11 senior clinical coder jobs found

Job Description About the Role: We are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts. Requirements and Qualifications: A minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment. Proficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records. In-depth understanding of supporting evidence requirements for accurate coding. Practical experience using grouper software for MS-DRG and APR-DRG assignment. Strong communication skills to interact...

Job Title Working at the Primary Care Center, you become a part of something very special. Providing care to all individuals, regardless of wealth, vulnerability, immigration or refugee status, is immensely gratifying. In this work, you will be joining others with a similar mission and vision, including the opportunity to volunteer in the community. Benefits Paid time off (PTO) Various health insurance options & wellness plans Retirement benefits including employer match plans Long-term & short-term disability Employee assistance programs (EAP) Parental leave & adoption assistance Tuition reimbursement Ways to give back to your community Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer. Responsibilities Apply the appropriate diagnostic and procedural code to patient health records for purposes...

divh2DRG Coding Auditor/h2pCarelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending./ppBuild the Possibilities. Make an Extraordinary Impact./ppThe DRG Coding Auditor is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physicians statement sent in by acute care hospitals on submitted DRG./ppPrimary duties may include, but are not limited to:/pulliAnalyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical...

Ceris Certified Coder I Ceris is seeking a certified coder. The Ceris certified coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote role. Essential functions and responsibilities: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations to referring office Communicates claim status with referring office Reads and comprehends all medical reports Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Complies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program ("IIPP"), as well as, maintains HIPAA compliance Knowledge and skills: Ability to learn rapidly to develop knowledge and understanding of...

DRG Coding Auditor Principal This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...

Anticipated End Date: 2026-02-06 Position Title: DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) Job Description: Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (60%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This position involves comprehensive medical record review to extract essential medical and demographic data. You will interpret and apply diagnoses and procedures using the ICD and CPT coding systems, contributing to the reduction of average accounts receivable days. ESSENTIAL RESPONSIBILITIES Thoroughly reviews and interprets medical information, physician treatment plans, outcomes, and determines the correct ICD-10 CM/CPT codes for diagnoses and procedures. (60%) Abstracts vital data elements to meet statistical requests from the hospital, health system, and medical staff, ensuring accurate entry of all coded/abstracted information into the designated systems. (15%) Manages medical information effectively and optimizes cash flow concerning the unbilled coding report. (10%) Stays updated with the latest changes and updates in ICD-10 CM/CPT guidelines through training...

DRG Coding Auditor Principal _Virtual: _ _ ​_ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

A leading healthcare provider is seeking a Medical Records Coder II for a remote position. The successful candidate will be responsible for assigning diagnosis and procedural codes and mentoring junior coders. Candidates should have at least 2 years of coding experience and relevant certifications preferred. This is a PRN status position, meaning it is as needed and non-benefit eligible. Join us in promoting clinical excellence with a focus on trust and compassion. #J-18808-Ljbffr

Registered Nurse - Diagnosis Related Group Coding Auditor Principal – Carelon Payment Integrity Location: Alternate locations may be considered. This position will work in a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate, and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical records and attending physician’s statements provided by acute care hospitals on paid DRG,...