2937 coder lll jobs found

University of Colorado Medicine (CU Medicine) is the region's largest and most comprehensive multispecialty physician group practice. At our primary and specialty care clinics across the Denver metro area and Front Range, CU Anschutz School of Medicine physicians and advanced practice providers bring the latest medical knowledge and new advancements to the care they provide every day. CU Medicine also provides business operations, revenue cycle and administrative services to support the patients of CU Anschutz School of Medicine providers. We are seeking a highly motivated senior-level Surgical Coder who is looking to step away from production coding, and shift focus toward leading peer review & education efforts for assigned specialties.  This job can be performed 100% remotely and out of state candidates will be considered. The primary responsibility of the Coding Quality Educator is to support and lead coding quality assurance, peer quality reviews,...

Your Role The Risk Adjustment Compliance Specialist, Principal is responsible for ensuring organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare Advantage lines of business. This role involves auditing, monitoring, and evaluating risk adjustment processes, identifying areas of non-compliance, and recommending corrective actions. The Principal collaborates with internal teams and external partners to maintain the integrity of risk adjustment data and supports the development and implementation of compliance programs. Responsibilities Your Work In this role, you will:  Conduct regular audits and reviews of risk adjustment data submissions to ensure compliance with regulatory requirements (e.g., CMS, OIG, HHS). Monitor changes in risk adjustment guidelines, policies, and regulations, and communicate updates to relevant stakeholders. Analyze risk adjustment...

Job Summary The Professional Fee Coder (ProFee) is responsible for reviewing provider documentation and assigning accurate ICD-10-CM, CPT, and HCPCS Level II codes for physician professional services. This role supports compliant coding, timely charge capture, and clean claim submission in accordance with current AMA, CMS, NCCI, and payer guidelines. Specialty Experience Required At least three years of recent professional fee coding experience, including direct, recent experience in all of the following areas: Inpatient neonatal and NICU coding Pediatric coding Neonatal and pediatric critical care coding Responsibilities Include, but Are Not Limited To Review provider documentation and assign accurate ICD-10-CM, CPT, HCPCS Level II codes, and applicable modifiers for professional fee services. Select appropriate Evaluation and Management levels based on current MDM and time guidelines and ensure documentation supports code selection. Apply neonatal...

Risk Adjustment Coder, Auditor and Educator Location:   West Palm Beach, FL (On-site/Local — Multi-Site Primary Care Medical Group)   Job Type:   Full-Time   Department:   Coding & Risk Adjustment / Clinical Quality About the Role Our multi-site primary care medical group is seeking an experienced   MRA Coder and Educator   to lead risk adjustment coding education and training across our West Palm Beach–area clinics. This role is central to ensuring accurate, complete, and compliant HCC/risk adjustment documentation and coding practices among our primary care providers and clinical staff. The ideal candidate is both a   coding subject matter expert   and a   skilled communicator and presenter   — someone who can translate complex risk adjustment concepts into clear, actionable training that resonates with busy physicians and site-level management, while building strong, trust-based relationships across the organization. Key Responsibilities...

About Us Undeniable Health puts AI billing agents to work inside the revenue cycle operations of healthcare providers and the billing companies that serve them. We handle the full claim lifecycle: charge entry, credentialing, prior authorization, claim submission, claim management, and denial recovery, including the denied claims traditional billing teams can't afford to chase. We work inside our clients' existing systems, under their credentials, as an embedded member of their team. No software to sell. No dashboards to manage. We get the money back. We're backed by investors who know the RCM space, and led by co-founders Alex Poon and Jason Griffith, repeat entrepreneurs with multiple successful exits. We service all specialties, with a current focus on diagnostic labs and behavioral health. The Role This is a production billing job, and we mean that as a compliment. You'll work inside client billing systems every day doing the work that keeps revenue moving: entering...

University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado. We are seeking a motivated Coding Education Specialist with an emphasis in Surgery experience to join our Coding Services department.    This job can be performed 100% remotely and out of state candidates will be considered. The Coding Education Specialist will primarily be responsible for supporting and leading ongoing education to existing coding staff,...

