78 analyst siu certified coder jobs found

The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Responsibilities Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent with medical record documentation. Provide detailed written summary of medical record review findings. Must be able to articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc. Research and accurately apply state or CMS guidelines related to the audit with minimal...

We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform all audits based on specific departmental need. *****On-Site Only**** Examples of Duties PBS Auditor: 100% Conduct quality and productivity reviews of coding staff using structured and consistent review programs and methods. Demonstrate in-depth knowledge and experience with SIU-HC supported applications, including but not limited to...

Salary: $25.89 - $28.48 Hourly Location : Springfield, IL Job Type: Civil Service Job Number: 2401379 Department: SIU HealthCare Coding-SMS Division: Administration Opening Date: 04/24/2026 Closing Date: 6/22/2026 3:30 PM Central FLSA: Non-Exempt Bargaining Unit: Non-Represented Shift: Days ExemptorNon_Exempt: Non-Exempt We recommend using the following browsers to complete the application: Desktop: Google Chrome, Edge with Chromium Mobile: Google Chrome, Safari Description The Revenue Cycle Coding Auditor will perform reviews for employees in the Coding department. Audits will include, but are not limited to; employee productivity and quality based on proper documentation, accuracy and coding guidelines. The Auditor will also provide feedback and support relating to departmental/role specific productivity and quality expectations. The incumbent for this position will utilize a high level of in-depth knowledge of the coding role to perform...

Job Description Job Description Description: Job Title: Certified Medical Coder/Biller Location: Richmond Hill, GA | Hybrid Remote Employment Type: Full-time Reports to: Billing Manager Department: Revenue Cycle Management Job Summary: The Certified Medical Coder/Biller is responsible for accurately submitting claims to insurance companies, ensuring timely reimbursement for medical services provided by the healthcare facility. This role involves reviewing patient bills for accuracy and completeness, resolving any billing issues, and communicating effectively with patients, insurance companies, and healthcare providers. The ideal candidate will have strong attention to detail, excellent organizational skills, and a solid understanding of medical billing processes and insurance guidelines. Key Responsibilities: 1. Claims Processing: · Prepare and submit accurate and timely insurance claims for services rendered. · Verify patient insurance coverage...

Medical Biller, CMG Business Office This position participates in various functions including the review, correction, submission/resubmission, and/or appeal of rejected, denied, unpaid, or improperly paid insurance claims. This position is responsible for billing and follow-up functions for payors in all financial class categories. Serves as a resource for Medical Biller Is, seeking guidance from Supervisor when necessary. This positions also provides patient customer service and releases billing records to approved entities. This position responsible for the timely and accurate completion of assigned tasks to facilitate proper claim processing. Responsibilities Acts a resource for Medical Biller Is with resolving intermediate to complex account and claims issues. Provides guidance to other departmental roles (including Customer Service, Collections, Payment Posting) as it pertains to plan eligibility, claims processing details, and patient balance explanations as needed....

Coder Boone Memorial Hospital is seeking a detail-oriented and motivated Coder (HIM Coder) to join our Health Information Management team. In this role, you will play a critical part in ensuring accurate coding, regulatory compliance, and timely reimbursement for outpatient services. If you have a passion for medical coding, enjoy working independently, and take pride in accuracy and attention to detail, we encourage you to apply. Essential Functions Review medical record documentation and accurately assign diagnosis and procedure codes using ICD-10-CM, CPT, and HCPCS guidelines. Abstract patient information into electronic medical record systems while ensuring data accuracy and integrity. Apply CMS regulations, payer-specific guidelines, and coding compliance standards to support ethical and accurate reimbursement. Resolve coding-related claim edits and assist with denial management. Collaborate with providers, billing staff, and ancillary departments to answer...

Medical Biller Under general supervision, the incumbent is responsible for examining, verifying, and maintaining data involved in processing medical care claims for alternate resources reimbursement and performing other third-party billing-related duties. The primary function of this position is to bill/process all medical care claims timely to ensure reimbursement from third-party payers. The work involves the review of medical claims to ensure accuracy and completeness and obtain missing information. The incumbent performs various accounting, budget, or financial management support-related duties or assignments related to medical billing. Essential duties and responsibilities include: Responsible for received claims up until Third-Party Payer has paid the claim. Receives and examines alternate resource claims to ensure they are complete with appropriate supporting documents. Verifies accuracy of health claim number that claimed amounts are authorized and that the...

Job Description Job Description Join our dedicated team at Harrison County Hospital in Corydon, IN, where your expertise as a Certified Physician Coder will make a significant impact in the healthcare community. This onsite position offers the unique opportunity to collaborate with healthcare professionals and enhance patient care through accurate coding practices. You will play a vital role in ensuring excellence in our medical billing processes while maintaining our commitment to customer-centricity. Being a part of our organization means contributing to an environment that values professionalism and compassion. If you are passionate about coding and eager to work in a supportive, dynamic setting, this role is perfect for you. You can get great benefits such as Medical, Dental, Vision, 401(k), Life Insurance, Health Savings Account, Flexible Spending Account, Paid Time Off, Snack/Drink Room, and Employee Discounts. Take the next step in your career and help us uphold our...

