38 jobs found

Position Summary The Certified Medical Biller and Coder is responsible for accurately reviewing medical documentation, assigning appropriate diagnosis and procedure codes, and supporting the billing process to ensure timely and compliant reimbursement. This role plays a critical part in maintaining the integrity of the revenue cycle by ensuring claims are coded correctly, submitted efficiently, and compliant with payer and regulatory guidelines. The position requires strong knowledge of CPT, ICD-10-CM, HCPCS coding systems, payer requirements, and medical billing workflows. Essential Duties and Responsibilities Review provider documentation and assign accurate CPT, ICD-10-CM, and HCPCS codes Ensure coding compliance with Medicare, Medicaid, and commercial payer guidelines Verify documentation supports medical necessity and appropriate coding Apply correct modifiers and place-of-service codes Prepare and review claims prior to submission to ensure...

CNY Family Care's commitment to excellence sets us apart and guides us as we provide care for our community. The Medical Coder and Auditor will be responsible to conduct prospective audits of coding and billing; analyze physician and provider documentation in outpatient office health records; correct evaluation and management (E/M) service levels, appropriate procedure codes, and any necessary modifiers.  Medical Coder and Auditor Responsibilities: Navigate the patient health record, office visit notes, and procedure reports in the determination of diagnoses, reason for visit, procedures, and modifiers to be coded. Code outpatient records utilizing coding books, online tools, and references, in the assignment of ICD, CPT, and HCPCS codes and modifiers. Document individual encounter audit findings and communicates results to providers. Access charge work queues to validate and assign charges. Perform all required EMR functions as efficiently as possible and according...

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...

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)...

Position Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare.  As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing. Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides. Collaborates with physician reviewers, as needed. Ability to prioritize and organize workload and complete tasks independently....

Billing & Coding Integrity Specialist Full Time (Benefit Eligible) Monday - Friday (No weekends or holidays), 8:00 am - 5:00 pm  This role is an on‑site position and is not eligible for remote work. The Patient Financial Services Department is seeking a full time Billing and Coding Integrity Specialist to join the team. Under the direction of the Director of Patient Financial Services the specialist is responsible for implementing and promoting consistent revenue integrity practices that will improve compliance, accurate billing, and charge capture at the point of service to ensure optimal reimbursement for Keystone Health.  The specialist is responsible for auditing and monitoring appropriate coding guidelines and regulations. Recommending any corrective action and assists with implementing the corrective action.  This position is also responsible for providing billing/coding training and education to providers and staff and maintaining a current...

Physicians' Choice is currently seeking a highly proficient and seasoned Medical Coding Auditor specializing in Evaluation and Management (E/M) services, with a comprehensive understanding of Emergency Medicine, to join our esteemed team. If you possess extensive expertise in current E/M coding guidelines and have a strong background in auditing, we invite you to apply for this exceptional opportunity. Job Description:  As a Medical Coding Auditor you will play a vital role in ensuring accurate and compliant coding practices within our organization. You will be responsible for conducting detailed audits of medical records, coding documentation, and related billing processes to verify compliance with established coding guidelines, regulatory requirements, and internal policies. Responsibilities: Perform comprehensive audits of medical records, coding documentation, and billing processes. Evaluate the accuracy, completeness, and appropriateness of medical...

Are you an experienced and motivated Medical Biller specializing in Home Infusion Therapy? The ideal candidate would have experience in billing for implanted pain pumps. We are seeking a skilled 1099 contractor with experience in billing for Florida-based home infusion services and in Payer credentialing. This is a remote contract position offering flexibility and competitive compensation. Expericence in Billing  Key Responsibilities: Experience in credentialing and billing with CareCentrix BCBSFL- UB-04 Claim Submission: Efficiently and accurately prepare, review, and submit Home Infusion claims using the UB-04 and EDI Formats as required by payers. Payer Credentialing: assist with credentialing and re-credentialing processes with various commercial and government payers, specific to the state of Florida. A/R Management: Follow up on outstanding claims, denials, and appeals to ensure timely and maximum reimbursement. Compliance:...

Billing Specialist Seeking a detail-oriented and dependable Billing Specialist to join our integrated care team in Newton, Kansas. This is a full-time position offering the opportunity to support patient care in a collaborative, mission-driven environment. We value collaboration, open communication, and a positive environment where everyone's input counts. As a vital member of the billing team, you play a critical role in the financial health of the organization and supporting access to care for our patients. We value the unique expertise each team member brings and are committed to supporting ongoing learning and professional development within the organization. What You'll Do Review charges for correct coding prior to claim submission, ensuring compliance with all federal and state regulations. Prepare and submit clean claims timely to insurance companies, electronically, via paper and through insurance portals. Resolve clearinghouse and payer...

