967 coder reimbursement specialist jobs found

The goal is this position is to educate providers on proper use of CPT codes, ICD10 codes,  modifiers and audit activities related to health plan operations, risk adjustment, payer audits and  regulatory requirements. This role ensures accurate medical coding, documentation integrity, and  adherence to federal, state, and payer-specific guidelines. The ideal candidate will possess  advanced CPC coding expertise, strong analytical skills, and extensive experience  supporting compliance initiatives within a managed care or health plan environment. This is a full-time position, on site, 5 days a week. Responsibilities: • Serve as subject matter expert on CPT, HCPCS, ICD10 and modifier coding for physicians  and coders. • Ensure provider documentation and coding practices comply with CMS, Medicare,  Medicaid, commercial payer, and applicable federal and state regulatory requirements.  • Conduct coding compliance audits to identify...

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...

We are seeking a detail-oriented and experienced Medical Billing and Coding Specialist to join our growing team. This on-site position is ideal for a motivated professional who thrives in a fast-paced, collaborative environment while maintaining the ability to work independently. You will support multi-specialty clinics by ensuring accurate claim submission, resolving billing issues, and driving process improvements that contribute to organizational success. Key Responsibilities Review, code, and submit claims accurately and timely Manage assigned billing work queues and charge capture Investigate and resolve claim denials and rejections Analyze denial trends and recommend solutions Prepare and submit appeals with supporting documentation Utilize payer portals for claim corrections and resubmissions Collaborate with staff and providers to resolve billing issues Required Skills & Qualifications Advanced knowledge of ICD-10, CPT coding, and CMS...

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...

About the role:                                                        The Audit and Coding Specialist (“Audit and Coding Specialist”) is an integral member of Community Reach Center’s Quality Improvement (“QI”) Division. The Audit and Coding Specialist is responsible for managing all aspects of assigned projects, reviewing compliance standards to maintain quality assurance functions, and support risk management activities for the agency. Additionally, the Audit and Coding Specialist will have other duties and responsibilities as determined from time to time by the Utilization Manager. Essential Functions:  Designs and implements internal compliance audits, regularly monitoring accuracy and adherence to documentation requirements in collaboration with Utilization Manager to support continuous quality improvement and compliance as identified in the Quality Management Plan (QMP). Conducts audits as determined by the Manager or Director. Oversees...

Cardiology and Vascular Billing Specialist Location: Port Richey, FL Position Overview We are seeking a detail-oriented   Cardiology and Vascular Authorization and Billing Specialist   to join our team in Port Richey, FL. This role is responsible for ensuring timely insurance approvals (prior authorizations) for cardiac procedures and vein treatments, while managing accurate billing, coding (ICD-10, CPT), and reimbursement processes. The ideal candidate will prevent denials by verifying benefits, providing clinical documentation to payers, and coordinating with clinical staff for peer-to-peer reviews. Key Responsibilities Prior Authorization Acquisition:   Obtain authorization for appointments, tests, and complex vascular/cardiovascular procedures by reviewing clinical documentation and understanding payor guidelines. Clinical Collaboration:   Partner with physicians to gather medical necessity documentation for insurance reviews. Billing & Coding:...

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...