Alignment Health is a remote company focused on senior care. The Medical Risk Adjustment (MRA) Coding Auditor role supports departmental quality assessment audits of internal coding analysts and vendors to ensure accurate and complete data submission to CMS. General Duties / Responsibilities Supports regular quality assurance audits of the internal Coding Analyst Team to validate and confirm coding & abstracting quality (95% HCC accuracy), ensuring coding quality and performance improvement standards are maintained. Tracks and reports progress of QA audits performed on coding vendors to verify coding accuracy and quality of data submitted to AHP for CMS submission. Works with Risk Adjustment Management on any MRA data validation or coding audit to ensure completeness and coding accuracy of all CMS submissions; this may include data reconciliation, data flow integrity, UAT testing, review of high‑cost/low‑risk score members, retrospective chart reviews, or other related data...

We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R – Respect S – Stewardship Billing and Coding Specialist Summary Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty. A Day in the Life Review provider documentation (including hospital procedures) and translate services into correct codes. Append payer specific modifiers and claim criteria when applicable. Review incomplete encounters and code based on available documentation in EHR systems. Know and understand several different coding systems, including ICD-10-CM, ICD-10-PCS, CPT, Level 1 HCPCS and Level 2 HCPCS. Use computers / billing software to create and bill encounters that generate...

Medical Biller Work Location: Brooklyn, NY, 11223 Work Setting: In-Person About NSIPA: Network Solutions IPA (NSIPA) is a leading New Yorkbased Independent Practice Association with a diverse, multi-specialty provider network. The organization has grown to more than 600 physician members, serving over 100,000 patients across New York City, Nassau, Suffolk, and Westchester counties. We are committed to helping independent providers succeed in the transition to value-based care.? Through strategic partnerships, operational support, and robust payer relationships, NSIPA delivers the tools, resources, and expertise that allow practices to grow, perform, and succeed in todays complex healthcare landscape without sacrificing independence. ? We achieve this by collaborating with payers to deliver Quality Incentive Programs, Shared Savings arrangements, and Risk-Based Contracts. Contracted with over 21+ Payers for over 600+ Providers. NSIPA provides a...

Job Type Full-time Description MAKE A DIFFERENCE AT OCHIN OCHIN is a nonprofit leader in health care innovation and a trusted partner to a growing national provider network, delivering the clinical insights and tailored technologies needed to expand patient access, strengthen care teams, and improve the health of rural and medically underserved communities. We are hiring for a number of new positions to meet increasing demand. When you choose to join OCHIN, you have the opportunity to continuously grow your skills and do meaningful work to help fulfill our vision of good health and well-being for everyone. At OCHIN, we value the unique perspectives and experiences of every individual and work hard to maintain a culture rooted in our values. Founded in Oregon in 2000, OCHIN employs a growing virtual workforce of more than 1,200 skilled professionals, working remotely across 49 states. We offer a generous compensation package and are committed to supporting our...

SummaCare - 1200 E Market St, Akron, OH Full-Time / 40 hours / Days Hybrid or Remote Join a mission‑driven health plan where precision and expertise protect both members and resources—we’re seeking a certified coder who can identify discrepancies others miss, analyze coding patterns with accuracy, and turn complex clinical data into clear, actionable insights; if you bring deep knowledge of coding standards, a sharp analytical mindset, and a passion for ensuring integrity in healthcare claims, this is your opportunity to make a meaningful impact and strengthen the quality of care delivery. Summary Performs review of medical claims to ensure compliance with industry standard coding practices and plan payment policies through a comprehensive medical record evaluation for all provider types. Determines correct coding and appropriate documentation required while ensuring state, federal and company policies are met. Makes recommendations to Medical Directors, Compliance, Internal...

Position Summary Evaluates medical records, provides clinical and surgical abstraction and assigns appropriate clinical diagnosis and procedure codes in accordance with nationally recognized coding guidelines. Core Functions Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic...

Jefferson Health Transcribe speech and language samples from people with aphasia using broad principles of the International Phonetic Alphabet. Job Description Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. Learn and apply specialized coding systems, such as Correct Information Unit (CIU) analysis to transcribed data. Manage and organize data sets using Excel. Assist with general duties of research and lab operations as warranted. Work Shift: Workday Day (United States of America) Worker Sub Type: Temporary Employee Entity: Albert Einstein Medical Center Primary Location Address: 60 Township Line Road, Elkins Park, Pennsylvania, United States of America Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge...

Summary/Objective Under limited supervision the Coder Physician reviews medical records and performs coding on all diagnoses, procedures, DRG/APC, and charge codes. The Coder Physician uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient’s treatment. The Coder Physician will be charged with maintaining the confidentiality of patient records and procedures. Essential Job Functions Responsible for abstracting, coding, sequencing and interpreting the clinical information from inpatient, outpatient, emergency department, pro fee, and clinical medical records. Responsible for the assignment of correct principal diagnoses, secondary diagnoses and principal procedure and secondary procedure codes with attention to accurate sequencing. Utilizes technical coding principals and DRG/APC reimbursement expertise to assign...

