86 jobs found

Job Description Job Description Medical Billing & Coding Specialist Position Summary The Medical Billing & Coding Specialist is responsible for managing insurance billing, claims processing, coding accuracy, and collection activities. This role ensures timely reimbursement, maintains compliance with coding guidelines, identifies documentation gaps, and works collaboratively with clinical and administrative teams to support accurate billing practices. This is an on-site position and is not remote. Education, Experience, and Certification Requirements High school diploma, GED, or equivalent required. Associate degree, bachelor’s degree, or relevant experience in medical records, healthcare administration, billing, or claims processing preferred. Experience with Kentucky Medicaid, medical billing, coding, insurance claims, or revenue cycle management preferred. Certification preferred: Certified Coding Associate (CCA) through AHIMA Certified Coding Specialist...

Job Description Job Description Position Overview We are looking for a detail-oriented and experienced Patient Account Representative II to join our team. If you have a strong understanding of Revenue Cycle Management processes, especially in handling denials and appeals, we would love to hear from you. Key Responsibilities Analyze denials and determine the best course of action for appeal or resubmission. Prepare and submit accurate and compliant appeals for denied claims. Collaborate with billing, coding, and clinical staff to gather necessary information for appeals and resolve denial issues efficiently. Maintain detailed records of denial cases, including appeals filed and communications with insurance representatives. Monitor the status of appealed claims and follow up with insurance representatives to expedite resolution. Generate and analyze reports on denial trends, identify root causes, and recommend process improvements. Qualifications Required Education, Licensure,...

Medical Coder 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. We're focused on improving the health of our members, enhancing our operational effectiveness, and reinforcing our reputation for high-quality health services. As a Medical Coder, you will provide coding and coding auditing services directly to providers. You'll play a key part in healing the health system by making sure our high standards for documentation processes are being met....

Medical Record Technicians (MRTs) (Coder) MRTs are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. MRTs apply knowledge of medical record content, terminology, anatomy, diseases processes, and official coding guidelines to assign codes to the most basic and routine inpatient facility and/or professional services.

Summary Medical Record Technicians (MRTs) (Coder) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multi-specialty clinics, and specialty centers. MRTs apply knowledge of medical record content, terminology, anatomy, diseases processes, and official coding guidelines to assign codes to the most basic and routine inpatient facility and/or professional services. Learn more about this agency Duties Help Total Rewards of a Allied Health Professional Duties of the position will vary dependent on grade for which selected, but may include: Selecting and assigning codes from the current versions of the International Classification of Diseases (ICD), Clinical Modification (CM), and Procedure Coding System (PCS) for inpatient facility MS-DRG coding, Current Procedural Terminology (CPT), and/or Healthcare Common Procedure Coding System (HCPCS) for...

Are you a sharp, analytical Medical Billing Specialist who loves solving the puzzles behind healthcare revenue? If you have a knack for spotting data discrepancies, navigating payer rules, and ensuring accurate reimbursement, we want you on our team! We are seeking a motivated, experienced Medical Billing Specialist for a contract-to-hire position. This role offers an incredible opportunity to showcase your revenue cycle expertise, seamlessly integrate with our billing team, and transition into a permanent position with great long-term benefits and stability. Qualifications: Experience: 2-3 years of direct experience in medical billing and revenue cycle management. Coding Proficiency: Working knowledge of ICD-10-CM and CPT coding guidelines. Payer Expertise: Familiarity with the billing nuances of major commercial payers, Medicare, and Medicaid. Systems Savvy: Experience working with NextGen, Electronic Health Records (EHR) and medical billing software (e.g.,...

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Job Description Certified coder who has experience coding for Emergency Department claims at the facility level for a...

Medical Billing Specialist Are you a sharp, analytical Medical Billing Specialist who loves solving the puzzles behind healthcare revenue? If you have a knack for spotting data discrepancies, navigating payer rules, and ensuring accurate reimbursement, we want you on our team! We are seeking a motivated, experienced Medical Billing Specialist for a contract-to-hire position. This role offers an incredible opportunity to showcase your revenue cycle expertise, seamlessly integrate with our team, and make a significant impact on our healthcare services.

