24 cpc certified professional coder jobs found in Madison, WI

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. 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. Conduct a...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $24.65 - $27.10/hr based on experience * We are seeking candidates with experience in at least one of the following; Cardiology, Ortho, Podiatry, Radiology Oncology, OBGYN, Gynecology Oncology, Behavioral Health, RHC, Urology, Nephrology, Vascular, Neurosurgery and General Surgery. * The Forensic Coder is a certified coder with expert knowledge in front and back end coding.  This position is responsible for root cause analysis of trending front and/or back end identified coding opportunities; internal and external coding/documentation education; supporting and at times leading coding opportunity improvement projects. This position will also perform and/or assist with special coding projects as determined by leadership.       Job Responsibilities: Complete root cause analysis of...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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 attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

Humana Inc. seeks a Senior Medical Coding Professional, Inpatient, to support payment integrity by reviewing inpatient claims for coding accuracy, DRG assignment, and compliance with guidelines. You will report to the Manager, Payment Integrity. You will apply ICD-10-CM/PCS coding guidelines, assess reimbursement impact, conduct retrospective audits, and collaborate with clinical reviewers and data analysts to drive accurate DRG coding and financial outcomes. #J-18808-Ljbffr

**Company :** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs thorough medical record review to abstract medical and demographic data, interpret and apply diagnoses and procedures utilizing ICD and CPT coding systems and assists in decreasing the average accounts receivable days. **ESSENTIAL RESPONSIBILITIES** + Reviews and interprets medical information, physician treatment plans, course, and outcome to determine appropriate ICD-10 CM/CPT codes for diagnoses and procedures. (65%) + Abstracts data elements to satisfy statistical requests by the hospital, health system, medical staff, etc. and enters all coded/abstracted information into designated system. (15%) + Ensures efficient management of medical information and cash flow as it pertains to the unbilled coding report. (10%) + Keeps informed of the changes/updates in ICD-10 CM/CPT guidelines by attending appropriate training, reviewing coding clinics and other resources and...

Become a part of our caring community Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures, processes and techniques, and...

A leading health data company is seeking experienced inpatient coders to join their fully remote team. The ideal candidate will have at least 3 years of inpatient coding experience and certifications like CCS or RHIT. Responsibilities include coding, auditing, and ensuring high accuracy rates. Full-time employees enjoy comprehensive benefits including medical, dental, and 401k. The hourly pay range for this position is estimated at $32-$42. Join a values-driven team shaping the future of healthcare! #J-18808-Ljbffr

CVS Health is hiring a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU), ensuring coding accuracy and compliance across medical, behavioral health and related records. The CPC will audit CPT/HCPCS, ICD-10 and UB04 data, articulate findings to investigators and leadership, and help identify billing errors, potential fraud and opportunities for savings. This full-time role offers strong benefits and a focus on quality and integrity. #J-18808-Ljbffr

It's more than a career, it's a calling. WI-REMOTE Worker Type: Regular Job Summary Coordinates, organizes and prioritizes the work flow activities for the coding area. Primary Responsibilities Leads and/or coordinates shift operations, work assignments and daily priorities of assigned activities, resources, and/or associates. Serves as a leader through modeling, mentoring and training assigned staff. Manages assigned charge review and coding-related claim work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plan follow-up steps. Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer‑specific...

A leading AI development company is seeking proficient programmers to work remotely and contribute to advanced AI systems. You will take on dynamic coding tasks, write high-quality code, and evaluate AI-generated outputs. Ideal candidates should have fluency in English, experience with Kotlin and other programming languages, and a bachelor's degree (in progress is acceptable). Enjoy competitive pay, flexibility in projects, and a significant impact on future AI technologies. #J-18808-Ljbffr

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). The CPC will audit medical records for proper CPT/HCPCS coding and documentation, ensuring compliance with state, federal, and company guidelines. Strong communication and analytical skills are essential to articulate findings to investigators and regulators. The role requires 3+ years of coding experience, CPC certification, and knowledge of CPT/HCPCS, ICD-10, #J-18808-Ljbffr

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. 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. Conduct a...

A leading AI development company is seeking proficient programmers to join their remote coding team. You can set your own schedule and choose projects that fit your availability. Responsibilities include designing coding problems for AI systems and evaluating code for accuracy. Ideal candidates should be fluent in English, familiar with Kotlin, and proficient in various programming languages. Competitive hourly pay starts at $50+, with potential for higher rates based on performance. #J-18808-Ljbffr

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $24.65 - $27.10/hr based on experience * We are seeking candidates with experience in at least one of the following; Cardiology, Ortho, Podiatry, Radiology Oncology, OBGYN, Gynecology Oncology, Behavioral Health, RHC, Urology, Nephrology, Vascular, Neurosurgery and General Surgery. * The Forensic Coder is a certified coder with expert knowledge in front and back end coding.  This position is responsible for root cause analysis of trending front and/or back end identified coding opportunities; internal and external coding/documentation education; supporting and at times leading coding opportunity improvement projects. This position will also perform and/or assist with special coding projects as determined by leadership.       Job Responsibilities: Complete root cause analysis of...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position pays between $57,400 to $99,000 annually based on experience The Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client SOW. Provides guidance and leadership to coding and billing management in the implementation and administration of effective systems, processes, and procedures. Performs annual performance reviews and quality assurance reviews to assess comprehension of training efforts. Serves as a subject matter expert for professional fee coding for all involved personnel; ensures that information is accurate and current, meeting...

