85 jobs found

Professional Coding Analyst II The Professional Coding Analyst II will be responsible for reviewing clinical documentation, assigning appropriate diagnosis, procedure, and in some cases level of service codes to resolve claim edits and denials. Ensures clinical documentation supports the charges posted, following the American Medical Association (AMA), Medicare, and Commercial coding guidelines on claims. Communicates trends and issues to leadership for investigation and resolution. This is a remote role working Monday-Friday, day shift hours. Responsibilities Reviews claims in assigned work queues in Cerner Revenue Cycle including CMG Review and Ambulatory Edit failure work items. Analyzes coding edits, reviews timeline notes, reviews clinical documentation, including provider orders, progress notes, surgical and test results thoroughly to interpret and ensure documentation supports the posted charges. Determines appropriate action needed to resolve coding edits/issues and...

Hospital Inpatient Coding Specialist The Hospital Inpatient Coding Specialist reviews inpatient medical records and assigns International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10 CM) diagnosis and International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) procedure codes that derives an All Patient Refined Diagnosis Related Group (APR-DRG) or Medical Severity Diagnosis Related Group (MS-DRG) for optimal reimbursement. The Hospital Inpatient Coding Specialist will work in collaboration with the Clinical Documentation Integrity Specialist at times to ensure accuracy consistent with Centra's coding policies. The Hospital Inpatient Coding Specialist will abstract pertinent information according to established guidelines for the organization and will formulate provider queries to clarify information. Responsibilities Assigns diagnosis and procedure codes. Verifies accuracy of DRG Accurately abstracts required...

Associate Director of Major Gifts - Health Sciences and Technology and Fralin Biomedical Research Institute The Associate Director of Major Gifts, Health Sciences and Technology (HST), and Fralin Biomedical Research Institute at VTC (FBRI, located in Roanoke, VA) will solicit philanthropic gifts from alumni, families, friends, and supporters which align with the Institute's fundraising goals, and overall university health sciences strategic priorities. This highly motivated professional will be involved with the planning and implementation of major gift fundraising in support of current operations, endowment, capital, and other priorities from private sources in support of operations and growth for HST and FBRI. Identification, cultivation, solicitation and stewardship of potential prospects will be the primary focus of this role, requiring travel around the region and nationally. This position will fulfill the duties under the direction of the Assistant Vice President for Health...

Neonatologist Leadership Role in Virginia; NICU Medical Director or Associate Director Come practice in Roanoke, Virginia. Roanoke is a mountain city and hub for innovation, offering miles of trails, parks within walking distance, a vibrant downtown, and friendly community neighborhoods with character. Your CompHealth recruiter is your coach who will find the best fit for you and help highlight your strengths during the interview process.

Using advanced knowledge required for the complex analytical functions of this job, the Analyst conducts compliance and privacy investigations using expertise of investigative procedures, research, and analysis, applies independent judgement and critical decision making to determine regulatory compliance risk to patients and the organization. The Analyst uses the advanced knowledge of the regulatory compliance profession, and research and auditing procedures. Uses professional verbal and written communication skills to document and communicate results and findings of compliance research, analysis and decision- making. Ensures health system compliance with applicable regulatory, accreditation and requirements. 1. Identifies, researches and analyzes compliance and regulatory risk Researches and collects all data points relevant to the issue being investigated. Using advanced knowledge of federal, state and local regulations, analyzes the actual and/or potential...

Occupational Therapist (OT) - Acute Care Southside Medical Center in Petersburg, VA Full Time, Days (8AM - 4:30PM; one weekend a month required) Job Summary: The Occupational Therapist plays a crucial role in enhancing patients' ability to perform daily tasks related to work and life. They conduct assessments, devise treatment plans based on physician referrals, and document patient progress. This encompasses outpatient, inpatient, pediatric, and off-site settings. Essential Functions: Review physician referrals and patient medical history to determine therapy needs. Conduct and document patient evaluations, re-evaluations, and treatment plans according to department protocols. Administer prescribed occupational therapy treatments and create custom equipment for individual needs. Develop programs focusing on functional skills, vocational training, daily activities, and motor skills. Monitor progress and adjust treatment goals and plans as necessary, participating in...

