59 value based coder ii jobs found

The Value Based Coder II is an experienced professional within the Quality Management/ Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis o Coder, Total Rewards, Education, Medical, Health, Healthcare

Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding....

Where You’ll Work Baylor St. Luke’s Medical Center is an 881-bed quaternary care academic medical center that is a joint venture between Baylor College of Medicine and CHI St. Luke’s Health. Located in the Texas Medical Center, the hospital is the home of the Texas Heart® Institute, a cardiovascular research and education institution founded in 1962 by Denton A. Cooley, MD. The hospital was the first facility in Texas and the Southwest designated a Magnet® hospital for Nursing Excellence by the American Nurses Credentialing Center, receiving the award five consecutive times. Baylor St. Luke’s also has three community emergency centers offering adult and pediatric care for the Greater Houston area. Job Summary and Responsibilities The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on...

Value Based Coder II The Value Based Coder II is an experienced professional within the Quality Management/Risk team, responsible for independently reviewing patient medical records to identify, assess, monitor, and review coding opportunities, with a growing emphasis on Hierarchical Condition Categories (HCC). This role focuses on developing and delivering provider education and contributing to process improvement initiatives. The Value Based Coder II acts as a valuable resource in identifying clinically appropriate risk-adjusting conditions and supporting provider documentation improvement. 1. Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC. Validate the accuracy and completeness of HCC documentation and coding. 2. Advanced Documentation...

Catholic Health Initiatives - St Luke's Health [Medical Records Clerk] As a Coder at Catholic Health Initiatives, you'll: Accurately abstract information from the service documentation, assign and sequence appropriate CPT, ICD-9/10, and HCPCS codes into the appropriate billing systems; Be responsible for working encounters in the coding work queue or task lists in a timely manner; Review and resolve coding denials; Meet or exceed organizational coding production and quality standards...Hiring Immediately >>

Catholic Health Initiatives - St Luke's Health [Medical Records Clerk] As a Coder at Catholic Health Initiatives, you'll: Accurately abstract information from the service documentation, assign and sequence appropriate CPT, ICD-9/10, and HCPCS codes into the appropriate billing systems; Be responsible for working encounters in the coding work queue or task lists in a timely manner; Review and resolve coding denials; Meet or exceed organizational coding production and quality standards...Hiring Immediately >>

Inpatient Coder II (Remote) We're seeking an experienced Inpatient Coder II to join our remote team supporting a high-acuity, Level I Trauma academic environment. In this role, you'll accurately assign ICD-10-CM, ICD-10-PCS, and MS-DRG codes across a wide range of complex inpatient cases, collaborate with CDI specialists, and submit electronic queries when clarification is needed. Responsibilities: Code diverse inpatient specialties, including trauma and critical care Maintain 95% accuracy and meet productivity standards Assign POA indicators and support accurate DRG assignment Assist with mortality, rehab, and special case types Support denial rebuttals and participate in projects Requirements: -A minimum of three (3) years of experience as an inpatient coder at an academic facility. Required Education: -Coding Certificate Program Completion or Associate Degree in HIM or equivalent. Preferred Education: -Bachelor's degree in HIM or...

Where You’ll Work With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. Job Summary and Responsibilities You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills – but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success....

4 days ago Be among the first 25 applicants Get AI-powered advice on this job and more exclusive features. Colorado Community Managed Care Network provided pay range This range is provided by Colorado Community Managed Care Network. Your actual pay will be based on your skills and experience talk with your recruiter to learn more. Base pay range $53,000.00/yr - $70,000.00/yr Direct message the job poster from Colorado Community Managed Care Network Director of Human Resources and Business Operations Description https://recruiting.paylocity.com/recruiting/jobs/All/3736f22c-4667-493c-828e-5131b681ff09/Colorado-Community-Managed-Care-Network. Applicants will must apply through this link to be considered. Responsibilities: The Value Based Coding Advisor will interact with operational and clinical leadership to assist in the identification of Risk Adjustment/HCC coding opportunities, and will provide targeted education to CHC providers, billers, coders, and...

