27 coc certified outpatient coder jobs found in Worcester, MA

Join to apply for the Outpatient Coder II role at UMass Memorial Health . Position Details Exemption Status: Non-Exempt Schedule: Monday through Friday, 7:30 AM - 4:00 PM, Day Shift, 8 Hours Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) Job Description Interprets clinical and diagnostic documentation to process outpatient charges. Assigns ICD-CM, CPT codes, and modifiers according to official guidelines. May assign ICD-PCS codes based on account type. Responsibilities Review medical records and analyze documentation to assign appropriate codes and modifiers. Verify documentation supports assigned codes. Resolve issues related to incomplete or missing documentation. Participate in coding audits and performance management. Maintain a coding accuracy rate of at least 95%. Attend training and in-services annually. Assist in training staff on coding practices. Report backlog or documentation issues to...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Schedule Details: Monday through Friday Scheduled Hours: 7:30 AM - 4:00 PM Shift: Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver—regardless of their title or responsibilities. We are committed to exceptional patient care, academic excellence, and leading-edge research. Our team of over 16,000 employees works together as one health system to heal our patients, community, and each other. Every individual plays an important role every day. Job Description Interprets a wide...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Schedule Details: Monday through Friday Scheduled Hours: 730 - 400 Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 16,000 employees, working together as one health system in a relentless pursuit of...

Datavant is a data platform company and the world’s 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 world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

Datavant is a data platform company and the world’s 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 world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

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 plans in...

Summary: Responsible for reviewing patient medical records after a visit and translating the information into codes that insurers use to process claims from patients. Duties include confirming treatments with medical staff, identifying missing information and submitting information to insurers for reimbursement. Participates in peer review to ensure accuracy and timeliness standards are maintained. Resolve complex coding questions that arise from team. Does this position require Patient Care? No Essential Functions: Evaluates medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support outpatient visits and to ensure that data complies with legal standards and guidelines. -Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10 and CPT codes. -Provides technical guidance to...

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. This per diem coding role is supporting orthopedic surgery coding. Job Summary Summary: Responsible for reviewing patient medical records after a visit and translating the information into codes that insurers use to process claims from patients. Duties include confirming treatments with medical staff, identifying missing information and submitting information to insurers for reimbursement. Participates in peer review to ensure accuracy and timeliness standards...

JOB SUMMARY The Coding Auditor 1 is proficient in various types of coding and is responsible for performing coding quality audits and providing feedback to coders. The Coding Auditor 1 utilizes the International Classification of Disease (ICD-10-CM/PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.) ESSENTIAL FUNCTIONS OF THE ROLE ESSENTIAL FUNCTION OF THE JOB Performs routine coding quality reviews on all coders including third party suppliers as appropriate. Performs coding quality reviews in collaboration with or for internal customers of the organization. Provides feedback as appropriate depending on findings. Abstracts and validates required data elements into the coding and abstracting system. Works collaboratively with the Clinical...

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 plans in...

Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other providers of pro Surgical, Medical, Coder, Remote, Health, Healthcare, Benefits

DRG Coding Auditor Principal Virtual: This role enables associates to work virtually full-time, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients. Specializes in review of DRG coding via medical record and attending physician’s statement provided by acute care hospitals on paid DRG, especially on very complex coding cases that are paid using APS-DRG, APR-DRG, AP-DRG, MS-DRG or TRICARE methodology and findings may be so complex and advanced that disputes or appeals may only be reviewed by other...

Working under the supervision of the Central Billing Department Supervisors will share the responsibilities of being accessible to physicians, staff and patients regarding billing questions; assures that all billing functions are completed in a timely fashion and develops billing goals. Responsible for accurately coding provider's outpatient and inpatient visits based on the documentation provided and abstracting accurate and complete patient care data to ensure optimum and timely reimbursement. Applies knowledge of specialized information specific to coding and medical terminology according to all coding guidelines Reports to: Revenue Cycle Supervisor Manages: N/A Education/Training: High school diploma or equivalent Licenses/Certification: • CPC or AHIMA coding certification Required Qualifications and Skills: Minimum of 1-2 years of medical billing experience in either charge, payment or follow-up work Minimum of 1-2 year of coding experience for primary care,...

