175 jobs found

Medical Coding and Billing Compliance Auditor Location: Remote Division: Coding Compliance About the Role: The Medical Coding Auditor is a detail-oriented position responsible for reviewing medical coding accuracy, documentation integrity, ensuring compliance with federal and state regulations, payer guidelines, and internal policies. The ideal candidate will bring strong analytical skills, extensive coding knowledge, and a passion for maintaining the highest standards of quality and compliance. The candidate will demonstrate a strong background in Microsoft Office applications including PowerPoint, Word, Excel, Outlook, TEAMS, and SharePoint. The Medical Coding Auditor will have a background in physician feedback and education on documentation integrity and coding accuracy. The ideal candidate will have extensive knowledge of CPT coding, ICD-10-CM coding, E/M coding, HCC methodologies, modifiers, telehealth, and HCPCS coding. The candidate will understand and know where to access...

Middleburg Heights 1 7500 Old Oak Blvd Middleburg Heights, OH 44130, USA Responsibilities Coordinate and supervise department work assignments and staffing levels. Monitor work lists to verify work is being completed within required TAT (Turn Around Time). Move staff as needed to ensure the work is covered. Conduct scheduled staff meetings and other activities. This would include both onshore and offshore team members. Participate in client meetings, as needed, for discussion on process flows and billing issues. Conduct monthly quality audits on domestic and offshore staff to ensure all team members are following the client SOPs and meeting quality targets. Measure productivity for every staff member against established targets. Supervise staff in company policies and processes by coaching, counseling, disciplining employees, and appraising job contributions. Review employee timesheets and monitor overtime. Contact insurance companies to resolve unusual or difficult claim...

Join to apply for the Medical Billing Supervisor, Prebilling role at Quadax, Inc. 1 week ago Be among the first 25 applicants Join to apply for the Medical Billing Supervisor, Prebilling role at Quadax, Inc. Coordinate and supervise department work assignments and staffing levels. Monitor work lists to verify work is being completed within required TAT (Turn Around Time). Move staff as needed to ensure the work is covered. Conduct scheduled staff meetings and other activities. This would include both onshore and offshore team members. Participate in client meetings, as needed, for discussion on process flows and billing issues. Conduct monthly quality audits on domestic and offshore staff to ensure all team members are following the client SOPs and meeting quality targets. Measure productivity for every staff member against established targets. Supervise staff in company policies and processes by coaching, counseling, disciplining employees, and appraising job contributions....

A healthcare provider in Centerville is seeking a Billing Associate to manage insurance claims, process payments, and maintain patient billing records. Candidates should have strong organizational skills, experience with billing software, and a high school diploma as a minimum. The role offers competitive hourly pay and benefits including employer-paid insurance options. This is a full-time entry-level position. #J-18808-Ljbffr

A healthcare organization is seeking a coding specialist to abstract provider documentation and assign appropriate ICD and CPT codes based on clinical documentation. This role requires a high school degree or GED, along with relevant certifications. Essential skills include strong anatomical knowledge, excellent typing speed, and effective communication abilities. Responsibilities involve assisting with billing queries, ensuring compliance with coding regulations, and maintaining documentation accuracy. The position is based in Norwood, Ohio, offering an opportunity to contribute significantly to healthcare coding standards. #J-18808-Ljbffr

Pharmacy Compliance Auditor – 340B Program Join to apply for the Pharmacy Compliance Auditor – 340B Program role at TriHealth . Job Description Play a vital role in ensuring access to affordable medications for underserved communities. Protect the integrity of the 340B Drug Pricing Program—a federal initiative that enables healthcare organizations to stretch resources and provide comprehensive care. As a Pharmacy Compliance Auditor, you’ll work closely with pharmacy leadership to conduct audits, monitor compliance, and identify opportunities for improvement. This role offers the chance to develop specialized expertise in 340B operations, gain advanced certifications, and make a meaningful impact on patient care and organizational success. Minimum Job Requirements Minimum of High School Degree or GED is required Must successfully complete Apexus 340B University within the first 6 months in the position. Advanced 340B Operations Certificate within the first 12 months....

A healthcare organization in Norwood, OH is seeking a Pharmacy Compliance Auditor for the 340B Program. This mid-senior level position involves conducting audits, monitoring compliance, and providing insights for improvement within the pharmacy operations. The candidate should have a high school diploma, relevant experience in pharmacy practices, and an interest in compliance and pharmacy practice advancement. The role offers competitive wages and the potential for career growth. #J-18808-Ljbffr

Job Description Located in Moraine, OH Full-time REMOTE AVAILABLE We are seeking a Medical Billing Specialist with experience in pathology billing. A coding certification is preferred, and experience with cancer-related coding is a plus. Position Summary : Under the supervision of the Billing Department Management team: perform the daily account processing tasks of the Billing Department. Be knowledgeable in all areas of the Billing Department. Assist in training new hires, retraining current reps on any issues found, accession audits, special projects and other duties as assigned. Responsibilities: Be knowledgeable of all areas and processes within the Billing Department. Effective in identifying and analyzing problems Generates alternatives and identifies possible solutions Maintain organized workflow to allow efficient processing of accounts and to enable smooth transition of job duties during absences Follow department standard processes. Consult with immediate supervisor...