Job Summary The University of Chicago Physicians Group (UCPG) team is responsible for the overall management of clinical revenue for physician billing. This includes frontend revenue capture, working of edits, conducting audits for physician education, and ensuring the workflow of charge capture through invoice creation. UCPG is seeking an Abstractor/Coder to work with providers and staff on professional billing and compliance activities. Strong knowledge of evaluation and management coding guidelines and requirements is strongly preferred. This position is eligible for a flexible work arrangement. Responsibilities Obtain appropriate reimbursement levels for professional services by reviewing and coding medical procedures, diagnoses, and physician visits. Analyze denial and rejection reports, and appeal wherever appropriate. Submit charges in a timely manner. Work in collaboration with the Clinical Revenue Supervisor and others, providing guidance to faculty and staff on the...

All CDC recommended vaccines are required vaccinations at Oaklawn. Seasonally, and upon determination of Senior leadership, the Influenza Vaccine may be mandatory; in those years, compliance is required. For all vaccines, Religious Exemptions and Medical Contraindications are available. Coder Abstractor - Health Information Services Job Summary: Under limited supervision, codes and abstracts patient records using the appropriate coding/abstracting system. Communicates with Medical Staff and hospital staff to improve the documentation to support the coding process. Essential Functions: Consistently uses an outward mindset and puts forth exemplary effort in accomplishing his/her goals and objectives in a manner that helps others to achieve their goals and objectives. Code outpatient (for example day surgery, observation, emergency room, outpatient service, diagnostic) records using the appropriate coding system for diagnoses (ICD-10) and procedures (CPT & PCS) Maintain coding...

Certified Coder, Special Investigations Unit (SIU) (Job ID: 59225) SummaCare - 1200 E Market St, Akron, OH Full‑Time / 40 Hours / Days Hybrid or Remote Join a mission‑driven health plan where precision and expertise protect both members and resources—we’re seeking a certified coder who can identify discrepancies others miss, analyze coding patterns with accuracy, and turn complex clinical data into clear, actionable insights; if you bring deep knowledge of coding standards, a sharp analytical mindset, and a passion for ensuring integrity in healthcare claims, this is your opportunity to make a meaningful impact and strengthen the quality of care delivery. Summary Performs review of medical claims to ensure compliance with industry standard coding practices and plan payment policies through a comprehensive medical record evaluation for all provider types. Determines correct coding and appropriate documentation required while ensuring state, federal and company policies are met....

Medical Biller, CMG Business Office This position participates in various functions including the review, correction, submission/resubmission, and/or appeal of rejected, denied, unpaid, or improperly paid insurance claims. This position is responsible for billing and follow-up functions for payors in all financial class categories. Serves as a resource for Medical Biller Is, seeking guidance from Supervisor when necessary. This positions also provides patient customer service and releases billing records to approved entities. This position responsible for the timely and accurate completion of assigned tasks to facilitate proper claim processing. Responsibilities Acts a resource for Medical Biller Is with resolving intermediate to complex account and claims issues. Provides guidance to other departmental roles (including Customer Service, Collections, Payment Posting) as it pertains to plan eligibility, claims processing details, and patient balance explanations as needed....

Job Details Location: DHS Winston Salem, Winston Salem, NC 27103; Position Type: Full Time; Education Level: High School; Travel Percentage: None; Job Shift: Day; Job Category: Finance; No weekends, nights, or call would apply for this position. Job Overview Responsible for the reimbursement and/or resolution of patient insurance account balances with the goal of working accounts to resolution. This role performs account management and analysis; as well as complete, timely and accurate follow up of insurance (hospital, physician or ASC) account balances with the objective of optimizing insurance reimbursement. Primary Job Duties Maintain a professional and compassionate demeanor in all interactions with patients. Work all insurance follow up (hospital, physician and ASC), which includes a focus on claims that have been denied, need more information or are paid incorrectly by insurances. Interacts with, and leverages, external and internal resources to overcome barriers, problem...

Certified Professional Coder Clearview Cancer Institute is north Alabama's leading cancer treatment facility. For over 30 years Clearview Cancer Institute has provided leading-edge treatment and compassionate care to those diagnosed with cancer or blood disorders. Clearview offers every service and amenity needed in an outpatient setting and our dedication to research and involvement in Phase I-IV clinical trials gives our patients the opportunity to receive potentially life-saving treatment options. Job Purpose The purpose of the Certified Professional Coder is to input diagnostic codes for medical services rendered and ensuring that the assigned codes meet required regulations. Essential Job Functions Input appropriate diagnostic codes for various medical services. Make sure the assigned codes meet all federal, legal, and insurance regulations. Assist in monthly evaluations and management audits. Understand and translate physician's diagnosis and treatment plan into...