Coder I The Coder I reviews, analyzes and codes diagnostic and procedural information using ICD-10-CM diagnosis and procedures and CPT coding for reimbursement. Assign and sequence ICD-10-CM/CPT codes by applying regulatory coding guidelines. Apply advanced knowledge of disease processes to assign codes for conditions and procedures not listed in the indexes of coding books. Follow appropriate guidelines and policies to code accurately from physician documentation within the medical record. Queries physicians for diagnoses or missing/ambiguous information for accurate coding. Apply organizational documentation policies and procedures in conjunction with official coding guidelines. Applies knowledge of coding and Prospective Payment System and Medical Necessity guidelines for ethical and optimal reimbursement. Competent to accurately code and abstract all 23-hour observations, same day surgery, emergency room and/or clinic records in a consistent, accurate and timely manner....

ResponsibilitiesEvaluates coding based on Coding Guidelines.Reviews records for all care settings.Identifies high volume, high risk coding, and reimbursement and quality problems.Responsible for accurate assessment, analysis and summary of findings for coding validation.Provide auditing and feedback that is incorporated into training education programs.This position offers a fully remote work opportunity.Employees in this role must reside in one of the following states to be considered for fully remote positions :Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina or Louisiana.QualificationsRequired :One year coding in healthcare settingOne of :CCA or CCS or CPCDesired :DiplomaCertified Coding Associate OR Certified Coding Specialist OR Certified Professional Coder.

Description At ScionHealth, we empower our caregivers to do what they do best.We value every voice by caring deeply for every patient and each other.We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking.Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates.Job SummaryCodes medical records, including all diagnoses, operative and diagnostic procedures in patient medical records, using the International Classification of Diseases and enters coded information into an automated system Essential FunctionUsing the coding system, assigns and records an accurate code to all diagnoses, procedures, and operations as documented in the patient medical record based on official coding guidelinesEnsures that all factors necessary for assigning an accurate DRG (Diagnostic Related Group) are present, and that all diagnoses are ranked properlyContacts hospital designee...

General Job Summary Contributes in the delivery of excellent orthopaedic care in a patient centered environment by completing data entry and coding for all premier orthopaedic care provided within the multi-specialty practice. Essential Job Functions Establishes and maintains effective working relationships with coworkers, managers and providers. Collects, reviews, codes, and data entry of all charges for a multi-specialty practice. Responsible for quality control of all billable charges according to the coding compliance plan. Maintains current records of hospital admissions, surgeries, discharges, and consultations as necessary. Maintains required billing records, reports, files, etc. Responsible for educating providers regarding charges. Responsible for contributing to claims corrections and appeals. Provides accurate coding information to all pertinent departments. Maintains doctor’s standards according to coding compliance. Ensure certification is current. Ensure...

What we offer Excellent health benefits plan, which includes medical, vision and dental options 401(k) with company match Company profit sharing plan Generous paid time-off and paid holidays Paid parental leave 2 free on-site fitness rooms Employee Assistance Program Employee Resource Groups Personal and professional development program Job Summary The Jr. Franchise Compliance Auditor II will manage and optimize our audit activities. They will conduct and oversee company franchise audits from planning through to completion. Tasks will include planning the audit process, research, reviewing current processes, and providing recommendations to enhance company policies and provide training to Franchise owners in the royalty reporting process. The Jr. Franchise Compliance Auditor II will assist in developing skills, provide training and support for the audit staff and Franchisee. You will Guide and assist franchise audit staff within...

What we offer Excellent health benefits plan, which includes medical, vision and dental options 401(k) with company match Company profit sharing plan Generous paid time-off and paid holidays Paid parental leave 2 free on-site fitness rooms Employee Assistance Program Employee Resource Groups Personal and professional development program Job Summary The Senior Franchise Auditor provides training, guidance, and support to Franchise Audit Staff. Serving as a subject matter expert on SERVPRO royalty processes and policies, this role conducts complex royalty audits and contributes to the development of training, communications, and departmental documentation. The position also supports audit planning, departmental initiatives, and continuous process improvement. You will Train, mentor, and provide ongoing oversight to Franchise Compliance Auditors and Interns, ensuring audit work meets departmental standards and support their...