Overview Top candidates will have experience with Oncology Coding.   As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA   This position is responsible for abstracting, coding, and interpreting of outpatient clinic and provider services for professional and/or facility billing. This position uses coding knowledge to abstract and record data from medical records and provides support to areas related to documentation and coding. This position codes and charges complex or specialty services and may serve as a resource for other coders. This position is not responsible for...

Adventist HealthCare seeks to hire an experienced Lead Coding Specialist for our Medical Coding Department who will embrace our mission to extend God’s care through the ministry of physical, mental, and spiritual healing. As a Lead Coding Specialist, you will: Conduct reviews to validate I-10-CM diagnosis codes and PCS procedure codes for inpatient bill hold related to PSI, PPC & other reimbursement conventions to be resolved prior to final coded data. Manages daily DNFB and DNFC reports and work queues for un-coded or outstanding records. Under the direction of the coding manager, the coding specialist lead should be proficient in communicating with the coding team. Oversees coding corrections, abstracts elements for HSCRC submissions, and ensures coding compliance with coding standards. Liaison between coding and other departments, managing coding-related tasks and denials. Provides mentoring support to coders on coding...

Job Title:   Accounts Receivable (AR) Specialist Company:   Client First RCM, LLC Location:   In-Office/Remote/Hybrid– Pennsylvania Job Type:   Full-time About Us Client First RCM, LLC is a multi-specialty Revenue Cycle Management company serving providers across multiple states. We specialize in ethical, accurate, and efficient medical billing services with a focus on provider success and patient satisfaction. Job Summary We are seeking a dependable and detail-oriented Accounts Receivable (AR) Specialist to join our in-office team in Pennsylvania. This position plays a key role in managing AR follow-ups, claim resolution, and reimbursement activities across multiple medical specialties. Responsibilities: Follow up on unpaid or underpaid claims via phone, web portals, and written communication Resolve claim denials and rejections using EOBs and remittance advice Submit corrected claims and appeals with appropriate documentation Post...

General Summary:   U.S. Urology Partners, LLC (USUP) and its physician groups are committed to promoting conduct that is responsible, ethically sound, and compliance with applicable law.  USUP’s Compliance Department (CD) fosters a corporate culture of ethical behavior and integrity in all matters related to compliance with the laws and regulations that govern the delivery and reimbursement of health care.  An integral function of USUP’s compliance program is auditing and monitoring compliance with billing, coding, and documentation requirements of its providers.    An CPC, CCS-P, or CPMA is required for this position.     Compliance Audit Services:   Compliance audit initiatives include physician, other providers, and facility documentation audits as well as preparation of guidance documents and tools to assist physicians and staff in appropriate billing, coding, and documentation.  The audit program looks at professional fee billing,...

Job Summary Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from medical records for complete and accurate statistical documentation. Minimum Qualifications Minimum Education:   High School Diploma or Equivalent Minimum Years of Experience:   3 Years of Professional Coding Experience Covering Multiple Clinical and/or Surgical Specialties (Combination of Surgical, E/M, or other coding experience as approved by Director), which they Successfully Met Quality and Productivity Standards Substitutable Education & Experience (Optional):   None. Required Certifications/Licensure:   Active AAPC or AHIMA Coding Credential Required Training:   Experience working with CPT, ICD diagnosis coding; Experience with CCI edits; Experience with Medicare LCDs and NCDs; Understanding of state and federal regulations as well as payor...

Help safeguard accuracy, integrity, and regulatory compliance across our organization. We are seeking a skilled Compliance & Coding Audit Specialist to support the Corporate Compliance Program through detailed auditing, monitoring, and provider education related to coding, billing, and clinical documentation practices. What You’ll Do Conduct ongoing coding, billing, and documentation audits to ensure compliance with hospital policies and federal and state regulations Interpret medical records and related documentation using advanced coding knowledge to assess accuracy and risk Execute compliance audit assignments with a high degree of independence, confidentiality, and professional judgment Analyze findings, prepare audit documentation, and identify trends or improvement opportunities Present audit results directly to physicians and providers, delivering clear feedback and education on documentation and coding best practices...

JOB LOCATION:   Remote (Considering applicants residing in Georgia, Florida, Ohio, North Carolina, South Carolina, West Virginia, Utah, Arizona, and Missouri.) DEPARTMENT:   REVENUE CYCLE MEDICAL GROUP, SGMC Health SCHEDULE:   Full Time, 8 HR Day Shift, 8-5 Abstracts ICD-10 and CPT codes for Diagnosis and Procedures on professional services. Reviews and analyzes medical records verifying and coding the diagnosis, evaluation and management service, minor procedures, or other codes required for the completeness and accuracy of the record. Additionally, will code and/or review principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, any applicable supply, medication, and injectable drugs. Maintains communication with Management, Practice Manager, and Provider to ensure timely notification of identified documentation issues. Interact with other team members of the revenue cycle and provider clinics. Responsible for continuing education of...

