge capture, documentation, and coding processes. This role works collaboratively with Coding, HIS, Billing and other internal and external teams to evaluate complex billing issues and initiate...

Senior Billing Compliance Hospital Reviewer  Dana-Farber Cancer Institute  Boston, MA  Full Time Reporting to the Director of Billing Compliance, the Senior Billing Compliance Reviewer will be responsible for the identification and performance of Billing Compliance inpatient and ambulatory activities. The Senior Reviewer will provide oversight related to reviewing the accuracy and appropriateness of ICD-10-PCS procedure coding and assessing DRG assignment. The Senior Reviewer will assist in the development and execution of the annual Billing Compliance work plan. They will monitor federal and state regulatory requirements and industry developments and work to determine applicability and risk to both technical and operational aspects of the organization. Metrics will be developed and reported quarterly. The Senior Reviewer will be expected to pursue successful completion of multiple tasks collaborating effectively with many departments across the institute, Mass...

ruralMED Management Resources, an Ovation Healthcare partner, seeks a Hospital Outpatient Specialty Coder. This role, under general direction, is responsible for critical access hospital coding; including emergency department, infusions, Critical Access Hospital Specialty Clinic, professional fees, and Rural Health Clinic. They will ensure the timely and accurate coding of medical claims while maximizing reimbursement for services. Duties and Responsibilities: Employee must have the skills, ability and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation.  Specific job duties will vary based upon client assignment.  Employee will also abide by ruralMED’s policies as a condition of employment. Charge Entry Receive and review charge entry data from practice sites Identify and investigate incomplete or missing charges Coding: Abstract clinical information; translates medical...