11 jobs found

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start  Caring. Connecting. Growing together. High Level Overview of the Role: Coding Consultant is responsible for investigating and resolving instances of healthcare fraud and abuse of medical providers. Coding Consultant uses information from a tip, member benefits, and medical records to document relevant findings. This position will achieve applicable targets and metrics as determined.This individual will provide mentoring,...

Cardiology Coding Auditor – Part-Time Remote Are you passionate about cardiology coding, compliance, and education? Gill Compliance Solutions (GCS) is growing, and we're looking for an experienced Cardiology Coding Auditor to join our nationally recognized consulting team in a part-time, remote position. Our consultants work directly with physician practices, hospitals, health systems, emerging healthcare technology companies, and legal firms across the country to improve documentation, coding accuracy, compliance, and reimbursement. Every day presents new challenges and opportunities to make a measurable impact. If you enjoy auditing complex cardiology services, identifying coding and reimbursement opportunities, educating providers, and solving challenging coding issues, we'd love to meet you. Duties May Include: Perform cardiology coding and documentation audits to ensure accuracy of CPT, HCPCS, ICD-10 codes, and modifiers in accordance with...

Must reside in Texas, Georgia, Mississippi, Montana, North Carolina, Oklahoma, or Wisconsin Salary: up to $40/hr. with experience Job purpose The certified coder prepares and submits clean claims to insurance companies electronically and by paper, and provides appropriate coding for each patient’s medical history, diagnosis, tests and treatment plan. Duties and responsibilities Primarily codes from final office visit, surgical/procedural operative reports signed by providers Reviews medical records and accurately code primary and secondary diagnoses using CPT, ICD-9 and ICD-10 conventions; sequence the diagnoses and procedures using coding guidelines Verifies accuracy and submits claims to insurance using Electronic Medical Records systems and paper claims Enters patient copayment information into the EMR Reconciles charges against the schedule list to ensure no charges are missed Investigates rejected claims to see why denials were issued as...

Multiple ED, SDS and IP Coding Assignments Available & Data Quality Auditors Needed Description: Coders and Auditors with 3-5+ years of facility coding experience are needed to provide coverage to Pena4’s clients. Responsibilities : Pena4 M edical Coders are responsible for accurately assigning ICD-10-CM/PCS diagnosis and CPT procedure codes for inpatient and outpatient hospital services. This role ensures coded data is complete, compliant, and supports appropriate reimbursement, quality reporting, and regulatory requirements. Coders must meet or exceed determined productivity and quality standards for respectively assigned client engagements in order to ensure the highest level of coding.  Summary: Position Type: 1099 Independent Consultant 100% Remote Assignments Schedule/Shift varies per assignment. See current assignment details below.   Credentials: CPC, CCS, RHIA, RHIT (preferred) 3-5+ years of Facility Coding Will be required to complete ED,...

Primary Purpose of the Position: The Revenue Cycle Medical Coding Supervisor provides daily operational supervision of assigned coding staff and coding inventory. The Supervisor assigns work, monitors throughput and quality, performs and coordinates quality reviews, supports training and onboarding, resolves complex coding issues, and promptly escalates backlog, documentation, compliance, vendor, and system risks to the Coding Manager. The role may also perform complex coding to support operational needs while maintaining appropriate separation between production work and independent quality review. Required Knowledge and Experience: Active CPC through AAPC or CCS through AHIMA; specialty coding credentials are desirable. Minimum five years of professional medical coding experience preferred, including complex surgical or multi-specialty coding; prior lead or supervisory experience preferred. Advanced knowledge of medical terminology, anatomy and physiology,...

Risk Adjustment Auditor and Physician Educator Health Information Management | Full-Time | Renton, Washington Help Improve Clinical Documentation and Support Better Patient Care Valley Medical Center is seeking an experienced Risk Adjustment Auditor and Physician Educator to join our Health Information Management team. This role combines clinical documentation expertise, risk adjustment auditing, coding knowledge, data analysis, and physician education to help ensure the accurate and complete capture of patient conditions and the clinical complexity of the care we provide. The ideal candidate brings strong experience in Medicare risk adjustment, medical record auditing, ICD-10-CM coding, and physician education , along with the ability to translate complex coding and documentation requirements into practical guidance for providers. This is an opportunity to play a meaningful role in improving documentation quality, supporting value-based care initiatives, and...

Billing Compliance Curriculum Development Specialist Dana-Farber Cancer Institute  Boston, MA  Full Time, Remote (Occasional Onsite)  Overview Reporting to the Manager of Billing Compliance, the Billing Compliance Curriculum Development Specialist is responsible for designing, implementing, and maintaining a comprehensive billing compliance education and awareness program that supports adherence to federal and state regulations and aligns with industry standards. This role develops and delivers training for billing providers, including physicians and advanced practice providers, and provides post-review education and feedback in collaboration with Billing Compliance Reviewers and Senior Billing Compliance Reviewers, as needed. The Specialist creates, updates, and manages instructional materials such as presentations, tip sheets, slide decks, and other training resources, and tracks training completion and effectiveness. The position also supports the...

About Us Undeniable Health puts AI billing agents to work inside the revenue cycle operations of healthcare providers and the billing companies that serve them. We handle the full claim lifecycle: charge entry, credentialing, prior authorization, claim submission, claim management, and denial recovery, including the denied claims traditional billing teams can't afford to chase. We work inside our clients' existing systems, under their credentials, as an embedded member of their team. No software to sell. No dashboards to manage. We get the money back. We're backed by investors who know the RCM space, and led by co-founders Alex Poon and Jason Griffith, repeat entrepreneurs with multiple successful exits. We service all specialties, with a current focus on diagnostic labs and behavioral health. The Role This is a production billing job, and we mean that as a compliment. You'll work inside client billing systems every day doing the work that keeps revenue moving: entering...