123 cpc certified professional coder jobs found in Pawtucket, RI

Women & Infants Hospital seeks an HIM Certified Coder to review medical records and assign diagnosis and procedure codes using ICD-9CM, CPT and HCPCS, in line with coding guidelines. The role requires CCS certification; CPC candidates may be considered but must pass CCS within one year. Minimum 2 years in a hospital setting; high school diploma; terminology and anatomy knowledge preferred. #J-18808-Ljbffr

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. Duties & Responsibilities Reviews Patient's records for procedures and diagnosis. Enters and maintains codes in the computer system. Planning, Productivity and Decision Making. Preserves and protects patients' rights to confidentiality. Performs other job- related duties as requested. Requirements High school graduation plus active certification as a Certified Coding Specialist (CCS) with evidence of additional education in Medical Terminology and Anatomy & Physiology required. Certified...

SUMMARY: Under general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Review all denied claims, correct them in the system and send correctedppealed claims asbr / written correspondence, fax or via electronic submission. Identify and analyze denials and enact corrective measures as needed to effectivelybr / communicate and...

Summary Reporting to the Manager of Professional Coding, the Professional Coding Specialist is responsible for the accurate review, interpretation, and assignment of ICD-10-CM, CPT, and HCPCS Level II codes for physician and other qualified healthcare provider services. This role ensures coding accuracy and compliance with federal regulations, payer guidelines, and organizational policies to support appropriate reimbursement and minimize audit risk. Summary Reporting to the Manager of Professional Coding, the Professional Coding Specialist is responsible for the accurate review, interpretation, and assignment of ICD-10-CM, CPT, and HCPCS Level II codes for physician and other qualified healthcare provider services. This role ensures coding accuracy and compliance with federal regulations, payer guidelines, and organizational policies to support appropriate reimbursement and minimize audit risk. The Coding Specialist collaborates with providers, revenue cycle teams, and clinical...

Brown University Health is seeking a Professional Coding Specialist to accurately review and assign codes for physician services in a fully remote role. You will interpret ICD-10-CM, CPT, and HCPCS Level II guidelines to ensure compliant billing and minimize audit risk. In this position you will collaborate with providers, revenue cycle, and clinical teams while maintaining HIPAA privacy, and adhering to CMS and payer policies. #J-18808-Ljbffr

Summary Brown University Health is seeking a highly motivated Full-Stack AI Developer to join a government-funded research team working at the intersection of artificial intelligence, digital health, and public health interventions. The ideal candidate will play a key role in the development and optimization of multimodal AI models, AI-driven chatbots, and agent-based modeling frameworks, contributing to research on HIV prevention, sexually transmitted infection (STI) prevention, nutrition counseling, overdose prevention, and opioid use disorder (OUD) treatment. C. A. R. E. Values Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core...

Full-Stack AI DeveloperBrown University Health is seeking a highly motivated Full-Stack AI Developer to join a government-funded research team working at the intersection of artificial intelligence, digital health, and public health interventions. The ideal candidate will play a key role in the development and optimization of multimodal AI models, AI-driven chatbots, and agent-based modeling frameworks, contributing to research on HIV prevention, sexually transmitted infection (STI) prevention, nutrition counseling, overdose prevention, and opioid use disorder (OUD) treatment.Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect and Excellence, as these values guide our everyday actions with patients, customers and one another.In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success...

Summary: Under the general supervision of the Coding Manager and according to established procedures, accountable for assignment of diagnoses and procedures for outpatient surgical and other services. Interprets clinical and diagnostic documentation and assigns appropriate ICD-10 (current edition) and / or CPT codes as well as modifiers, ED facility levels, Infusions/Injections and other charges as appropriate adhering to official coding guidelines. Requires knowledge of hospital coding, ambulatory classifications and coding guidelines. Abstracts required data into hospital information system. Ensure records are coded in an accurate and timely manner. Education: High School diploma or equivalent required. Licensure: Medical coding certification and training in medical terminology from an accredited program preferred. Recognized programs include: American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC). Must complete and pass...

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...

Brown University Health seeks a Professional Coding Specialist to review and assign ICD-10-CM, CPT, and HCPCS Level II codes for physician services. This role emphasizes accuracy, CMS/NCCI compliance, and collaboration with providers and revenue cycle teams. The ideal candidate has 1-3+ years of physician-based coding, CPC and/or CCS/CCS-P, and strong knowledge of coding guidelines. This is a fully remote position based in Providence, RI with standard work hours. #J-18808-Ljbffr

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. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical...

Certified Professional Coder (CPC)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.Position SummaryThe Certified Professional Coder (CPC) will perform medical claim reviews 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.Activities...

Claims Follow-Up SpecialistUnder general supervision of the Follow-up Supervisor, performs all duties necessary to follow up on outstanding claims and correct all denied claims for a large physician multi-specialty practice. Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate.Responsibilities:Review all denied claims, correct them in the system and send corrected appealed claims as written correspondence, fax or via electronic submission.Identify and analyze denials and enact corrective measures as needed to effectively communicate...

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. What We’re Looking For We’re looking for experienced and credentialed inpatient 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...