*May be eligible for hybrid work option for the right candidate within RI, CT, MA* Job Summary: Responsible for accurate coding of all Integra Community Care Network, LLC, and Women & Infants claims generated through inpatient services, outpatient services, outpatient professional services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS as well as other specialty systems as required by diagnostic category. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic for HCPCS), and CPT Assistant published by American Medical Association /ICD-10-CM Official Guidelines, CPT-4 manual, HCPCS and CMS coding guidelines. As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Coders may assist in...

This position can be fully remote based on the work activity. A certification as a Certified Coding Specialist (CCS) is required for this position. Job Summary: Responsible for accurate coding of all outpatient services, procedures, diagnoses, and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS as well as other specialty systems as required by diagnostic category. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS and CMS coding guidelines. As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Requirements: Must have at least three (3) years hospital or surgical center coding experience within the last five years. Certification: This position requires certification as...

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. . Minimum of 2 year's experience in a hospital inpatient or outpatient setting required. Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group,...

This position can be fully remote based on the work activity. A certification as a Certified Coding Specialist (CCS) is required for this position. Job Summary: Responsible for accurate coding of all outpatient services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. - Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS as well as other specialty systems as required by diagnostic category. - All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCSand CMS coding guidelines. - As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Requirements: • Must have at least three (3) years hospital or surgical center coding experience within the last five years • Certification: This position requires...

Responsible for accurate coding of all outpatient services, procedures, diagnoses, and conditions, working from the appropriate documentation in the medical record. - Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS, and other specialty systems as required by diagnostic category. - All work must be carried out in accordance with the rules, regulations, and coding conventions of the American Hospital Association (Coding Clinic), ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS, and CMS coding guidelines. - Coders may assist and serve as a resource for data integrity for other employees requiring clarification and assistance in coding. Requirements: At least three (3) years of hospital or surgical center coding experience within the last five years. Certification as a Certified Coding Specialist (CCS) and/or five (5) years of compensatory experience. Completion of courses in medical terminology, anatomy and physiology, ICD-9, ICD-10, CPT coding conventions, and...

*May be eligible for hybrid work option for the right candidate within RI, CT, MA* Job Summary: Responsible for accurate coding of all Integra Community Care Network, LLC, and Women & Infants claims generated through inpatient services, outpatient services, outpatient professional services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS as well as other specialty systems as required by diagnostic category. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic for HCPCS), and CPT Assistant published by American Medical Association /ICD-10-CM Official Guidelines, CPT-4 manual, HCPCS and CMS coding guidelines. As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Coders may assist in...

Career Opportunities with Women & Infants Hospital A great place to work. Current job opportunities are posted here as they become available. Subscribe to our RSS feeds to receive instant updates as new positions become available. 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. Minimum of 2 years experience in a hospital inpatient or outpatient setting...

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. Minimum of 2 year’s experience in a hospital inpatient or outpatient setting required. Care New England Health System (CNE) and its member institutions are trusted organizations fueling the latest advances in medical research, attracting top specialty-trained doctors, and honing renowned services and innovative...

DRG CODING AUDITOR Location : This position will work virtually. Alternate locations may be considered. 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 responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physician’s statement sent in by acute care hospitals on submitted DRG. How you will make an impact: Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding expertise, clinical guidelines, and industry knowledge to substantiate conclusions. Utilizes audit tools and auditing workflow systems and reference information to make...

Anticipated End Date: 2025-04-04 Position Title: DRG Coding Auditor Job Description: DRG CODING AUDITOR Location: This position will work a hybrid model (remote and office). The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations. 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 responsible for performing clinical reviews of medical records and other documentation to evaluate issues of coding and DRG assignment accuracy. Specializes in review of DRG coding via medical record and attending physicians statement sent in by acute care hospitals on submitted DRG. How you will make an impact: Analyzes and audits claims by integrating medical chart coding principles, clinical guidelines and objectivity in the performance of medical audit activities. Draws on advanced ICD-10 coding...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. The OP Coder Project Specialist will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP Coder Project Specialist will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP Coder Project Specialist is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description: Essential Duties & Responsibilities: Professional Coding Responsibilities: Provides review and/or coding of any professional services including but...