Supervisor certified professional coder jobs

Full Time

Remote - Clinical Payment Integrity DRG Validator

ClarisHealth Remote

Job Summary: The DRG Coding Validator integrates advanced clinical nursing knowledge with expert inpatient coding proficiency to perform comprehensive validation of Diagnosis-Related Group (DRG) assignments and associated inpatient medical record coding. Drawing on dual expertise as a Registered Nurse (RN) and a Certified Inpatient Coder (CIC or CCS), this role evaluates both the clinical validity of documented diagnoses and procedures and the accuracy of ICD-10-CM/PCS code assignments, DRG sequencing, and discharge dispositions. This position serves clients by identifying coding inaccuracies, unsupported clinical documentation, and DRG assignment errors across MS-DRG and APR-DRG reimbursement methodologies. Why You'll Love Working at ClarisHealth We believe our team deserves the best, and we’re proud to offer a comprehensive benefits package designed to support your success, both at work and in life. Here’s what you can look forward to: Medical,...

Full Time

Certified Billing and Coding Specialist

New York Oncology Hematology Hybrid (NY)

SCOPE: Under minimal supervision performs periodic, comprehensive coding audits for all assigned regional oncologists (medical, radiation and surgical oncology). Verifies charge documentation and charge submission processes are in compliance with Federal and State regulations, as well as payer guidelines. Coordinates efforts with manager and front office managers to ensure optimal revenue cycle processes and adherence to compliance and revenue cycle policies and procedures. Provides effective educational feedback to physicians and staff on findings from audits and updates in Payer billing regulation . ESSENTIAL DUTIES AND RESPONSIBILITIES: Develops Audit and Education Programs Abstracts relevant clinical and demographic information from the medical record to assign current ICD and CPT codes in accordance with coding and reimbursement guidelines. Codes with an accuracy of 97% based on QA internal reviews Performs Evaluation and Management (E&M)...

Full Time

Documentation and Coding Consultant 1

Northwest Permanente Hybrid

Overview: The Documentation and Coding Consultant 1 provides training, consultation, review, and feedback to clinicians on their medical service documentation and coding to ensure KPNW receives appropriate reimbursement and conforms to applicable guidelines and regulations. This is a hybrid position that is a blend of working both remotely and in office. Must reside in the Northwest Service Region (Oregon or Washington). Major Responsibilities / Essential Functions: Consulting and Coding services Provides expert consultation to specialists or primary care clinicians as assigned on coding and documentation education and questions. Within assigned clinical specialties, maintain current knowledge to ensure that KPNW coding and documentation meets regulatory guidelines and audit standards. Follow coding specificity guidelines using coding rules and guidelines. General coding knowledge and understanding of Risk Adjustment models and submission...

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Full Time

coding and documentation auditor

Texas Tech University Health Sciences Center Hybrid (Amarillo, TX)

Position Summary Performs coding and documentation quality audits, providing feedback and education to coding and reimbursement specialists, coders, and providers. Minimum Qualifications · High School graduate or equivalency and five years of coding and reimbursement experience of which 1 year may be as a coding auditor. · Additional job-specific education may substitute for the experience. · Active professional coding certification from an accredited organization, e.g., American Association of Professional Coders (AAPC), American Health Information Management Association (AHIMA). · Certification to remain current during term of employment. · Knowledge of CPT, ICD-CM, ICD-10, and HCPCS nomenclature. Position Specific Qualifications • Billing and coding experience in a multi-specialty group practice and/or academic practice setting is preferred. • Five...

Full Time

Coder II

Cheyenne Regional Medical Center Remote

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...

SM

Full Time

Billing / Coding Compliance Specialist

SIU Medicine Hybrid (Springfield, IL)

This position has the primary function of coordinating and supporting the Deputy Chief Compliance Officer with administrative, analytical, and program coordination activities. This position will provide support related to compliance auditing activities and programs, assisting with developing and coordinating the Compliance Audit Plan, supporting proactive and reactive audits of professional fee billings in clinic and facility settings, including federally qualified health centers. Proactively support audit activities related to billing and coding risks to the SOM, identifying and calculating potential overpayments based on audit results, participating in the repayment process if necessary, reviewing research billing compliance issues and assisting the Deputy Chief Compliance Officer in designing and managing a comprehensive billing/auditing program. The position supports compliance-related activities by gathering information, coordinating documentation reviews, monitoring...

Full Time

Billing Compliance Reviewer

Dana-Farber Cancer Institute Remote (Boston, MA)

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...

Full Time

Senior Billing Compliance Hospital Reviewer

Dana-Farber Cancer Institute Remote (Boston, MA)

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...

Full Time

Certified Coder- Primary Care

Maryland Primary Care Physicians Hybrid (MD)

Position Summary: The Certified Medical Coder is responsible for reviewing patient medical records and accurately assigning diagnosis and procedure codes using ICD, CPT, and HCPCS classification systems. This role ensures compliance with regulatory guidelines, supports timely claims submission, and collaborates with clinical and billing staff to maintain coding accuracy and completeness. Reports to: Coding Director Supervisory responsibilities : None Key Responsibilities include but not limited to: Assign accurate diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS systems Review and abstract medical record documentation, including chronic conditions and quality measures Ensure proper code sequencing in compliance with federal regulations and payer requirements Validate that documentation supports all coded diagnoses, procedures, and charges Identify and resolve documentation gaps; query providers for clarification when needed...

9 supervisor certified professional coder jobs found