11 certified professional coder special investigations unit jobs found

General Summary of Position Assists the MedStar Family Choice (MFC) compliance and privacy programs. Conducts both internal and external audits to ensure compliance with regulatory requirements. We recruit, retain, and advance associates with diverse backgrounds, skills, and talents equitably at all levels. Key Responsibilities Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards, and safety standards. Complies with governmental and accreditation regulations. Analyzes existing clinical policies and makes recommendations to improve program integrity and organization processes. Assists in investigating potential compliance/privacy violations. Assists with and tracks responses to external government inquiries, investigations, data requests, subpoenas, and fair hearings. Responds to government requests for claims data/information. Assists with internal and external Compliance and...

Location: Chicago, IllinoisBusiness Unit: Rush Medical CenterHospital: Rush University Medical CenterDepartment: PB Revenue IntegrityWork Type: Full Time (Total FTE between 0.9 and 1.0)Shift: Shift 1Work Schedule: 8 Hr (7:30:00 AM - 4:00:00 PM)Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).Pay Range: $32.00 - $52.08 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.Summary:As a key role in the Revenue Integrity team, the Auditor & Educator is responsible for conducting reviews of EMR documentation of patient encounters to ensure coding accuracy and documentation...

Berkshire Hathaway Homestate Companies, Workers Compensation Division, has an immediate opening for a Medical Bill Analyst to join its Medical Management team. This individual is responsible for processing medical billing in accordance with jurisdictional regulatory requirements, while applying appropriate fee schedule and PPO reductions. ESSENTIAL RESPONSIBILITIES Masters appropriate application of procedural (CPT) codes, diagnostic ICD-9 codes, diagnostic ICD-9-CM codes, Diagnosis Related Group (DRG) codes, Ambulatory Payment Classification (APC) codes, and modifiers. Exhibits continuous improvement under the guidance of the Medical Bill Review Supervisor, and demonstrates mastery of fundamental bill review knowledge and skills. Efficiently reviews medical bills and data reports for data accuracy and completeness. Examines bills for legibility and takes appropriate action to ensure accuracy of documentation. Accurately identifies data from claim information....

Job Description Job Description Seeking a Claims Reconsideration Coder for a temporary to permanent hire position with a prestigious insurance company in RI. This position is immediately available for the successful candidate. Experience is preferred; however, consideration will be given to newly certified applicants who have passed the certification exam and can present their certification number. This is a full-time position working 37 1/2 hours weekly, on site, and offers a comprehensive benefits package when/if hired permanently. Responsibilities include, but are not limited to: Responsible for all aspects of Claim Reconsideration Requests and Contracted Provider Administrative Appeals including reviewing, resolving, adjusting, and development of written communication to providers Independently abstract and interpret of all medical notes required to determine if the services billed are supported for reimbursement using current industry standard coding, CMS guidelines,...

Summary This position is located in the Health Information Management (HIM) section of the Business Office at the Orlando VA Healthcare System. MRTs (Coders) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multispecialty clinics, and specialty centers. ***ALL APPLICANTS MUST POSSESS A CURRENT MRT CERTIFICATION THROUGH AHIMA OR AAPC . A COPY MUST BE SUBMITTED WITH YOUR APPLICATION. This job is open to Internal to an agency Current federal employees of the hiring agency that posted the job announcement. Clarification from the agency THIS VACANCY IS OPEN TO CURRENT PERMANENT EMPLOYEES OF THE U. S. DEPARTMENT OF VETERANS AFFAIRS (VA NATIONWIDE) ONLY. Videos Duties AMENDED - THIS IS NOT A VITRUAL POSITION MUST BE ON STATION! The Medical Records Technician (Coder-In/Outpatient), Assigns codes to documented patient care encounters...

Summary The Medical Record Technician (Coder) Auditor is a staff position located under the Health Information Management Division of the Facilities Support Directorate located at the Captain James A. Lovell Federal Health Care Center. This position is responsible for maintaining the quality of patient records, assigning of appropriate International Classification of Diseases, Current Procedural Terminology and Healthcare Common Procedure Coding System codes, and various other duties as assigned. This job is open to Federal employees - Competitive service Current federal employees whose agencies follow the U.S. Office of Personnel Management's hiring rules and pay scales. Federal employees - Excepted service Current federal employees whose agencies have their own hiring rules, pay scales and evaluation criteria. Internal to an agency Current federal employees of the hiring agency that posted the job announcement. Clarification from the agency First...