Description At CrescentCare, we bring caregivers and the community together as partners in health and wellness for all. Our experience builds on more than 40 years of impact. In 2014, we became a Federally Qualified Health Center to offer an expanded range of health and wellness services for anyone and everyone who is seeking healthcare services in Greater New Orleans and Southeastern Louisiana.   Our Mission Strengthening our entire community through whole-person healthcare and education.   Position Summary This position is responsible for managing all aspects of the revenue cycle functions for CrescentCare a Federally Qualified Health Center.  These functions include, but are not limited to, claims submissions, managing denials and rejections, coding services, payment recording, credentialing services and collections.  This position is responsible for ensuring compliance with insurance billing and coding standards (Medicare, Medicaid,...

About Med USA Med USA is a Utah-based medical billing/provider services company with a nationwide presence. We have been in business for over 45+ years and provide practice management, payer credentialing and contracting, and full-cycle management (RCM) services, including coding, billing, follow-up, and denial resolution. Join our fast-paced, high-energy team as a medical billing specialist, with great company benefits and opportunity for growth. The ideal candidate is motivated, professional, and detail-oriented, with a strong commitment to producing high-quality work and making a positive impact on the team. If you enjoy helping others, solving problems, and working in an open, collaborative, fast-paced environment, this is a great opportunity for you. Medical billing or insurance experience is preferred, but we’re happy to train the right candidate. Position Summary The Certified Medical Coder is responsible for reviewing clinical documentation and...

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. Risk Adjustment Coding Specialists are an important part of the Team at Virtix Health. The HCC Coding Team Member will review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models. Coders will follow Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. Equipment provided along with Encoder software with access to AHA Coding Clinic ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and...

JOB SUMMARY: Management and 24-hour responsibility for the planning, organizing, staffing, coordinating, and controlling of all functions of the Health Information Management Department. Serves as Livingston HealthCare’s designated Privacy Officer and is responsible for establishing, implementing, and overseeing an effective privacy program to ensure the appropriate access, use, disclosure, confidentiality, and security of protected health information and personally identifiable information. This position ensures organizational compliance with HIPAA Privacy requirements, supports HIPAA Security compliance in collaboration with the Security Officer, and promotes privacy practices consistent with state and federal regulations, Livingston HealthCare policies, and the organization’s mission, vision, values, and Code of Conduct. Schedule: 1.0FTE (40 hours) Mon-Fri 8a-5p ESSENTIAL FUNCTIONS, DUTIES, AND RESPONSIBILITIES: Prepares and...

Medical Billing Supervisor will handle the daily operation of the billing department for a private practice with 8 providers.    Responsibilities include but are not limited to the following:  Ensure posting and collections of all billable encounters are completed in an accurate and filed in a timely manner. Manage changes in billing and coding environments as they occur through each payor source including Medicaid, Commercial, and Private Pay. Train billing and clinical staff in use of new codes Ensure that current fee schedules and billing manuals are being used for all payers billed while adhering to all organizational billing policies and procedures. Monitor, track and handle systems for billing (e.g. claim rejection) and provide detailed bi-weekly reports. Monitor aged accounts on a continuous basis working with staff to address oversights or problems within payers and patients. Ensure staff follow the process to work unpaid claims Maintain EHR user status...

Are you passionate about physician coding, compliance, and education? Gill Compliance Solutions is growing, and we're looking for an experienced Audit & Education Manager (remote) to join our nationally recognized consulting team. Our consultants work directly with physician practices, hospitals, health systems, new tech, and legal firms across the country to defend providers,  improve documentation, coding accuracy, compliance, and reimbursement. Every day presents new specialties, new challenges, and opportunities to make a measurable impact. If you enjoy educating providers, solving complex coding issues, presenting audit findings to executive leadership, and staying at the forefront of healthcare regulations, we'd love to meet you. Duties may include but are not limited to the following:      Managing and performing audits from electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in...

Candidates must be able to work on-site. This position is not remote. GENERAL PURPOSE OF JOB: The Claims and Appeals Specialist II is a certified medical coder that performs audits for correct coding and claims payments and oversees the claims appeal process for provider and member appeals. This position also investigates Coordination of Benefit (COB) claims. The Claims and Appeals Specialist II reports to the Director of Claims Oversight. ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate...

Position Overview We are seeking an experienced Billing Specialist to join our busy infertility practice. The ideal candidate is preferred to have billing experience in women's health care. This role requires strong knowledge of medical billing workflows, insurance follow-up, denial management, payment posting, claims resolution, and patient account management specific to women’s health. Key Responsibilities   Submit clean claims accurately and timely through our EMR system  Review and resolve claim rejections and denials across all insurance platforms  Follow up with insurance companies on unpaid claims  Post insurance and patient payments accurately in our EMR system  Work aging reports and outstanding AR  Review patient accounts for billing accuracy and follow-up needs  Handle billing corrections, resubmissions, and appeals  Communicate with registration/front desk, clinical staff, and management to resolve   billing issues  Maintain compliance with...