What we offer Excellent health benefits plan, which includes medical, vision and dental options 401(k) with company match Company profit sharing plan Generous paid time-off and paid holidays Paid parental leave 2 free on-site fitness rooms Employee Assistance Program Employee Resource Groups Personal and professional development program Job Summary The Junior Franchise Compliance Auditor I performs audits of franchise owners from start to finish, from selection of Franchises audited to issuance of audit reports and collection of audit findings. In addition to performing audits of franchises, this position is responsible for reviewing other businesses owned by SERVPRO® franchise owners and personal accounts of SERVPRO® owners. The audits are performed primarily in order to determine if franchises are properly reporting and paying royalties. Auditors will provide recommendations to franchises regarding office procedures and bookkeeping....

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. As a Medical Coder , you will provide coding and coding auditing services directly to providers. You will play a key part in healing the health system by ensuring our high standards for documentation processes are met. At Optum, you will contribute to improving the health of our members, enhancing operational effectiveness, and reinforcing our reputation for high‑quality health services. Hours and Location This position is full‑time (40 hours / week), Monday – Friday, 8‑hour shifts (5 days a week). You will work with your manager on your schedule. You'll enjoy the flexibility to telecommute from anywhere within the U.S. As a telecommuter, you will be required to adhere to UnitedHealth...

Optum, a leading healthcare organization, is looking for a full-time Medical Coder. This remote position involves providing coding and auditing services critical to the health system. Responsibilities include assigning accurate diagnostic codes, managing workloads effectively, and ensuring coding compliance. Candidates should have a High School Diploma, professional coding certification, and relevant experience with coding systems. Compensation ranges from $20.00 to $36.00 per hour based on experience and market factors. #J-18808-Ljbffr

Presque Isle Downs, Inc. in Owensboro, Kentucky seeks a Revenue Auditor to audit all areas of the business using checklists and GAAP-aligned procedures, investigate variances, and report findings to the Accounting Manager/Sr Director of Finance. The role focuses on internal controls and gaming policy compliance. Ideal candidates have an associate degree in accounting or a related field, 2–4 years in accounting or revenue audit, strong Microsoft Office skills, attention to detail, and excellent #J-18808-Ljbffr

Aditi Consulting is seeking a compliance-focused professional to help assure adherence to SOPs, cGMP, and CFR guidance in the manufacturing of solid oral dosage pharmaceuticals. The role emphasizes accuracy, documentation integrity, and cross-functional collaboration. Responsibilities include reviewing SOP revisions, conducting real-time batch record audits, performing environmental monitoring, and supporting CAPA-driven site improvements. #J-18808-Ljbffr

Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Profee Coder with Parallon you can be a part of an organization that is devoted to giving back! Job Summary and Qualifications As a ProfeeCoder, you will be responsible for reviewing and coding clinical notes and operative reports for a minimum of one specialty. You will provide feedback and documentation advice to the physician, practice management, and other coders. You will also work with the denials team to resolve coding-related denials. You will be a key promoter of Central Coding and responsible for setting the tone of the Coding Physician Service Center as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs. What you will do in this role: Reviews and codes clinical notes and operative reports for assigned specialty/specialties. Coordinates and reconciles multiple schedules to ensure complete charge capture....

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 physician...

A leading U.S. healthcare company is seeking a Medical Coding Auditor who will review medical claims to ensure correct coding guidelines are followed. The position requires a minimum of 3+ years' experience with outpatient specialty surgeries and a relevant certification. This remote role includes varied work assignments, and candidates must be detail-oriented and able to manage multiple priorities. A competitive pay range and bonuses are part of the offer. #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

Become a part of our caring community 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. Where you Come In 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 accuracy of...