112 jobs found

ICD-10 Coding Specialist You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be willing to travel to NYC twice a year for required meetings. Position Purpose: The focus of this position is to establish processes to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review. Analyze moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance. Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. Provide...

divh2US Healthcare Medical Biller for Athena - WFH/Remote Job/h2pLocation: Remote (Philippines-based) Employment Type: Full-time, Mid-level/ppAre you an experienced Medical Biller with a strong command of the Athena platform? Do you thrive in a remote work environment and are looking for a role where your expertise directly impacts healthcare revenue cycles? Neolytix is looking for a dedicated Athena Medical Biller to join our growing team!/ppAt Neolytix, we specialize in comprehensive revenue cycle management, helping healthcare providers maximize reimbursements and maintain compliance. We pride ourselves on our commitment to efficiency, accuracy, and client satisfaction. If youre passionate about medical billing and ready to contribute to a dynamic, diverse team, we want to hear from you!/ppWhat Youll Do:/ppAs an Athena Medical Biller, you will be a crucial part of our operations, ensuring seamless financial processes for our US healthcare clients. Your responsibilities will...

Coding Educator, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Provides consulting services to the organization's management and staff and may coordinate requested coding investigations. Responsible for education and training for all Covenant coders, CDI, and/or physician office staff. Serves as a resource to coders, CDI staff, Quality and Case...

Health Information Coding Specialist Health information coding is the transformation of verbal descriptions of diseases, injuries, and procedures into numeric or alphanumeric designations. The coding process reviews and analyzes health records to identify relevant diagnoses and procedures for distinct patient encounters. Coders are responsible for translating diagnostic and procedural phrases utilized by healthcare providers into coded form procedure codes that can be utilized for submitting claims to payers for reimbursement. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. Job Duties: Reviews the content of the medical record for hospital and professional inpatient or outpatient records to identify principal diagnosis, secondary diagnoses and procedures performed that explain the reason for service being provided or the admission and patient...

Outpatient Coder 2 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift: Day (United States of America) Job Summary: The Outpatient Coder 2 position reports directly to the Supervisor of Coding. Key responsibilities of the role include: Reviewing documentation in outpatient and/or IVR (interventional radiology) medical records, and accurately and completely assigning appropriate ICD-10-CM diagnostic and ICD-10-PCS/CPT-4 HCPCS procedural codes to the greatest specificity, assigning the most accurate DRG/APC, when appropriate. Abstracts demographic and...

Coding Analyst Covenant Health is the region's top-performing healthcare network with 10 hospitals, outpatient and specialty services, and Covenant Medical Group, our area's fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area's largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes "Best Employer" seven times. Position Summary: Analyzes the medical records to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT codes. Confirms appropriate DRG assignment. Communicates with physicians for clarification of documentation for coding. Abstracts and enters data from the medical records in order to...

Coder Analyst Specialist, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Covenant Medical Group is Covenant Health's employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Analyzes documentation in the medical record to obtain information necessary for the appropriate sequencing and assignment of ICD-10-CM and CPT-4 codes. Abstracts and codes procedures in conjunction with the provider to code services rendered with correct coding initiatives....

Overview Coding Educator, Clinical Document Integrity Full Time, 80 Hours Per Pay Period, Day Shift Must be located in East TN. Position is remote and onsite. Covenant Medical Group is Covenant Health’s employed and managed medical practice organization, with more than 300 top Physicians and providers spanning the continuum of care in 20 cities throughout East Tennessee. Specialties include cardiology, cardiothoracic surgery, cardiovascular surgery, endocrinology, gastroenterology, general surgery, infectious disease, neurology, neurosurgery, obstetrics and gynecology, occupational medicine, orthopedic surgery, physical medicine and rehabilitation, primary care, pulmonology, reproductive medicine, rheumatology, sleep medicine and urology. Position Summary: Provides consulting services to the organization’s management and staff and may coordinate requested coding investigations. Responsible for education and training for all Covenant coders, CDI, and/or physician office...

Overview Medical Biller Full Time , 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region’s top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) , outpatient and specialty services (http://www.covenanthealth.com/services/) , and Covenant Medical Group (http://www.covenantmedicalgroup.org/) , our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. Position Overview: Demonstrates expanded knowledge of the billing requirements for UB and 1500 claims for...

divh2Field-Based Medical Marketing Team Member/h2pAt Neurocrine Biosciences, we pride ourselves on having a strong, inclusive, and positive culture based on our shared purpose and values. We are dedicated to discovering and developing life-changing treatments for patients with under-addressed neurological, neuroendocrine and neuropsychiatric disorders./ppA field-based key member of the Medical Marketing team who is aligned to a specific specialty or function within the broader Marketing team. Acts as the primary Marketing point of contact for field intelligence through gathering valuable insights from Key Opinion Leaders (KOLs) and customers to help shape and inform marketing strategies./ppYour contributions (include, but are not limited to):/ppstrongBrand Strategy/strong/pulliPartners actively in brand planning and strategic development across HCP, Patient, and Medical Marketing initiatives/liliPartners with Marketing leadership to transform field insights and real-world feedback...

Certified Coder (Varied) Location: Remote Shift: Varied scheduling in alignment with department needs; scheduling is between the hours of 5:00 am and 10:59 pm CST/40 hours guaranteed Duration: 13 weeks with possible extension Description: Fully remote position! Applicant must have the necessary equipment for the contract; 2 monitors, keyboard, mouse, web camera. If not, Ag...