JOB SUMMARY:   CERTIFIED ANESTHESIA CODER   ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES   •      Review anesthesia records, operative reports, and medical documentation for completeness and accuracy. •      Ensures accurate coding, billing compliance. •      Analyzes Epic electronic medical record for assigning appropriate CPT, ICD-10-CM, HCPCS and Modifiers for anesthesia services. •      Apply appropriate anesthesia modifiers such as AA, QK, QX, QY, QZ •      Identify documentation deficiencies and communicate via EPIC query with providers for clarification.   •      Review denials, coding corrections related to anesthesia services.   •      Maintains confidentiality of patient information as per the MediSys Health Network policy. •      Meeting productivity levels of charts,60-100 anesthesia charts per day not limited to number of transactions filed or complexity of the account.   •      Reviews assigned work queues. •...

JOB SUMMARY: CDI Specialists will collaborate extensively with physicians, nursing staff, other patient caregivers, and medical records coding staff to improve the quality, specificity, accuracy and completeness of the documentation of care provided and coded. CDI Specialist will review medical records for opportunities for diagnosis clarification and validity as it pertains to DRG assignment, severity of illness, risk of mortality, and case mix data as well as timely, accurate and complete documentation of clinical information used for measuring and reporting physician and facility outcomes. These goals will be accomplished by chart review and query placement when appropriate following AHIMA guidelines and CorroHealth policies and procedures. This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended...

JOB SUMMARY: Coding Specialists are an important part of the Team at CorroHealth. Will be Coding Professional Fee charts in several specialties for clinics. Specialties needed: Trauma, Neurology/Neurosurgery, Interventional Radiology, Hospitalist, and Orthopedic This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member. This is a remote position Must live in the US. Specialties needed: Trauma,   Neurology/Neurosurgery,   and Interventional Radiology Team Member must be able to work...

Director of Operations/Revenue Cycle Manager Millstone Healthcare Full-Time | In Person/Leadership Role | Physical Medicine Practice About Millstone Healthcare Millstone Healthcare is a growing multi-disciplinary physical medicine practice with over $3 million in annual revenue and a team of 35+ employees dedicated to delivering exceptional patient care. We specialize in Federal Workers Compensation, Personal Injury, & Aesthetics.  Our collaborative environment brings together providers and staff focused on improving patient outcomes while creating an efficient, positive experience for every patient we serve. We are seeking an experienced, highly organized, and results-driven  Director of Operations/Revenue Cycle Manager  to oversee the daily operations of our practice and help lead our next phase of growth. Position Summary The Director of Operations/Revenue Cycle Manager will be responsible for the overall administrative and operational...

Summary The Experienced Medical Billing Specialist provides best-in-class full RCM billing services for our private pediatric practice clients. Review claims for accuracy; oversee processing of claims to payers; resolve insurance company payments that are late, underpaid or denied; work closely with providers, practice managers and staff to implement best practice protocols. Responsibilities Learn and become proficient with the premiere pediatric system in the industry - Physician’s Computer Company (PCC) Billing. Efficiently analyze insurance claims throughout the submission process, insuring claims are accurately coded in a timely fashion, and for optimum reimbursement and compliance. Ensure that all claims reach the payers, and independently resolve any issues (underpayments, denials, etc.) with the claims so they are paid fully and on time. Post payments, organize processing of patient correspondence and statements. Answer phone inquiries from...

SCOPE/GENERAL PURPOSE OF JOB:   The Coding Specialist is responsible for abstracting all E/M, CPT, HCPCS, ICD-10-CM, modifier, and units from the medical record documentation.  Other responsibilities include accurately entering data into coding/billing software and/or Excel reports.  Performing accurate coding using applicable guidelines and facility protocols and communicating with staff and/or providers as needed.  Provide written feedback of coding results as needed in the form of comments, summary of findings, and recommendations.  Ensure compliance with federal and state laws, regulations and standards related to health information and coding principles.       ESSENTIAL DUTIES AND RESPONSIBILITIES:   Assign ICD-10 CM and CPT codes with modifiers for services provided in the facility environment (Ancillary, ED, Evaluation and Management, Observations, Outpatient surgeries, and/or Professional fee coding) depending on the specific...