11 jobs found

Description Codes outpatient charts and/or professional charts and abstracts all required data from records according to established procedures; including medical necessity for Medicare charts. Uses ICD-10 CM/PCS/CPT-4/chargemaster to code all diagnoses, operative procedures and physician procedures performed for outpatient procedures. Verifies/changes levels of care provided according to level of care guidelines. Captures all missing records and documentation, i.e. IV start/stop times, etc. Interacts with physicians and physician's offices regarding diagnoses or coding questions. Performs other work as needed to help within the department. Keeps current with coding practices and skills through in-services, seminars, workshops and current literature to increase coding knowledge. Reviews the entire medical record for identification of all documented conditions, diagnoses and procedures. Demonstrates the ability to read physicians...

Overview Hybrid position, need to live in the area or be willing to relocate.   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   The Trauma Registrar is responsible for the traumatic injured patient identification, collection, entry, validation and maintenance of injury data for our American College of Surgeons (ACS) verified Level 1 Trauma Center. Utilizing analytical and cognitive skills, the Trauma Registrar collects trauma data used for improvement in clinical care, injury research, national benchmarking, epidemiology, prevention and quality initiatives,...

I. JOB SUMMARY/RESPONSIBILITIES Performs review of physician and other health care provider services by QMC and QEC providers to ensure services are coded with appropriate CPT and ICD-9 codes. Conducts education, training, and continuously monitors QMC and QEC providers related to PATH guidelines, coding and documentation of professional services rendered, in accordance with government, insurer, and other regulatory agency standards.  Effective October 2014, ICD-10 codes shall be required. II. TYPICAL PHYSICAL DEMANDS: Essential: sitting, stooping/bending, finger dexterity, seeing, hearing, speaking, lifting, and carrying usual weight of 5 pounds, repetitive arm/hand motions, static gripping of an object for prolonged periods, frequent gripping of an object.  Occasional: standing, walking, kneeling, climbing stairs, squatting, twisting body, lifting weight up to 10 pounds, pushing/ pulling usual weight of 2 pounds up to 5 pounds, reaching above, at and below shoulder level....

We have an opportunity at our corporate offices in Chicago for a Sr. CPT Regulatory & Communications Manager (Hybrid) on our Health Solutions team. This is a hybrid position reporting into our Chicago, IL office, requiring 3 days a week in the office.  This role will serve as a senior regulatory lead responsible for developing and executing the CPT communications program and providing operational leadership for implementation of clinical AI coding initiatives. Partner with AMA leadership, the CPT Editorial Panel, and external stakeholders to support the implementation of CPT priorities related to emerging clinical AI technologies. Leads cross-functional collaboration and stakeholder engagement to support CPT communications and clinical AI coding initiatives. RESPONSIBILITIES: CPT Proactive Communications Develop and execute the CPT proactive communications plan in alignment with organizational priorities, producing written collateral, digital...

Children’s Orthopaedic and Scoliosis Surgery Associates, LLP (COSSA) is seeking an experienced Medical Billing Specialist to join our pediatric orthopaedic practice. This position focuses on insurance accounts receivable, denial resolution, and obtaining accurate, timely payment for physician services. You will work independently on assigned accounts, with support from an established billing team. We value people who investigate problems, follow through, share knowledge, and help prevent recurring billing issues. Responsibilities Research and resolve outstanding insurance balances using payer portals and direct communication with insurance representatives. Review electronic claim rejections and denials, determine the appropriate corrective action, and submit corrected claims, reconsiderations, and appeals. Investigate underpayments using payer policies, contracts, and fee schedules. Prepare appeal letters supported by relevant...

Summary: Florida residency required Applies expert knowledge of ICD‑10‑CM, CPT, and HCPCS coding to accurately code inpatient and outpatient encounters in compliance with AMA and CMS guidelines. Reviews clinical documentation for medical necessity, resolves coding and billing issues, supports charge capture and denial prevention, and collaborates with providers to ensure accurate, compliant reimbursement. Position Responsibilities Knowledge of medical coding rules, regulations and compliance allowing to better handle issues such as medical necessity, claims denials, bundling issues and charge capture. Knowledge of medical terminoogy, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes and identify specific clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record. Knowledge of official coding conventions and rules established by the...

We are seeking a biller for our family owned dermatology clinic in St. Petersburg, Fl.  We are highly focused on patient care but also our culture/work environment. We always say that our patients AND staff are equally important.  We have grown over the last 9 years from one provider to a bustling clinic with 6 providers seeing around 400-500 patients a week. We have grown by word of mouth only, on the back of our outstanding reputation for patient care. Strongly prefer a biller with extensive experience with the full revenue cycle in an outpatient clinic. Our biller will need to electronically submit claims, post era's, eob's, and payments, work denials, send statements, manage patients in collections, handle all billing related phone calls, interact with patients in the office who have billing concerns or questions, etc. This job is not a reclamation project.  We are not in need of a biller to come in and clean up a mess. We have a great billing system in place with a...

Primary Purpose of the Position: The Revenue Cycle Coding Manager provides strategic and operational leadership for professional coding and charge capture. The Manager is accountable for coding quality, productivity, inventory, compliance remediation, workforce planning, vendor performance, physician and division engagement, and coding-related revenue integrity. The position establishes clear standards, analyzes trends, and develops corrective action plans to support accurate, timely, and compliant claim submission.   Essential Duties of the Position May Include the Following: Leads day-to-day and long-range coding operations, including staffing, workload allocation, coverage planning, production priorities, and escalation management. Owns the coding operating model and clearly defines responsibilities among the Coding Manager, Coding Supervisor, internal coders, and external coding vendors. Establishes, monitors, and reports key performance indicators for...