Description The Supervisor, Pharmacy is a pharmacist supervisor responsible for overseeing and optimizing pharmacy operations or clinical services, including process development, staff support, and medication use advocacy. This role performs administrative duties while maintaining operations and clinical continuity of the pharmacy. What You Will Do Responsible for coordination of the activities of professional and technical pharmacy employees engaged in operational or clinical activities. This position may require Responsible Person/TDDD license responsibility for a designated pharmacy. Provides direct supervision to professional and/or technical pharmacy employees, including performance evaluations. Assists in regulatory compliance by developing policies for operations in accordance with laws and regulations. Monitors compliance with policies and continuous quality improvement of pharmacy services. Creates and implements the orientation and training of new and existing...

Outpatient Coder – Dayton Children’s Hospital Job Overview Under general supervision of the Coding Manager, the Coding Analyst supports Dayton Children’s goals for reimbursement through accurate and timely diagnosis and procedural coding of emergency department, specialty clinic, inpatient, observation, outpatient surgery, and outpatient ancillary services. This includes the examination and interpretation of electronic medical documentation to assign and report the appropriate diagnostic and procedural codes for clean claim submission. Location & Schedule Work From Home – Ohio Full time 40 hours per week Monday‑Friday 8:00 am‑5:00 pm (flexible) No weekends or holidays Education & Certification Requirements High School Diploma or GED (required) A.A.S. in Health Information Technology or B.S. in Health Information Management (preferred) Certified Coding Specialist (CCS), CCS‑P, RHIA, or RHIT (required) Experience 2+ years of coding experience (preferred)...

A leading healthcare institution is seeking a Senior Physician Coding Specialist in Shaker Heights, Ohio. This role involves monitoring coder productivity, auditing, and training while maintaining strong communication with payors and departments. The ideal candidate will have over 3 years of medical billing experience, possess a Certified Professional Coder (CPC) certification, and have extensive knowledge of ICD-9 and CPT coding. The position requires excellent interpersonal skills and attention to detail. This is a full-time role with a dynamic work environment. #J-18808-Ljbffr

A Brief Overview Under the direction of the Billing Supervisor – the Senior Physician Coding Specialist monitors coder productivity, trains, audits, codes surgical encounters, and serves as a resource for physicians and other departments within the system. Identifies trends with insurance‑related issues and reports findings to the team. What You Will Do Analyzes, on a daily basis and in accordance with established time frames, the outstanding insurance accounts. Initiates appropriate and effective telephone and/or written follow-up on the identified accounts. Communicates with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims. Researches and responds to all telephone inquiries from the customer service department, in a prompt, professional manner meeting departmental guidelines. Reviews and corrects coding rejections. May code ICD-9 from written documentation. May abstract CPT/HCPCS...

Job Description – Pro Fee Denials/Follow‑Up Coder (Remote – 25000CTF) A Brief Overview Under the direction of the Revenue Cycle Supervisor – Coding, the Physician Coding Specialist II monitors and analyzes unresolved third‑party accounts for multi‑specialty group practices. This position initiates contact and negotiates appropriate resolutions to ensure timely payments of outstanding claims. What You Will Do Analyze, on a daily basis and in accordance with established time frames, outstanding insurance accounts and initiate appropriate and effective telephone and/or written follow‑up on the identified accounts. Communicate with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims. Research and respond to all telephone inquiries from the customer service department in a prompt, professional manner meeting departmental guidelines. Review and correct coding edits and denials. May code...

A leading healthcare organization in Ohio is looking for a Physician Coding Specialist II to manage and analyze unresolved insurance claims. This remote position requires over two years of medical billing experience and knowledge of coding practices. You will communicate with payors, review coding edits, and ensure timely payments. Candidates must possess a High School Equivalent and relevant certifications like CPC. This role emphasizes professionalism, attention to detail, and effective communication skills, ideal for those looking to grow in a dynamic healthcare environment. #J-18808-Ljbffr

A healthcare institution in Shaker Heights is seeking a Physician Coding Specialist II who will monitor and analyze unresolved insurance accounts, initiate contact for resolutions, and ensure timely payments. Candidates should have strong analytical skills, effective communication abilities, and a certification in medical coding. The role requires maintaining patient confidentiality and meeting specific productivity and quality standards. #J-18808-Ljbffr

A children's healthcare provider is looking for an Outpatient Coder to work from home in Ohio. The successful candidate will be responsible for accurately coding diagnoses and procedures to ensure proper reimbursement for a variety of services, including outpatient and inpatient care. A High School diploma is required, along with certification in coding. The role offers flexibility with a full-time schedule, allowing for work-life balance without weekends or holidays. #J-18808-Ljbffr

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. GENERAL SUMMARY Works under the supervision of the HIM Manager (Operations & Auditing). The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting. Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately. Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines. Performs other duties as assigned. QUALIFICATIONS Education: High School Diploma or successful completion of an equivalent High School...