Medical Billing Specialist Neolytix is a boutique Consulting and Management Services Organization that works with small & medium-sized healthcare providers across the United States. Our portfolio of services caters to micro verticals and is built on the expertise we have developed in enabling these practices. At Neolytix, you will learn to hone your Consultative skills, develop drive & leadership, balance work with family time and importantly have fun! Medical Billing Specialist is responsible for posting medical charges, payments, and journal entries to patient accounts in a timely and accurate manner. Responsibilities include: Working directly with the insurance company, healthcare provider, and the patient to get a claim processed and paid. Verifying correct insurance filing information on behalf of the client and patient. Verifying receipt of all patient registration data from the client and notifying the client of potential coding problems. Prepare, review,...

Job Title Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role.

Occupational Therapist The Occupational Therapist plays a crucial role in enhancing patients' ability to perform daily tasks related to work and life. They conduct assessments, devise treatment plans based on physician referrals, and document patient progress. This encompasses outpatient, inpatient, pediatric, and off-site settings. Essential Functions: Review physician referrals and patient medical history to determine therapy needs. Conduct and document patient evaluations, re-evaluations, and treatment plans according to department protocols. Administer prescribed occupational therapy treatments and create custom equipment for individual needs. Develop programs focusing on functional skills, vocational training, daily activities, and motor skills. Monitor progress and adjust treatment goals and plans as necessary, participating in patient care conferences. Educate patients and families on at-home treatment procedures. Required Licensing &...

Job Title: Outpatient Medical Coder 3 Department: Health System Shared Services | MIM CDI and Coding Scope of Position Coding services assigns diagnosis and procedural codes to inpatient and outpatient medical records to facilitate the reimbursement and data collection for the individual business units of the OSU Health System. ICD-10-CM/PCS diagnoses and procedure codes are applied to inpatients and CPT-4 procedure codes are applied to all outpatients treated within the OSU Health System that are not captured through the charge description master. Medical record abstract data is assigned based on information reviewed for accuracy in IHIS during the coding process. Position Summary The position is responsible for coding medical records and other documents at the conclusion of the patient's visit. A senior medical records coding specialist requires the skill set to code multiple work types for inpatient and outpatient services (outlined below). This requires selection of...

Medical Billing And Coding Specialist Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology enabled expert services for outpatient healthcare. With a 97% long-term, client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values: Respect, Innovation, Trust, and Energy, permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and...

Inova Health is looking for a dedicated Medical Records Coder 2 to join the HB Coding Operations team. This role is Full-time working daytime hours Monday to Friday | REMOTE. Inova is consistently ranked a national healthcare leader in safety, quality and patient experience. We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation. Featured Benefits: Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program. Retirement: Inova matches the first 5% of eligible contributions - starting on your first day. Tuition and Student Loan Assistance: offeringup to $5,250 per year in education assistance and up to $10,000 for student loans. Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost. Work/Life Balance:...

Job Family: Strategy & Transformation Consulting Travel Required: Up to 25% Clearance Required: None Is life sciences in your DNA?  Breakthroughs in pharma are helping people live healthier lives, while medical devices enable patients to proactively maintain health – this is undoubtedly a transformative time for health care companies. Guidehouse’s Life Sciences practice is an engine of innovation, helping pharmaceutical, biotech, medical device, and diagnostic companies develop custom solutions that tackle today’s challenges, while anticipating tomorrow’s. You will have an immediate impact by partnering with our clients, across all levels, to deliver product planning, pricing, reimbursement, product commercialization, and regulatory and compliance solutions.  Do you think you are up for the challenge?   We continuously strive to foster an inclusive and diverse work culture and thoughtfully develop our people through challenging work, valuable learning and...

Medical Record Reviewer Position Status Label: Non-Exempt Labor Category: Admin Remote/Onsite: Remote Additional Informations: This job is for new sourcing The purpose of this position is to review the medical record to assure specificity of diagnoses, procedures and appropriate/optimal reimbursement for hospital and/or professional charges; Retrieves information from medical records, ensuring ...

Certified Medical Coder Specialist Our Business Department is currently welcoming a temporary full-time Certified Medical Coder Specialist! This position is fully in-person and not remote. Key responsibilities include assembling and analyzing all discharged records and maintaining an organized system for notification of deficiencies. Responsible for sending reports to referral sources and healthcare providers as identified. Assigns appropriate medical codes to charts to assure accurate billing. Assists with data collection and presentation for facility PI activities. Responsible for release of medical record information from active and discharge files in accordance with all applicable legal, accrediting, and regulatory agency requirements. Files all loose reports into discharged records. Maintains "copy" file and outside information file. Maintains permanent file and incomplete chart file. Coordinates the transcription of dictated or written materials for medical record reports....

