31 jobs found

Job Description Job Description Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance Billers experience in rehabilitation, physical therapy, occupational therapy billing WELCOME to Movementplus! Job Overview We are seeking a detail-oriented and organized Medical Biller to join our healthcare team. The ideal candidate will be responsible for managing the billing process, ensuring accurate coding, and maintaining compliance with medical billing regulations. This role requires a strong understanding of medical terminology, coding systems, and the ability to work efficiently in a fast-paced environment. Responsibilities Process and submit medical billing claims to insurance companies and government payers. Review and verify patient information and insurance coverage. Utilize ICD-9, ICD-10, and DRG coding systems to ensure accurate billing. Maintain detailed records of billing transactions and follow up on unpaid claims. Communicate with...

Become a part of our caring community and help us put health first The Inpatient Medical Coding Auditor 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 Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. What We're Looking For We're looking for experienced and credentialed inpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

A healthcare data company is looking for experienced outpatient coders. This fully remote position requires high attention to detail and expertise in medical coding. Ideal candidates will have at least 3 years of experience and must possess AHIMA or AAPC certification. Responsibilities include reviewing medical records, maintaining coding accuracy, and addressing documentation issues. Flexible schedules and competitive benefits are provided to support work-life balance. #J-18808-Ljbffr

A client of Innova Solutions is immediately hiring for a HIM Coder Position type: Full-time,Contract Duration: 5+ Months Location: Remote (Looking for candidates based out in HI, CA, WA or OR) As a HIM Coder, you will: The HIM Hospital Coder I is responsible for reviewing medical records and accurately assigning diagnosis and procedure codes in accordance with recognized coding guidelines and organizational standards. Day to Day Responsibilities Review inpatient and outpatient medical records daily to identify and assign accurate diagnosis and procedure codes. Abstract clinical data and ensure coding is completed within required productivity and compliance timelines. Apply ICD-10-CM, CPT, and HCPCS Level II guidelines to ensure proper code selection and sequencing. Communicate with physicians and internal teams to clarify documentation, diagnoses, and procedures when needed. Monitor coding accuracy, resolve discrepancies (including DRG-related...

Become a part of our caring community Humana is looking for an experienced medical coding auditor to handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, consider a Fortune 100 company that prioritizes its consumers' and staff's well-being. This company rewards performance, and you should strongly consider the Outpatient Medical Coding Auditor position. This role focuses on Outpatient Behavioral Health Coding disputes and is part of the PPI Coding Disputes Team with Humana. The Outpatient Behavioral Health Coding Auditor on the Disputes Team reports to the Manager. This role consults and collaborates with coding professionals within and across departments. The goal is to ensure high accountability of coding disputes outcomes for timeliness, compliance, and quality. Will be an experienced medical coding auditor with in-depth experience in outpatient Behavioral Health coding disputes and expertise in CPT/HCPCS...

Become a part of our caring community The Medical Coding Auditor reviews medical claims submitted against medical records provided to ensure correct coding guidelines are met. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor confirms correct CPT coding assignments. Analyzes, enters and manipulates the claim in the respective database. Responds to or clarifies internal requests for medical information. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures. Review medical documentation for clinical indicators to ensure procedures meet clinical criteria and correct coding guidelines Utilize encoders and various coding resources Perform CPT Procedure reviews Maintain strict patient and...

A leading healthcare company is seeking an experienced Outpatient Medical Coding Auditor to manage provider disputes in a remote setup. The ideal candidate will have proficiency in CPC or CCS certification and at least 3 years of behavioral health coding audit experience. This role involves ensuring compliance and accuracy in coding while utilizing effective communication skills. Benefits include health insurance from day one, a 401(k) plan with employer matching, and tuition assistance, making it an attractive opportunity. #J-18808-Ljbffr

Job Summary: Accounts for coding and abstracting of patient encounters, including diagnostic and procedural information, significant reportable elements and complications. Researches and analyzes data needs for reimbursement. Analyzes medical record and identifies documentation deficiencies. Serves as resource and subject matter expert to other coding staff. Essential Responsibilities: Reviews and verifies documentation supports diagnoses, procedures and treatment results. Identifies diagnostic and procedural information. Audits clinical documentation and coded data to validate documentation supports services rendered for reimbursement and reporting purposes. Assigns codes for reimbursements, research and compliance with regulatory requirements utilizing guidelines. Follows coding conventions. Serves as coding consultant to care providers. Identifies discrepancies, potential quality of care, and billing issues. Researches, analyzes, recommends and facilitates plan...