A healthcare facility in Dodgeville, WI is seeking a Medical Coding Team Lead to supervise and support a coding team. This full-time role involves mentoring coders, ensuring compliance with coding standards, and collaborating with healthcare providers. Requires an associate degree in Health Information Technology and relevant coding certifications. Benefits include comprehensive health packages, paid time off accruement from day one, and a retirement plan with matching dollars. #J-18808-Ljbffr

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note: Benefits may vary based upon position type and/or level. Job...

We are seeking a detail-oriented and experienced Medical Billing Specialist with a strong background in medical billing, coding, and insurance processes. The ideal candidate will be skilled in medical terminology, procedure coding, cost estimation, insurance appeals, and working within electronic health record systems. This role requires accuracy, excellent communication skills, and the ability to work with both patients and payers to ensure timely and correct reimbursement. This position may offer the opportunity to work from home, depending on experience and performance. Key Responsibilities: Accurately process and submit medical claims to insurance companies, government payers, and other third-party organizations. Perform medical coding using ICD-10, CPT, and HCPCS standards for a variety of procedures and diagnoses. Generate and communicate cost estimates for procedures based on insurance coverage and contract agreements. Review and verify accuracy of billing data within...

Current Madison College employees must apply to the internal career site by logging into Workday Job Posting Date: January 29, 2025 Application Deadline: Salary Information: Salary depends upon workload. Department: School of Health Science_OTA, MA, MC, OptTech, TM&Rad_PT Faculty Job Description: Madison College is recruiting a pool of highly motivated and qualified candidates to teach part time courses for the Medical Coding Specialist program. Applications will be accepted on a continuous basis for the 2025-2026 academic school year. If you possess the aspiration to help others succeed, this is an opportunity for you to positively impact the community and lives of our students. Madison College is a first-choice institution that offers exceptional educational opportunities to our students providing high-demand skills for professional and academic growth. Madison College's dedication to promoting equity, inclusion and diversity is reflected in our...

Medical Coding Specialist II Join the #1 hospital in Wisconsin! This is a full-time, 1.0 FTE position that is 100% remote. This will have flexible shifts scheduled Monday - Friday and will be discussed in the interview. Hours may vary based on the operational needs of the department. Applicants hired into this position can work from most states. This will be discussed during the interview process. To be eligible to work remotely, you must be in an approved remote work state for UW Health. We've included a link below to view the full list of approved remote work states. At UW Health, you will have: An excellent benefits package, including health and dental insurance, paid time off, retirement plans, two-week paid parental leave and adoption assistance. Options for a variety of schedules and shifts that offer flexibility and allow for work-life balance. Access to great resources through the UW Health Employee Wellbeing Department that supports your emotional, financial, and...

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). You will audit medical records for accuracy in CPT/HCPCS coding, summarize findings, and clearly communicate outcomes to investigators and regulators. Strong attention to detail and knowledge of CPT/HCPCS, ICD-10, CMS 1500, and UB04 are required. The role requires 3+ years of medical coding or auditing, CPC certification, and proficiency with Excel/Word. #J-18808-Ljbffr

Group Health Cooperative of South Central Wisconsin. BETTER TOGETHER Join our team as a Medical Coding Specialist! We are looking for a certified coding professional with strong attention to detail and a commitment to accuracy. Candidates should hold a CPC or CCS‑P certification and have completed an accredited Medical Coding Specialist Program or possess equivalent education and experience. Medical coding experience and insurance processing knowledge are preferred. The Medical Coding Specialist is responsible for reviewing electronic encounter documentation to verify that practitioner‑submitted codes are accurate, adhere to coding protocols, and comply with all applicable guidelines. This role is responsible for accurately assigning medical codes to patient records and supporting providers through education on coding and documentation requirements while contributing to coding‑related initiatives and research as needed. The position includes reviewing insurance claims to identify...

We are seeking a skilled Medical Biller to join our client's healthcare team in the United States. The ideal candidate will be responsible for accurately and efficiently processing medical claims and invoices, ensuring timely reimbursement from insurance companies and patients. The Medical Biller will work closely with healthcare providers, insurance companies, and patients to resolve billing discrepancies and ensure compliance with regulatory requirements. Job Responsibilities Claims Processing: Prepare and submit accurate medical claims to insurance companies, Medicare, and Medicaid for reimbursement. Billing: Generate and send invoices to patients for services rendered, following up on outstanding balances and resolving billing discrepancies. Insurance Verification: Verify patients' insurance coverage and eligibility, ensuring all necessary authorizations and referrals are obtained before services being rendered. Coding: Assign appropriate medical codes (ICD-10, CPT, HCPCS)...