Join to apply for the Lead Risk Adjustment Coder role at Augusta Health 7 months ago Be among the first 25 applicants Join to apply for the Lead Risk Adjustment Coder role at Augusta Health The Lead Risk Adjustment Coder is a system support position who completes coding and abstracting of patient encounters for the purposes of analyzing and improving the accuracy of complexity capture. The specialist works closely with physicians, the Population Health quality and data teams, the coding teams in AMG and the hospital, and the compliance department to identify and deliver high quality and accurate risk adjustment coding. The Lead Risk Adjustment Coder will demonstrate strong understanding of ICD-10-CM, CPT, HCC, and HCPCS coding guidelines and practices for outpatient and inpatient coding. Education High school diploma or equivalent is required 2 years of completed college coursework is preferred Licensure/Certification Certified Professional...

The Medical Call Center Supervisor provides front line staff supervision, coaching, and development including hiring and training new employees, assigning tasks, and assessing performance. Supervisors will motivate, support agents through feedback and communication, and monitor key performance metrics such as inbound/outbound calls/referrals, quality, scheduled appointments, and productivity. Essential Job Statements Provides direct line supervision for multiple staff members (15-25) including scheduling (inbound/outbound calling), referral management, performance evaluations, disciplinary action, time/attendance, coordination of staff activities, or other work as needed. Conducts hiring, interviewing, onboarding, and training of new employees. Manages learning of specialty skills to ensure staff members readiness to perform independently. Works to create a diverse and inclusive culture where all team members are supported and encouraged to maximize their skills,...

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...

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...

A leading healthcare provider in Richmond, VA is seeking a qualified individual for a role that includes performing DRG validation reviews and analyzing medical records. The ideal candidate will have RN or LPN licensure, experience with coding regulations like ICD-10, and strong Microsoft Office skills. This position offers a competitive compensation package, generous paid time off, and opportunities for career development within the organization. #J-18808-Ljbffr

Medical Call Center Supervisor The Medical Call Center Supervisor provides front line staff supervision, coaching, and development including hiring and training new employees, assigning tasks, and assessing performance. Supervisors will motivate, support agents through feedback and communication, and monitor key performance metrics such as inbound/outbound calls/referrals, quality, scheduled appointments, and productivity. Provides direct line supervision for multiple staff members (15-25) including scheduling (inbound/outbound calling), referral management, performance evaluations, disciplinary action, time/attendance, coordination of staff activities, or other work as needed. Conducts hiring, interviewing, onboarding, and training of new employees. Manages learning of specialty skills to ensure staff members readiness to perform independently. Works to create a diverse and inclusive culture where all team members are supported and encouraged to maximize their skills,...

Description Leidos, a global technology leader, is seeking a Combat Coder for our Sentinel program, supporting the United States Air Force in geographically distributed intelligence operations. Combat Coders directly support mission objectives by integrating data sources and interfaces quickly while being embedded with the user base. As a Combat Coder you will engage directly with our customers to build and modify all aspects of full-stack applications. Your contributions will move directly to production systems and get immediate feedback. You will be working with a small elite team of developers that focus on getting things done to support the mission. Join Leidos in our mission to enhance global security and efficiency through technology and innovation. Be part of a team that champions Integrity, Inclusion, Innovation, Agility, Collaboration, and Commitment. If you're ready to drive critical software deliveries, apply now to join Leidos as a Combat Coder for the...

Join to apply for the Hospice medical Biller role at Caregivers Home Health Services, Inc. Prepare and submit billing data and medical claims to insurance companies. Ensure the patients medical information is accurate and up to date. Prepare bills and invoices, and document amounts due to medical procedures and services. Collect and review referrals and pre-authorizations. Monitor and record late payments. Follow-up on missed payments and resolve financial discrepancies. Examine patient bills for accuracy and request any missing information. Investigate and appeal denied claims. Help patients develop patient payment plans. Maintain billing software by updating rate change, cash spreadsheets, and current collection reports. Requirements: Bachelors degree in business, health care administration, accounting or relevant field. A minimum of 2 years experience as a medical biller or similar role. Solid understanding of billing software and...

Job Posting Tryfacta is a leading, nationally renowned Workforce Management Solution provider for private & public sector firms across the US. We specialize in Healthcare, IT, Business Support, and Professional & Craft/Light Industrial ecosystems. Founded in March 1996, we have a presence in all 50 States. Tryfacta has ranked number 1 as one of the fastest-growing companies by Inc. Magazine.