Summary The Medical Records Technician (MRT) Coder is responsible for performing a quality review of patient care documents and assigning codes specific for the type of care provided. Inpatient MRTs (Coder) select and assign codes from current versions of ICD CM, PCS, and/or CPT and HCPCS classification systems for the full scope of inpatient facility and/or professional services. This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Internal to an agency Current federal employees of the hiring agency that posted the job announcement. Clarification from the agency This job announcement is open to all internal employees and to the public. Videos Duties Work Schedule : 8:00am to 4:30pm, Monday-Friday Compressed/Flexible :Not Authorized Telework : Not Available Virtual: This is a virtual position. Functional Statement # : 640-04175F (GS-4), 640-04176F (GS-5), 640-04177F (GS-6), 640-04178F...

Summary This position is located in the Health Information Management (HIM) section of the Business Office at the Orlando VA Healthcare System. MRTs (Coders) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multispecialty clinics, and specialty centers. ***ALL APPLICANTS MUST POSSESS A CURRENT MRT CERTIFICATION THROUGH AHIMA OR AAPC . A COPY MUST BE SUBMITTED WITH YOUR APPLICATION. This job is open to Internal to an agency Current federal employees of the hiring agency that posted the job announcement. Clarification from the agency THIS VACANCY IS OPEN TO CURRENT PERMANENT EMPLOYEES OF THE U. S. DEPARTMENT OF VETERANS AFFAIRS (VA NATIONWIDE) ONLY. Videos Duties AMENDED - THIS IS NOT A VITRUAL POSITION BUT BE ON STATION! The Medical Records Technician (Coder-In/Outpatient), Assigns codes to documented patient care...

Summary This position is located in the Health Information Management (HIM) section of the Business Office at the Portland VA Healthcare System. MRTs (Coders) are skilled in classifying medical data from patient health records in the hospital setting, and/or physician-based settings, such as physician offices, group practices, multispecialty clinics, and specialty centers. This job is open to Internal to an agency Current federal employees of the hiring agency that posted the job announcement. Clarification from the agency This announcement is only open to current VA employees This job is also open in another announcement to: The public Federal employees - Competitive service Federal employees - Excepted service Veterans This job is also open in another announcement to: The public Federal employees - Competitive service Federal employees - Excepted service Veterans Videos Duties The duties of this position include, but are not...

Summary Coders are skilled in classifying medical data from patient health records in the hospital setting/physician-based settings. These coding practitioners analyze and abstract patients' health records, and assign alpha-numeric codes for each diagnosis and procedure. To perform this task, they must possess expertise in International Classification of Diseases (ICD), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS). This job is open to The public U.S. Citizens, Nationals or those who owe allegiance to the U.S. Federal employees - Competitive service Current federal employees whose agencies follow the U.S. Office of Personnel Management's hiring rules and pay scales. Federal employees - Excepted service Current federal employees whose agencies have their own hiring rules, pay scales and evaluation criteria. Internal to an agency Current federal employees of the hiring agency that posted the job...

Summary Reemployed annuitant: This vacancy does not meet the criteria for appointment of annuitants. Responsibilities Serves as the Supervisory Auditor in a branch or resident office responsible for the supervision, conduct, and accomplishment of a segment of the audit program. Leads a major segment of the total audit program plan. Serves as a team leader and member of a participative work team (PWT) consisting of professional auditors. Establishes annual goals complementary to region/agency goals and objectives. Reviews audit programs, working papers, progress on the audit assignment, and draft audit reports. Ensures that quantitative methods and computerized auditing techniques are being utilized as appropriate in the audit process. Communicates DCAA audit services and maintains audit liaison with acquisition officials. Counsels and advises employees. Evaluates performance, recommends and approves training and development, recommends recognition and promotion, and initiates...