A healthcare organization seeks a Certified Coder at its Crestline, Ohio location. This role involves accurately coding diagnoses and treatments while adhering to standards for reimbursement. Candidates must have a high school diploma, RHIT or CCS certification, and a minimum of two years of hospital coding experience. The organization values a supportive workplace culture, competitive wages, and comprehensive benefits including health insurance and generous paid time off. #J-18808-Ljbffr

Certified Coder - Avita Health System – Crestline, Ohio Avita Health System is proud to serve the communities of Crawford and Richland counties through three hospitals and numerous clinic locations. Over the past few years, we’ve tripled in size, now employing over 2,200 team members and more than 160 physicians and advanced practitioners. Our mission is to deliver high-quality, compassionate care to the people who depend on us. We’re currently seeking a dedicated Certified Coder to join our Medical Records Department at our Crestline location. Position Overview Accountable for the conversion of diagnoses and treatment procedures into codes using the International Classification of Diseases. Requires skill in the sequencing of diagnoses and procedures to optimize reimbursement. Ensures that records are coded in an accurate and timely manner. Ability to work remotely if quality and productivity standards are maintained. Holds appropriate AHIMA certification. Reports to...

Corporate Compliance Auditor - Inpatient Focus LMHS Compliance Auditor Licking Memorial Health Systems (LMHS) is a leading, non‑profit healthcare organization dedicated to improving the health and well‑being of our community. Founded in 1898, LMHS remains a cornerstone of healthcare excellence in Licking County, offering a comprehensive spectrum of patient care services – from life‑saving emergency medicine to home healthcare – and specialized services in cancer, heart health, maternity, and mental wellness. When you join the LMHS team you become a vital part of your local community hospital. Working at LMHS is not just a job, it is an opportunity to directly impact the health and well‑being of friends, family, and neighbors. Your work extends beyond hospital doors into the heart of our community. Our commitment to diversity, equity, and inclusion ensures that every member of our community is served with respect and compassion. Under the general direction of the VP of Financial...

A regional healthcare provider in Lima, Ohio, is seeking a Coder – Professional to accurately code physician office medical records. Candidates must hold an Associate’s degree and current certification, with 2 years of coding experience preferred. This position requires knowledge of medical necessity and clinical documentation requirements. Work in a challenging environment that ensures compliance and accuracy in medical coding. #J-18808-Ljbffr

A regional health service provider in Lima, Ohio, is seeking a Coder – Professional to code medical records. The ideal candidate will have an Associate’s degree and at least two years of coding experience, with proficiency in medical grouper mechanics and clinical documentation. Certification as a CPC or AHIMA Coder is required, or the candidate must be actively enrolled in a certification program. Basic knowledge of Word and Excel is necessary, and familiarity with Quantim encoder and Meditech is preferred. #J-18808-Ljbffr

Job Summary We are seeking a highly skilled Certified Coder to join our healthcare team. Required to know general surgery, OBGYN, Breast surgery Duties Review and analyze medical records to assign accurate diagnostic and procedural codes using ICD-9, ICD-10, CPT, and DRG classifications. Ensure all coding complies with current industry standards and regulatory requirements. Collaborate with healthcare providers to clarify documentation and resolve discrepancies. Enter coded data into Electronic Medical Records (EMR) and Electronic Health Records (EHR) systems efficiently. Support medical billing and collection processes by providing precise coding information. Maintain up-to-date knowledge of coding guidelines, updates, and healthcare regulations. Assist in auditing medical records for accuracy and completeness. Manage medical records confidentiality in accordance with HIPAA regulations. Skills Proficiency in ICD-9, ICD-10, CPT coding, and DRG classifications. Strong...

A leading compliance consulting firm in Canton, OH is seeking an Associate for a Contract position in the Science job function. This role involves conducting audits, maintaining compliance paperwork, and training other staff members. Candidates should have at least 1 year of experience in an Environmental or EHS-related field or a related Bachelor's degree. Strong communication skills and knowledge of OSHA regulations are essential. Flexible shift availability is required. #J-18808-Ljbffr