22 jobs found

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

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...

Job Summary: The role of a Certified Outpatient Coder at Care New England is to ensure accurate assignment of ICD-10 CM, CPT and HCPCS codes on a wide range of patient medical records for outpatient services. Outpatient services include, but are not limited to observation, surgical, provider-based visits, interventional radiology, emergency room, oncology, and other specialty services. A proficient understanding and execution of coding guidelines to ensure accuracy of coding and maintain records in accordance with accepted medical and legal standards. Adherence and compliance to various regulatory guidelines from CMS, AHA and AMA. Duties and Responsibilities: • Analyze medical records, extracting clinical, pathological, therapeutic and epidemiologic data in accordance with established ICD-10-CM coding principles and guidelines • Assigns Codes and codes all diagnostic and operative information from the medical record using ICD-10-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS coding...

Job Summary : The HIM Certified Coder reviews medical records and appropriately assigns Diagnosis and Procedure codes. Classification systems include ICD-9CM, CPT, HCPCS as well as other specialty systems as required by diagnostic category and current coding standards. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD9 (ICD10 when applicable), AMA CPT and CMS coding guidelines. Specifications: High school graduation plus active certification as a Certified Coding Specialist (CCS) with evidence of additional education in Medical Terminology and Anatomy & Physiology required. Certified Professional Coder credential (CPC) candidates will be considered, but must pass the CCS exam within one year of initial hire. Minimum of 2 years' experience in a hospital inpatient or outpatient setting required. Care New England Health System (CNE) and its member institutions, Butler Hospital,...

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...

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...

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...

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...

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 a cutting-edge data collaboration platform transforming healthcare. Our mission is to enhance the security, accessibility, and actionability of health data, benefiting a variety of organizations across the healthcare sector, including providers, health plans, researchers, and life sciences companies. By leveraging health data, we are shaping the future of patient care and health outcomes. By joining Datavant, you will become part of a driven, collaborative team dedicated to making impactful changes in the healthcare landscape. We are seeking experienced outpatient coders to be key members of our team. The ideal candidate will have meticulous attention to detail and a solid understanding of medical terminology. This role is fully remote with a flexible schedule, enabling you to contribute to the healthcare revolution from home! Preferred: Experienced PRN Outpatient Coder with a minimum of 3 years in SDS and Observation coding. Key Responsibilities: Review...

Job Description Job Description We are a well established and rapidly growing third-party revenue cycle management/medical billing company located in Smithfield, RI and are seeking a full-time medical billing specialist to join our team. This position offers flexible daytime work hours and partial remote work opportunities.  Two years of medical billing experience in accounts receivable (insurance) follow up is required . The culture at Grey Ledge Medical is focused on providing the highest quality service to our clients, while creating a positive and friendly work environment for all. We offer comparable salary and benefits for all of our positions. Please reply back to this post with your resume. Thank you. Job Type: Full-time Benefits:   Flexible schedule   Ability to Commute:   Smithfield, RI 02917 (Required)   Ability to Relocate:   Smithfield, RI 02917: Relocate before starting work (Required)   Work Location: In person

A healthcare solutions company is seeking Customer Service Operations personnel in Providence, RI. This role involves conducting insurance verifications, handling inbound patient calls, and resolving billing issues. Candidates should have a high school diploma and 1-3 years of relevant experience in customer service. Flexibility and problem-solving skills are essential. The estimated hourly pay is between $15.75 and $18.50, along with a variety of benefits including medical coverage and paid time off. #J-18808-Ljbffr

A healthcare organization is looking for a HIM Certified Coder in Providence, RI. This role involves reviewing medical records and assigning relevant Diagnosis and Procedure codes while following established conventions and regulatory guidelines. Candidates must have at least a high school diploma and certification as a Certified Coding Specialist (CCS) along with relevant medical education. Experience in a hospital environment is also required. This is a great opportunity to contribute to healthcare coding standards. #J-18808-Ljbffr

A leading healthcare company is seeking a Medical Coder/Auditor to join their team in Rhode Island. The successful candidate will perform audits and ensure the accuracy of ICD codes submitted to CMS. They must have a CPC or CCS-P certification, proficiency in Microsoft Office, and at least one year of relevant experience. This full-time position offers a competitive pay range of $18.50 - $38.82 per hour, along with a comprehensive benefits package including medical plans and a 401(k). #J-18808-Ljbffr

A healthcare organization seeks a HIM Certified Coder to review medical records and assign appropriate Diagnosis and Procedure codes following established guidelines. The ideal candidate will hold an active Certified Coding Specialist (CCS) certification and have a minimum of 2 years of experience in both inpatient and outpatient hospital settings. This role is crucial in ensuring accurate coding compliant with American Hospital Association standards and contributes significantly to the healthcare system's efficacy and patient care. #J-18808-Ljbffr

A data collaboration platform for healthcare is seeking experienced inpatient coders to join their fully remote team. The ideal candidates will have strong attention to detail and in-depth knowledge of medical terminology. Responsibilities include assigning codes using ICD-10-CM/PCS, ensuring coding accuracy, and overseeing junior coders. A minimum of 3 years of inpatient coding experience is required, preferably in a Level I Trauma Center. This role provides a flexible schedule and significant contributions to transforming healthcare. #J-18808-Ljbffr

Job Summary Job Summary: The role of a Certified Outpatient Coder at Care New England is to ensure accurate assignment of ICD-10 CM, CPT and HCPCS codes on a wide range of patient medical records for outpatient services. Outpatient services include, but are not limited to observation, surgical, provider-based visits, interventional radiology, emergency room, oncology, and other specialty services. A proficient understanding and execution of coding guidelines to ensure accuracy of coding and maintain records in accordance with accepted medical and legal standards. Adherence and compliance to various regulatory guidelines from CMS, AHA and AMA. Duties and Responsibilities Analyze medical records, extracting clinical, pathological, therapeutic and epidemiologic data in accordance with established ICD-10-CM coding principles and guidelines Assigns Codes and codes all diagnostic and operative information from the medical record using ICD-10-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS...

A leading healthcare institution in Providence is seeking an HIM Certified Coder to review medical records and assign Diagnosis and Procedure codes. The role requires a high school graduation plus CCS certification. Candidates should have at least 2 years of experience in a hospital setting and knowledge of coding standards. Join a team dedicated to providing top-notch healthcare services while ensuring compliance with industry standards and guidelines. #J-18808-Ljbffr

A healthcare organization in Rhode Island is seeking a HIM Certified Coder to review medical records and assign accurate Diagnosis and Procedure codes. Candidates must possess a high school diploma and active CCS certification, along with additional education in Medical Terminology and Anatomy & Physiology. The role requires a minimum of 2 years’ experience in hospital settings. Join a trusted organization advancing medical research and patient care in a supportive environment. #J-18808-Ljbffr

A leading healthcare institution in Providence, RI is seeking a HIM Certified Coder responsible for reviewing medical records and assigning appropriate diagnosis and procedure codes. The ideal candidate will have active certification as a Certified Coding Specialist (CCS) and at least 2 years of experience in either inpatient or outpatient hospital settings. Knowledge of ICD-9CM, CPT, and HCPCS coding systems is essential for compliance with current standards. #J-18808-Ljbffr

A healthcare organization in Rhode Island is seeking an HIM Certified Coder to review medical records and assign Diagnosis and Procedure codes. Candidates must have active CCS certification and at least 2 years of experience in a hospital setting. This position demands attention to detail and adherence to coding guidelines. Join a trustworthy institution committed to advancing medical research and care standards. #J-18808-Ljbffr