11 scheduler coder analyst jobs found

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Job Description Join our team as a Pharmacy Compliance Auditor - 340B Program and play a vital role in ensuring access to affordable medications for underserved communities. In this position, you will help safeguard the integrity of the 340B Drug Pricing Program-a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care to more patients. As a Pharmacy Compliance Auditor, you'll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. If you are detail-oriented, passionate about compliance, and eager to grow in a critical area of pharmacy operations, we'd love to hear from you! Location: Norwood, OH Work Hours: Full Time, 80 hours biweekly Day shift No weekends,...

Anderson Hills Pediatrics' Expectations of all Employees: Adhere to all Anderson Hills Pediatrics' Policies and Procedures Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times Maintain a positive and respectful attitude with all work-related contacts Consistently reports to work prepared to perform the duties of the position Meets productivity standards and performs duties as workload necessitates Primary Function : Assists the Billing Manager with the claims submission and revenue cycle of the practice. Major Duties and Responsibilities : • Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information • Update patient demographic information including insurance coverage; make changes/corrections as...

Description Note: While this role is currently remote, we are prioritizing candidates within commuting distance of our Rossford, Dublin, or Brooklyn offices to accommodate a potential future shift to a hybrid schedule. Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans. Job Summary: Supervises staff, operations, and activities of the Risk Adjustment Retrieval and Coding Quality Department. Acts as a primary liaison between provider groups, medical coding, and chart retrieval teams to communicate appropriate documentation for Risk Adjustment coding. Serves as a Risk Adjustment documentation subject matter expert; delivers...

Become a part of our caring community and help us put health first The Inpatient 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

Join our team as a Pharmacy Compliance Auditor – 340B Program and play a vital role in ensuring access to affordable medications for underserved communities. In this position, you will help safeguard the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care to more patients. As a Pharmacy Compliance Auditor, you’ll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. If you are detail-oriented, passionate about compliance, and eager to grow in a critical area of pharmacy operations, we’d love to hear from you! Minimum Job Requirements High School Diploma or GED (required) Minimum of 2–3 years of experience in one or more of the...

Medical Coding and Billing Compliance Auditor Location: Remote Division: Coding Compliance About the Role: The Medical Coding Auditor is a detail-oriented position responsible for reviewing medical coding accuracy, documentation integrity, ensuring compliance with federal and state regulations, payer guidelines, and internal policies. The ideal candidate will bring strong analytical skills, extensive coding knowledge, and a passion for maintaining the highest standards of quality and compliance. The candidate will demonstrate a strong background in Microsoft Office applications including PowerPoint, Word, Excel, Outlook, TEAMS, and SharePoint. The Medical Coding Auditor will have a background in physician feedback and education on documentation integrity and coding accuracy. The ideal candidate will have extensive knowledge of CPT coding, ICD-10-CM coding, E/M coding, HCC methodologies, modifiers, telehealth, and HCPCS coding. The candidate will understand and know where to access...

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