RESPONSIBILITIES Diagnostic Laboratory Services, Inc. (DLS) is Hawaii's largest locally owned and operated medical testing laboratory. DLS is considered a leader in the Hawaii, Guam and Saipan communities we serve. As an integral part of the patient care team, DLS uses state of the art testing and value-based informatics to promote optimal patient care and positively impact patient outcomes. SCHEDULE Regular Full-Time Position (Eve/Night) Must be available Monday through Friday, starting as early as 2:00 PM. Must be flexible with schedule changes to meet operational needs. HIRING RANGE $83,320 to $102,717 annual Actual pay commensurate with experience JOB SUMMARY Supervises employees and operations for the department. Ensures operations meet regulatory requirements. Partners with the manager in hiring, developing and coaching employees. With department Manager, directs supervisory team and the overall operations of the department in support of the company and...

[Medical Biller] Employment type: Temporary, Part-time Times Pharmacy is looking for medical billers or pharmacy technicians for vaccination clinic billing. We are looking to hire independent, organized, detail-oriented, and motivated individuals to help us process and submit vaccination clinic claims. Availability: • Monday through Friday - Most days start around 8am and end around 5pm. May potentially end later (around 7PM) or may work on Saturday and/ or Sunday if there is a need. • Position begins in July or August and ends in mid November (~3-4 months) Responsibilities: • Enter vaccination clinic claims into pharmacy billing systems • Process and organize vaccination clinic files • Follow all operating policies and procedures • Conduct work in a professional manner at all times and provide excellent customer service • Proper phone etiquette when verifying health information with patients and/or healthcare professionals • Additional duties to...

POSITION SUMMARY: Under limited supervision, performs coding on all diagnoses, procedures, professional services, and supplies following the American Medical Association (AMA) official coding/reporting guidelines and other third party payer criteria for the purpose of reimbursement, research, and compliance with state and federal regulations. This person provides feedback to WCCHC physicians and/or professional staff to facilitate monitoring of medical records to reflect accurate and timely documentation of medical services and charges. Answer coding questions, assists in the development of programs and plans for orienting and training medical support staff in basic coding techniques. Education/Experience: 1. High School Diploma or equivalent 2. Current CPC or CCS certification, AND 3. Two (2) years of medical coding experience in each of the following coding classification systems: a. ICD-9-CM b. CPT-4 c. E&M d.HCPCS OR 4. Equivalent combination...

Medical Biller Times Pharmacy is looking for medical billers or pharmacy technicians for vaccination clinic billing. We are looking to hire independent, organized, detail-oriented, and motivated individuals to help us process and submit vaccination clinic claims. Availability: Monday through Friday Most days start around 8am and end around 5pm. May potentially end later (around 7PM) or may work on Saturday and/or Sunday if there is a need. Position begins in July or August and ends in mid November (~3-4 months) Responsibilities: Enter vaccination clinic claims into pharmacy billing systems Process and organize vaccination clinic files Follow all operating policies and procedures Conduct work in a professional manner at all times and provide excellent customer service Proper phone etiquette when verifying health information with patients and/or healthcare professionals Additional duties to be assigned as needed, such as attending vaccination clinics and...

I. Job Summary Under minimal supervision, plans and conducts environmental compliance audits of various entities to determine compliance with Federal and State regulatory requirements, programs and internal policies with a focus environmental regulations and capacity. II. Essential Duties and Responsibilities To perform this job successfully, an individual must be able to perform each of the following essential duties satisfactorily. Other minor duties may be assigned. Plan and conduct internal audits to determine compliance with Federal and State regulations. Review facility operations and records to ensure adequacy of internal controls, compliance with procedures, consistency with established laws, rules and regulations and guidelines applicable to overall compliance for the operation. Prepare audit reports, and implement administrative and technical audit procedures for audit program activities. Review and verify audit corrective actions and...

Join our dynamic team as a Medical Coding Specialist! This remote position is perfect for experienced coders specializing in Profee Outpatient Coding. We are looking for proactive team players committed to accuracy and collaboration. Your Role: Utilize your expertise in Profee Outpatient Coding for timely and precise assignment of Evaluation and Management (E&M) ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes from both paper and electronic medical records. Conduct thorough reviews of medical documentation to accurately determine principal and secondary diagnoses and procedures based on a solid understanding of anatomy, physiology, medical terminology, and pathology. Ensure compliance with official coding guidelines and federal regulations while sequencing diagnoses and procedures according to clinical significance for appropriate reimbursement. Review discharge summaries, history and physicals, physician notes, and lab reports to code diagnoses and procedures with...

Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance Billers experience in rehabilitation, physical therapy, occupational therapy billing WELCOME to Movementplus! Job Overview We are seeking a detail-oriented and organized Medical Biller to join our healthcare team. The ideal candidate will be responsible for managing the billing process, ensuring accurate coding, and maintaining compliance with medical billing regulations. This role requires a strong understanding of medical terminology, coding systems, and the ability to work efficiently in a fast-paced environment. Responsibilities Process and submit medical billing claims to insurance companies and government payers. Review and verify patient information and insurance coverage. Utilize ICD-9, ICD-10, and DRG coding systems to ensure accurate billing. Maintain detailed records of billing transactions and follow up on unpaid claims. Communicate with healthcare providers to...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or physician compliance topics. Assigned the most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN on audit approach and analysis. Responsible for creating and overseeing orientation of auditors. Leads all hospital or physician audits/investigations, auditing support and responses related to external audit activity. ESSENTIAL RESPONSIBILITIES: Establishes and implements orientation for all members of the AHN audit compliance team. Evaluates the progress of team members including review of reports and audit activities. Works with senior management responsible for AHN-wide case management/physician programs to develop processes that meet Medicare and 3rd party payor requirements. Provides guidance to staff auditors on audit topics and reports. (20%) Conducts educational sessions for...

Coder I : This position performs day-to-day review, analysis and coding of patient records; codes diagnoses and operative procedures and reviews and analyzes the medical records of discharged patients. Performs other duties as assigned. Coder II : This position independently assigns ICD-10-CM and CPT-4 codes for diagnoses, procedures and other services; abstracts clinical data for reports and summaries. Performs other duties as assigned. Required Qualifications : To qualify, you must meet all of the following requirements. Please note that unless specifically indicated, the required education and experiences may not be gained concurrently. In addition, qualifying work experience is credited based on a 40-hour workweek. Education : High school diploma or equivalent. Received ICD-10 training, coursework, or classes, within the last 2 years. Except for the substitutions provided for elsewhere in these specifications, applicants must have had progressively responsible...

This position supervises the coding section of the Medical Records department, performs day-to-day review, analysis and coding of patient records, monitors coding for quality control, codes diagnosis and operative procedures, reviews and analyzes the medical records of discharged patients, schedules work assignments, trains new employees and performs other duties as assigned. Location: This position allows for a hybrid (remote/in office) work environment for a State of Hawaii resident, with a requirement for an incumbent living outside of Hilo to work on-site on the Big Island at regular intervals throughout the year (approximately four times per year for visits of approximately one week each). Airfare and lodging will be paid for by the organization, in accordance with our policies. Required Qualifications : To qualify, you must meet all of the following requirements. Please note that unless specifically indicated, the required education and experiences may not be gained...

Job Summary: Under supervision, is responsible for assigning accurate diagnosis and procedure codes to the patients health information records, for: Observation, Hospital Ambulatory Surgery, Complex Hospital Outpatient Visit {Cardiac Catheterization (Percutaneous Coronary Intervention) Lab, Interventional Radiology}, Emergency Departments, and other select OP records. This responsibility requires appropriate code assignment for physician-documented patient diagnoses, conditions and procedures; utilizing various coding classification schemes including ICD- 10CM (may include PCS), and HCPCS/CPT. All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT) National Correct Coding Initiative (NCCI), and Kaiser Permanente...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources...

About Otsuka We defy limitation, so that others can too. In going above and beyond-under any circumstances-for patients, families, providers, and for each other. It's this deep-rooted dedication that drives us to uncover answers to complex, underserved medical needs, so that patients can push past the limitations of their disease and achieve more than they thought was possible each day. About the Role The Omnichannel Center of Excellence is dedicated to driving innovation, building, and delivering capabilities that enhance Otsuka's opportunity to make an impact in the lives of those we serve. We achieve this through our relentless focus on customer centricity, patient empathy, expertise in enabling pathways for disease education and awareness of management options, and our unwavering commitment to supporting access to treatment. We are looking for an Omnichannel Data Scientist , Medical Omnichannel with strong expertise in artificial intelligence, encompassing...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD coding systems and assists in decreasing the average accounts receivable days. ESSENTIAL RESPONSIBILITIES Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD codes for diagnoses and procedures. (65%) Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) Keeps informed of the changes/updates in ICD guidelines by attending appropriate training, reviewing coding clinics and other resources and implementing these...