15 senior coder jobs found

Senior Inpatient HIM Coder 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 effectively with the billing department regarding...

A leading health insurance company is seeking a Senior Specialist in Risk Adjustment to manage operations for Medicare Advantage and ACA lines of business. This remote position requires a bachelor's degree and certifications in coding, alongside at least two years of relevant experience. Key responsibilities include daily operations, compliance with standards, and participation in audits. The position comes with a competitive salary range and extensive employee benefits including medical and dental coverage, paid leave, and a 401(k) plan. #J-18808-Ljbffr

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...

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...

Overview Be inspired . Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoingmentorshipand leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Description Overview: Reporting to the Director, the Sr. Compliance Auditor, develops and executes audit, monitoring, and education for both facility and professional billing, coding and documentation programs that ensure compliance with regulatory standards across Physician Services. Continuously evaluates facility/professional billing compliance activities to...

Medical Coder Become a part of our caring community and help us put health first. The Medical Coder 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 Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coder confirms appropriate diagnosis related group (DRG) assignments. Review and analyze patient medical records to identify accurate ICD-10-CM diagnosis codes, ensuring all relevant conditions affecting patient's care are documented to the highest level of specificity. Validate that documentation supports risk adjustment coding and HCC capture in compliance with regulatory guidelines. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions are regarding the...

Risk Adjustment Coder Specialist 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 ourselvesone that behaves like a doctor in the family. About the role: The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for...

Become a part of our caring community and help us put health first The Medical Coder 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 Medical Coder assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Medical Coder confirms appropriate diagnosis related group (DRG) assignments. Review and analyze patient medical records to identify accurate ICD-10-CM diagnosis codes, ensuring all relevant conditions affecting patient's care are documented to the highest level of specificity. Validate that documentation supports risk adjustment coding and HCC capture in compliance with regulatory guidelines. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions are regarding the daily...

Job Description Job Description Hi, we're Oscar. We're hiring a Risk Adjustment Coder Specialist to join our Risk Adjustment. 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 Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) , and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas....

About the role The Senior Specialist, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing effective Risk Adjustment processes. You will report into the Manager, Risk Adjustment. Work Location This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; or Texas. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. Pay Transparency The base pay for this role is: $67,813 - $89,004 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities Responsible for daily operations pertaining to Risk...

Job Description Job Description Job Summary We are a growing Arthritis and Rheumatology Center, seeking a highly experienced Lead Certified Medical Coder to support a compliance-driven rheumatology and infusion practice in Cumming, GA. This role is in-person and requires expert-level knowledge of rheumatology and biologic infusion coding, strict adherence to CMS and payer regulations, and active oversight of coding compliance through audits, monitoring, and corrective action. The Lead Coder serves as the primary coding authority and risk mitigation resource for the organization. Key Responsibilities Coding Compliance & Audit Oversight Ensure accurate and compliant coding of rheumatology services, biologic therapies, and infusion encounters Apply CPT, ICD-10-CM, HCPCS (including J-codes), modifiers, units, and wastage in strict accordance with CMS and payer guidelines Validate documentation supports medical necessity, infusion start/stop times, dosing, and...

divh2Op Coder 2/h2pHow would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of whats possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in peoples lives./ppWork Shift Various (United States of America)/ph2Job Summary:/h2pA new chapter awaits at Wellstar! We value your experience and want to help you continue your career in a supportive environment./ppExperience the Wellstar Difference/ppCompetitive pay benefits/ppCareer growth development programs/ppFlexible schedules/ppSupportive, team-oriented culture/ppEmployee wellness programs/ppThe OP Coder 2 position reports directly to the Supervisor of Coding. Key responsibilities of the role include:...

Physician Compliance Auditor Grady Health System offers many career paths for experienced professionals. Whether you have many years of experience or are in the early stages of your career, you can find a rewarding career at Grady! Location: Atlanta, GA Job Type: FTE Shift/Schedule: Days This is a remote role, but the ideal candidate will be required to come into the office occasionally to meet with the providers. The Physician Compliance Auditor is responsible for conducting compliance audits, reporting results, researching/investigating issues, and establishing compliance monitoring processes. The Compliance Auditor is responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding accuracy, medical necessity, the appropriateness of treatment setting, HIPAA matters, and other compliance issues as directed by the Physician Coding Director, Compliance Director. This position requires effective communication with internal...

Supervisor, Medical Records, Release of Information Join to apply for the Supervisor, Medical Records, Release of Information role at Clinetic, an MRO Company Role: The Site Supervisor is responsible for managing the daily scheduling of the ROI Specialists at specific client site. The Site Supervisor will actowment liaison between MRO and Client Management staff to ensure that all ROI activities are compliant with established client policies, federal and state regulations emotions and are completed in a timely manner. Location: This is an on‑site position in Augusta, GA. Tasks and Responsibilities Manages workflow among on‑site employees to ensure maximum productivity and quality standards are met. Adjusts work assignments as needed encaraic to cover peak periods, leave and vacancies. Prioritizes work asigma of completion of ROI function. Adjusts work assignments as needed to cover peak periods, leavezept and vacancies at the staffed hospital sites. Provides coverage in...

Description WHAT IT'S LIKE AT SGMC HEALTH Purpose . No matter your role or area that you work in, at SGMC Health we are collectively working towards goals that will make our community a better place. Excellence . We strive to do the right thing the right way, are accountable in all we do, require competence of our people, and are compassionate in our service. Team Spirit. We encourage team effort, support personal and professional development, acknowledge individual talents and skills, and support innovation and empowerment. Award Winning Performance. We are committed to providing the best care possible and we are proud to be recognized locally, statewide, and nationally for the exceptional care that our staff provides. WHY YOU WILL LOVE SGMC HEALTH SGMC has great benefit options, depending on the role that you are going into- including healthcare, supplementary benefits, ways to save for the future, opportunities for career advancement, and opportunities...