Ever wanted to help build the organization you always wanted to be a part of? At Norwood we’re forging our own path. We’re a remote-first staffing and consulting company specializing in mid-revenue cycle management within the healthcare industry.  Our team of experts have delivered meaningful improvements to our partners with proven ROI with sustainable outcomes. We have also placed thousands of professionals that support organizations ranging from small, community-based hospitals to the largest healthcare systems in the nation. Our mission? Bringing health to hospitals’ bottom lines. We are looking for a motivated and relationship-driven Client Delivery Lead Consultant, to help manage the growth within Norwood’s Solutions division. The Client Delivery Lead Consultant will play an integral role leading and managing the successful development and delivery of various project types within the mid cycle space. Development and delivery success will including aligning team members with...

About Us We are a Central Billing Office (CBO) supporting multiple multi-specialty Ambulatory Surgery Centers (ASCs) across the tri-state area. Our team manages high-volume, end-to-end facility billing and accounts receivable in a collaborative, professional office environment. Our shared values —   CARE   — guide how we work, lead, and treat one another. In this role, you will be expected to: Commit to Integrity ( C ) – Perform your work accurately and honestly, doing what’s right for our patients and facilities. Assume Accountability ( A ) – Take responsibility for your tasks, follow through on billing and A/R responsibilities, and own your outcomes. Respect Through Professionalism ( R ) – Maintain high standards in your work and communications with colleagues, patients, and payers. Engage as One Team ( E ) – Collaborate closely with teammates and other departments to support shared success. This is an on-site position. Candidates must live within...

Physician Medical Coder Job Listing   PLEASE READ JOB DESCRIPTION    Profee coder to review coding denials and correct/validate CPT, ICD-10, HCPCS and modifiers for physician services.  Our coders will review medical records, research payer policy, and NCDs to make coding corrections and resubmit corrected claims in an accurate and timely manner. We work closely with other team members and management to translate clinical documentation consistently and accurately into ICD-10 and CPT codes with proper sequencing and modifiers. Through these efforts, the individual within this role will identify and report error patterns, resolve errors or issues associated with coding and billing processes, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors.     Job Requirements     At least one active certification is required. Additional certifications a plus. Accepted certifications...

Supporting the Vice President & Chief Compliance Officer, the Compliance Specialist assists in carrying out the activities of the Frederick Health Compliance Program, including risk assessment, training & education, audits, policy development and internal investigations. Requirements: BA/BS required. MBA/MHA preferred. 5-10 years' experience in healthcare compliance and internal auditing. Certification preferred. Knowledge of laws, regulations, policies and procedures of governmental authorities and payers. Experience in developing and carrying out training and education of staff. Excellent oral and written communication skills. Strong organizational skills and ability to prioritize and manage multiple tasks. Ability to maintain a high level of confidentiality. The following experience & credentials are strongly preferred: Experience in healthcare revenue cycle or patient accounting (coding and/or billing) internal auditing and compliance....

Provider Coding Specialist Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day. A Brief Overview Under the supervision of the Coding Supervisor, the Provider Coding Specialist is responsible for analyzing and assigning ICD-10-CM diagnostic codes, CPT, and HCPCS codes to professional surgical patient accounts, based on the medical information provided and consistent with regulatory guidance and best practices in the industry and Organization policy and procedure. Abides by the Standards of Ethical Coding as set forth by AHIMA and AAPC. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify documentation to ensure accurate code assignment. Organizes and prioritizes...

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation.   Supervisory Responsibilities: This position has no supervisory responsibilities.   General Requirements: All duties performed will be done accurately and in a timely manner.   1.        Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. 2.        Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. 3.        Must...

AAPC is seeking a highly motivated and dedicated coding professional to join our team as a Contract Coder. This position is a fully remote contract role. The ideal candidate must have at least 5 years of coding experience for physician practices, with various surgical specialties as well as E/M. The position requires one to be resourceful, organized, and extremely driven. The ideal candidate will possess the following: Minimum 5 years of coding experience Extensive coding in multiple specialties including: all primary care specialties, anesthesia, general surgery, dermatology, and orthopedics. Excellent written and verbal communication skills Detail oriented and deadline driven attitude Sound knowledge of medical terminology Strong computer skills (Excel, Word, and internet) Ability to multitask and keep a sense of urgency Excellent customer service skills Strong time management, organization skills, and work ethic Job Duties:...