Associate Director, Field Medical Affairs As an Associate Director, Field Medical Affairs, you will play a pivotal role as a field-based, professional within our General Medicine Rare Disease group. You will deliver both strategic and operational support by establishing, developing, and maintaining high-level scientific exchange with the medical and research community aligned with our strategic objectives. This role focuses primarily on rare bone disease will also support our genetic medicine portfolio. Additionally, we ensure the timely, ethical, and customer-focused and accurate exchange and distribution of clinical and scientific information relevant to both our in-line and pipeline products. Territory: Central U.S. (residency in Chicago, Atlanta, or other major airline hub city is preferred) A typical day may include the following: Scientific Expertise & Exchange Demonstrate deep expertise about assigned compounds and the therapeutic areas and disease states while...

Op Coder 2 How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Various (United States of America) Job Summary: A new chapter awaits at Wellstar! We value your experience and want to help you continue your career in a supportive environment. Experience the Wellstar Difference Competitive pay & benefits Career growth & development programs Flexible schedules Supportive, team-oriented culture Employee wellness programs The OP Coder 2 position reports directly to the Supervisor of Coding. Key responsibilities of the role include: reviewing...

Inpatient Hospitalist Coding At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team. Job Description Fulltime Remote Position (40 hour work week) Inpatient Hospitalist Experience needed for this role. Responsible for reviewing clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10-CM/CPT4 codes and modifiers for billing, internal and external reporting, research, and regulatory compliance....

Ed Remote Coder Join the winning team and work with the best! We are excited to announce that in 2022 and 2023, UASI was awarded the top workplace award by the Cincinnati Enquirer. Our 40 years in business and long-term partnerships with our valued clients contribute to our stability and the long tenure of our team. We are currently seeking experienced coding specialists to perform accurate code assignments for ED records (facility and profee) while working remotely from a home office. The ideal candidate will be flexible, detail-oriented, have the ability to work independently, quality conscious and be able to adapt well to change. Additional qualifications include: AHIMA or AAPC certification. A minimum of three years' experience coding ED records in an acute care setting is required. Technical competency with remote-based connectivity including virtual private networks, multi-factor authentication via smartphone, and video conferencing platforms. Proficiency with office...

Be Part of an Extraordinary Team Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. Build the Possibilities. Make an Extraordinary Impact. Title : DRG Coding Auditor (ICD-9/10CM, MS-DRG, AP-DRG, APR-DRG) **Virtual: ** _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Alternate locations may be considered if candidates...

WelbeHealth PACE (All-Inclusive Care for the Elderly) program provides seniors with the opportunity to continue living in their homes and in their communities. Our innovative and comprehensive range of medical services to participants is what ignites our passion to treat the whole person and not the symptoms! We employ a collaborative interdisciplinary team (IDT) approach to evaluate and guide participant care, which is key to WelbeHealth values, team culture, and mission. At the direction of the Coding Supervisor, the Coding Auditor and Educator focuses on ensuring coding is accurate and properly supported by clinical documentation within the health records, as well as educating our teams on best practices to promote compliance. Essential Job Duties: Assist with retrospective and concurrent coding for PACE (All-inclusive Care for the Elderly) Dual participants Conduct pre-visit chart preparations and post-visit chart reviews Oversee audits and participate...

Environmental Services Supervisor The Environmental Services EVS Supervisor is responsible for developing and implementing facility solutions. This role will lead the operations of facility accounts by ensuring areas of responsibility meet objectives and client expectations. Job Responsibilities: Model key leadership behaviors and ensure the highest levels of safety, quality and service excellence for employees, clients and consumers. Reward and recognize employees. Identify and engage top talent and develop team members to their fullest potential within the organization. Plan and lead team management meetings. Ensure safety and sanitation standards in all operations. Establish and maintain effective client and customer rapport for a mutually beneficial business relationship. Identify client needs and communicate operational progress. Deliver and model WEST as the foundation for delivering excellent customer service. Assists with planning and information as the...

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...

Anticipated End Date: 2026-01-30 Position Title: Coding Auditor Sr Job Description: JR171732 Coding Auditor Sr CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development....

A leading pharmaceutical company located in Nashville, TN is seeking an Associate Director, Strategic Planning & Operations. This role is pivotal in enhancing operational excellence across the Global Medical Affairs organization. The successful candidate will work closely with cross-functional teams to develop and implement strategic plans while managing budgets and driving process improvements. Applicants should possess at least 7 years of relevant experience in Global Medical Affairs, with strong project management and leadership skills. Competitive benefits are provided. #J-18808-Ljbffr

divh2Senior Inpatient HIM Coder/h2pWe are seeking a highly skilled and experienced Senior Inpatient HIM Coder to join our dynamic healthcare information management team. This role is crucial in bridging the gap between clinical data and technology, as we aim to develop cutting-edge AI solutions for medical coding and billing processes. The successful candidate will play a pivotal role in providing valuable insights and expertise to enhance our product development efforts./ppRequirements and Qualifications:/pulliA minimum of 3 years of hands-on experience as an acute HIM inpatient medical coder in a hospital environment./liliProficiency in identifying and extracting ICD-10-CM, ICD-10-PCS, HCPCS/CPT codes, and associated modifiers from patient records./liliIn-depth understanding of supporting evidence requirements for accurate coding./liliPractical experience using grouper software for MS-DRG and APR-DRG assignment./liliStrong communication skills to interact effectively with the...

divh2DRG Coding Auditor/h2pThis role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law./ppCarelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG CODING AUDITOR is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also...

divh2Datavant Inpatient Coder/h2pDatavant is a data platform company and the worlds leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the worlds leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, youre stepping onto a high-performing, values-driven team. Together, were rising to the challenge of tackling some of healthcares most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare./ph3What Were Looking For/h3pWere looking for experienced and credentialed inpatient coders to become an integral part of our...