Professional Coder II We are recruiting for a motivated Professional Coder II - Must Reside in Colorado to join our team! Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all: Humanity in action, Triumph in hardship, Transformation in health. The Coder II is a key member of the Coding/Compliance team and has shared accountability for the success of the department. The Coder II, under general supervision, reviews medical record documentation to abstract and assign diagnoses, procedures, and modifiers for statistical classification and reimbursement purposes. Performs various coding assignments under the direction of Coding Management. Provides feedback regarding documentation and coding issues. Utilizes software applications and coding references, including electronic, to perform coding related tasks. Assists with training. Essential Functions: Meets or exceeds the minimum coding productivity standard for the...

The CERIS Certified Coder reverse codes previously coded medical bills to determine coding accuracy. This role is responsible for making claim-related recommendations and communicating status of the claim to involved stakeholders. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations and communicates claim status to to referring office Read and comprehend all medical reports Adhere to client and carrier guidelines and participate in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Maintain HIPAA compliance Additional duties as assigned KNOWLEDGE & SKILLS: Ability to learn rapidly to develop knowledge and understanding of claims practices Strong organizational skills Ability to meet or exceed...

Job Summary and Responsibilities You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills - but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success. This is a senior level professional fee coding position with at least three (3) or more years' experience in multiple specialties; coding both inpatient and outpatient professional fee services. Coder II staff key duties include reviewing documentation to assign appropriate CPT, HCPCS, and ICD-10 diagnosis codes, resolve edits in WQs (charge review, claim edit, and follow up), and review denials for possible corrected claims or appeals. Coder II will work with clinic supervisors and/or providers to resolve coding issues and questions, following...

Certified Medical Coder Job Title: Certified Medical Coder (AAPC) - On-Site, Downtown Orlando Are you a skilled and detail-oriented Certified Medical Coder seeking an exciting opportunity to join Quest National Services, a thriving medical billing company? We are looking for a dedicated individual to join our dynamic team at our Downtown Orlando office. If you have a passion for accuracy, teamwork, and growth opportunities, we want to hear from you! Job Description Utilize your expertise as a Certified Medical Coder to accurately assign appropriate medical codes to diagnoses, procedures, and services, ensuring compliance with all relevant coding guidelines and regulations. Review medical documentation and superbills to extract essential information required for proper coding. Work collaboratively with medical providers and billing specialists at Quest National Services to clarify coding questions, resolve discrepancies, and optimize claim accuracy. Stay updated with the...

Core Responsibilities Code & Abstract: Assign ICD-10-CM (diagnoses) and CPT (procedures) codes from physician documentation and medical records. Documentation Review: Evaluate records for completeness, accuracy, and compliance with coding guidelines and payer policies. Billing & Revenue Cycle: Resolve billing edits, manage charge capture, prevent denials, and ensure proper service capture for accurate reimbursement. Physician Collaboration: Educate physicians on documentation standards and work with Clinical Documentation Improvement (CDI) specialists. Data & Reporting: Ensure accurate data for DRGs, quality outcomes, internal/external reporting, and regulatory compliance. Auditing & Training: Conduct internal audits, defend coding decisions, and provide training for Coder I/II roles. Key Requirements Certifications: CPC, CCS, RHIA, RHIT, or similar are required. Experience: Varies by role (e.g., 2+ years for Coder II, 5+ years for Coder III in acute care)....

Where You’ll Work With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. Job Summary and Responsibilities You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills – but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success....

Job Description Job Summary: Coder II assigns diagnosis and procedure codes using the appropriate coding classification system to reflect the care and services rendered to the patients in the emergency department, ancillary, and outpatient surgery settings. Ensure the accurate selection of the principal diagnosis and procedure and all other significant diagnoses and procedures. Abstract hospital-defined data from records for data collection purposes. Ensure compliance with official guidelines, AHA Coding Clinic, AMA CPT Assistant and Guidelines, AHIMA Standards of Ethical Coding and LifePoint Health Support Center (HSC) policies and procedures. Who We Are: People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Lake Cumberland Regional Hospital is a modern, state-of-the-art 295-bed acute care facility, offering an advanced neurosurgery program with Spine Center accreditation amongst other specialty services....