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. Position Summary The Certified Professional Coder (CPC) will perform medical claim reviews 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. Activities include: Conduct a...

Certified Outpatient CoderThe role of a Certified Outpatient Coder at Care New England is to ensure accurate assignment of ICD-10 CM, CPT and HCPCS codes on a wide range of patient medical records for outpatient services. Outpatient services include, but are not limited to observation, surgical, provider-based visits, interventional radiology, emergency room, oncology, and other specialty services. A proficient understanding and execution of coding guidelines to ensure accuracy of coding and maintain records in accordance with accepted medical and legal standards.Adherence and compliance to various regulatory guidelines from CMS, AHA and AMA.Duties & ResponsibilitiesAnalyze medical records, extracting clinical, pathological, therapeutic and epidemiologic data in accordance with established ICD-10-CM coding principles and guidelinesAssigns Codes and codes all diagnostic and operative information from the medical record using ICD-10-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS coding...

Certified Outpatient Coder The role of a Certified Outpatient Coder at Care New England is to ensure accurate assignment of ICD-10 CM, CPT and HCPCS codes on a wide range of patient medical records for outpatient services. Outpatient services include, but are not limited to observation, surgical, provider-based visits, interventional radiology, emergency room, oncology, and other specialty services. A proficient understanding and execution of coding guidelines to ensure accuracy of coding and maintain records in accordance with accepted medical and legal standards. Adherence and compliance to various regulatory guidelines from CMS, AHA and AMA. Duties & Responsibilities Analyze medical records, extracting clinical, pathological, therapeutic and epidemiologic data in accordance with established ICD-10-CM coding principles and guidelines Assigns Codes and codes all diagnostic and operative information from the medical record using ICD-10-CM/ICD-10-CM, ICD-10 PCS, CPT,...

eClinical Solutions, LLC in the United States is seeking a Medical Coder to lead centralized coding activities and SAE reconciliation for assigned clinical trials, ensuring accuracy and regulatory compliance across coding processes and pharmacovigilance data. In this role you will design guidelines, perform MedDRA/WHODrug coding, review terms, collaborate with safety and data management teams, document decisions, and support tooling maintenance within the elluminate platform. #J-18808-Ljbffr

eClinical Solutions helps life sciences organizations around the world accelerate clinical development initiatives with expert data services and the elluminate Clinical Data Cloud - the foundation of digital trials. Together, the elluminate platform and digital data services give clients self-service access to all their data from one centralized location plus advanced analytics that help them make smarter, faster business decisions. eClinical Solutions is committed to driving innovation in clinical trials through a better approach to data management and data analytics. We use the eClinical Solutions technology platform, elluminate , throughout the data management process to accelerate timelines for our clients and automate manual processes. We believe in a more agile approach to data management using our core technology elluminate - enabling our life sciences clients to proactively manage their clinical programs and make decisions. You will make an impact: The Medical Coder is...

Medical Physician Coder | Boston Childrens Hospital Position Summary Performs coding validation and review of charges for assigned medical departments to ensure timely and compliant submission of charges. Assigns, sequences, validates, and/or edits codes for assigned medical departments. Initiates, reviews, and/or edits physician queries in compliance with company policy, when appropriate. Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to ensure coding knowledge and skills remain current. Key Responsibilities Performs complex ICD-10 and CPT review and validation or ASA coding for assigned primary or medical departments. Establishes and maintains working relationships with Physicians to resolve specific case issues, as well as general questions and or principles. Participates in coding and reimbursement training programs. Provides instruction and education to staff on accurate charge entry and medical...

Boston Children’s Hospital is seeking a Physician Medical Coder to perform coding validation and review of charges across departments, ensuring timely and compliant submission of charges. The role requires CPC certification, two years physician coding experience, and a strong knowledge of ICD-10-CM and CPT-4/ASA. You will collaborate with physicians, provide education, and stay current on billing guidelines and payer rules. #J-18808-Ljbffr

Boston Children’s Hospital in Westwood seeks a Medical Physician Coder to validate and review charges, ensuring timely and compliant submissions. You will assign, sequence, validate, and edit codes for assigned departments and engage physicians for queries as needed. Two years of physician coding experience is required, with CPC certification and strong knowledge of ICD-10/CPT. This is a full-time on-site role located in Westwood, MA. #J-18808-Ljbffr

Medical Physician Coder | Boston Childrens HospitalPosition Summary Performs coding validation and review of charges for assigned medical departments to ensure timely and compliant submission of charges. Assigns, sequences, validates, and/or edits codes for assigned medical departments. Initiates, reviews, and/or edits physician queries in compliance with company policy, when appropriate. Reviews all official data quality standards, coding guidelines, company policies and procedures, and clinical/medical resources to ensure coding knowledge and skills remain current.Key ResponsibilitiesPerforms complex ICD-10 and CPT review and validation or ASA coding for assigned primary or medical departments.Establishes and maintains working relationships with Physicians to resolve specific case issues, as well as general questions and or principles.Participates in coding and reimbursement training programs. Provides instruction and education to staff on accurate charge entry and medical record...