Where You'll Work With more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services CommonSpirit is accessible to nearly one out of every four U.S. residents. Our world needs compassion like never before. Our communities need caring and our families need protection. With our combined resources CommonSpirit is committed to building healthy communities advocating for those who are poor and vulnerable and innovating how and where healing can happen both inside our hospitals and out in the community. Job Summary and Responsibilities You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills - but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your...

GoTo Telemed seeks an exceptional  Remote Medical Biller  to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide. As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers—with new clients and provider networks added every month as our organization scales. In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management. Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory. This...

The Supervisor, Medical Coding - Outpatient is responsible for the oversight and development of the office coding department. This includes mentorship and direct management of the outpatient medical coding team. The Supervisor of Medical Coding understands the organization’s core information technology and information management competencies to bring value to business processes and quality improvement initiatives. The Supervisor interacts with internal and external customers to ensure continuous improvement efforts are being achieved and new coding practices are being implemented. This will require periodic audits of documentation and productivity reports of staff. The Supervisor is responsible for the planning, organizing, and final execution of all processes necessary to provide timely, accurate, and complete posting and billing of patient demographic and clinical coding data as well as managing and tracking results. SECTION II: EDUCATION AND EXPERIENCE REQUIREMENTS:...

Company Description Job Title: Certified Medical Coder (AAPC) - On-Site, Downtown Orlando Are you a skilled and detail-oriented Certified Medical Coder seeking an exciting opportunity to join Quest National Services, a thriving medical billing company? We are looking for a dedicated individual to join our dynamic team at our Downtown Orlando office. If you have a passion for accuracy, teamwork, and growth opportunities, we want to hear from you! Job Description Utilize your expertise as a Certified Medical Coder to accurately assign appropriate medical codes to diagnoses, procedures, and services, ensuring compliance with all relevant coding guidelines and regulations. Review medical documentation and superbills to extract essential information required for proper coding. Work collaboratively with medical providers and billing specialists at Quest National Services to clarify coding questions, resolve discrepancies, and optimize claim accuracy. Stay updated with...

Join the Cleveland Clinic team, where you will work alongside passionate caregivers and provide patient-first healthcare. Cleveland Clinic is recognized as one of the top hospitals in the nation. At Cleveland Clinic, you will receive endless support and appreciation and build a rewarding career with one of the most respected healthcare organizations in the world. As a Professional Fee Coder III, you will be responsible for monitoring, reviewing, and accurately applying coding principles to clinical documentation received from ambulatory areas to support reimbursement, research, and regulatory compliance. In this role, you will assign appropriate diagnosis codes, CPT codes, and modifiers based on the medical record while ensuring adherence to federal coding guidelines. You will also identify and resolve billing discrepancies to ensure timely and accurate claim submission. This position supports Cleveland Clinic's mission and vision by helping submit clean claims for the services...

Job Summary: In addition to the responsibilities listed below, this position is also responsible for reviewing ambulatory medical records to identify edits to be remediated; and performing denial review/processing. Essential Responsibilities: Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members. Listens to, addresses, and seeks performance feedback. Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work. Assesses and responds to the needs of others to support a business outcome. Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; follows procedures and policies, and applies data and resources to support projects or initiatives with limited guidance and/or...

JOB SUMMARY This position will be functioning under minimal supervision while utilizing independent decision making. This position will assist the manager and supervisor in training new team members, coordinate inquiries from ancillary departments regarding DNFB and edit tasks. The Sr. Edit Coder will investigate and solve edit issues and communicate root cause data to management in order mitigate potential upstream and downstream impacts. Responsible for modifying and completing moderate to high complexity reviewing and resolving coding and charge edits using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Working in billing editor systems as required. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Performs claim edit...

Job Summary: In addition to the responsibilities listed below, this position is also responsible for reviewing emergency, outpatient, and ambulatory medical records to identify elements to be abstracted, as well as diagnostic and procedure codes, and beginning to review inpatient records. Essential Responsibilities: Pursues effective relationships with others by sharing resources, information, and knowledge with coworkers and members. Listens to, addresses, and seeks performance feedback. Pursues self-development; acknowledges strengths and weaknesses based on career goals and takes appropriate development action to leverage / improve them. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work. Assesses and responds to the needs of others to support a business outcome. Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; follows procedures and policies, and applies data and...