97 cpc certified professional coder jobs found in Providence, RI

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: 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...

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...

CVS Health is seeking a Certified Professional Coder (CPC) to perform medical claim reviews for the Special Investigations Unit (SIU). The role ensures coding accuracy and compliance by auditing CPT/HCPCS and modifiers against medical records. You will discuss findings with investigators and regulators, identify billing errors and potential fraud, and maintain up-to-date knowledge of coding guidelines across CMS and payer requirements. #J-18808-Ljbffr

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...

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...

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...

Women & Infants Hospital in Providence, RI is hiring a HIM Certified Coder to review medical records and assign Diagnosis and Procedure codes using ICD-9CM/ICD10, CPT, and HCPCS according to coding conventions. The role requires CCS certification with related education in medical terminology and anatomy, plus at least 2 years of hospital coding experience. CPC candidates may be considered but must complete the CCS exam within one year. #J-18808-Ljbffr

Job TitleHIM Certified CoderJob SummaryThe 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 & ResponsibilitiesReviews 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.RequirementsHigh school graduation plus active certification as a Certified Coding Specialist (CCS) with evidence of additional education in Medical Terminology and Anatomy & Physiology required. Certified...

Job Summary 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, HCPCS coding...

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...

Medical Coder/Biller – Full Time Child Health Associates is looking for an experienced Medical Coder/Biller to join our Billing team! We're looking for someone with strong Evaluation & Management (E/M) coding experience who is detail-oriented, organized, and enjoys working collaboratively to support accurate coding, timely billing, and quality patient care. This is a full-time, on-site position based in our Auburn office. What You'll Do Review provider documentation and assign accurate ICD-10-CM, CPT, HCPCS, and E/M codes. Ensure coding is compliant with CMS guidelines, payer requirements, and current coding regulations. Submit and monitor insurance claims for timely reimbursement. Review documentation to ensure it supports the appropriate level of E/M services and identify opportunities for improvement. Research and resolve claim denials, coding edits, and payment discrepancies. Work closely with providers and staff to improve documentation and coding accuracy. Perform...

Child Health Associates in Auburn, MA is seeking an experienced Medical Coder/Biller to join our Billing team. The role focuses on accurate ICD-10-CM, CPT, HCPCS and E/M coding to support timely reimbursement and quality patient care. The candidate should have 2-3 years of medical coding and billing experience, including E/M coding, and be proficient with ICD-10-CM, CPT, HCPCS, CMS guidelines, and EPIC or another EHR system. This is a full-time, on-site position based in our Auburn office. #J-18808-Ljbffr

Child Health Associates is seeking an experienced Medical Coder/Biller for our Auburn, MA office. The role focuses on accurate ICD-10-CM, CPT, HCPCS and E/M coding to support timely billing and quality patient care. You will review documentation, ensure CMS and payer guideline compliance, submit claims, and work with providers to improve coding accuracy. The position is full-time and on-site in Auburn, MA. #J-18808-Ljbffr

Signature-Healthcare in Massachusetts seeks a qualified coder to ensure accurate documentation, coding (CPT/HCPCS/ICD10) and billing for ambulatory services. The role involves delivering feedback to providers to improve coding and documentation practices, while upholding coding guidelines and regulatory requirements. Candidates must be a member of AAPC or AHIMA and credentialed as CCS-P, CPC or COC, with CRC preferred. #J-18808-Ljbffr

Coder Under the general supervision of the Ambulatory Coding Manager, the primary function of the coder is to ensure accurate documentation, coding (CPT/HCPCS/ICD10) and billing of service provided. The coder provides feedback, insight and guidance to providers regarding their coding and documentation practices. The coding position helps to insure compliance with established coding guidelines, third party and governmental policies, regulations and guidelines. Must be a member of AAPC or AHIMA. Must be credentialed as CCS-P, CPC, COC. Credentialed as CRC is preferred.

Coder/Abstractor Day Kimball Health is hiring a Coder/Abstractor for our Ambulatory Location: Putnam, CT Shift: Day Shift, 40 Hours Coder/Abstractor Job Summary Under the general supervision of the Coding, Reimbursement & Quality Assurance Supervisor; performs all phases of abstracting, diagnosis coding, and transmission of diagnosis codes to the Business Office, charge capture and posting through record analysis. Coder/Abstractor Key Responsibilities Reviews medical records for completeness in order to abstract and code clinical data, such as diseases, operations, procedures, and therapies, using standard classification systems and DKH Facility Coding Guidelines. Documents all coding discrepancies Reviews for and enters charges for outpatient service locations as applicable related to documentation to ensure that the documentation supports the billed services. Works with Revenue Integrity, CDI, Denials Management, and Case Management departments to clarify...

Coder/Abstractor Day Kimball Health is hiring a Coder/Abstractor for our Ambulatory Location: Putnam, CT Shift: Day Shift, 40 Hours Coder/Abstractor Job Summary Under the general supervision of the Coding, Reimbursement & Quality Assurance Supervisor; performs all phases of abstracting, diagnosis coding, and transmission of diagnosis codes to the Business Office, charge capture and posting through record analysis. Coder/Abstractor Key Responsibilities Reviews medical records for completeness in order to abstract and code clinical data, such as diseases, operations, procedures, and therapies, using standard classification systems and DKH Facility Coding Guidelines. Documents all coding discrepancies Reviews for and enters charges for outpatient service locations as applicable related to documentation to ensure that the documentation supports the billed services. Works with Revenue Integrity, CDI, Denials Management, and Case Management departments to clarify...

Day Kimball Health is seeking a Certified Coder/Abstractor for the Ambulatory Care Unit in Putnam, CT. You will perform abstracting, diagnosis coding and charge posting, ensuring documentation supports billed services. Requires AHIMA RHIT/CCS/CCS-P or AAPC CPC/CPC-H and training in medical terminology, anatomy and physiology. Position offers a day shift, 40 hours weekly, with competitive benefits; join a nonprofit healthcare provider serving Northeastern Connecticut. #J-18808-Ljbffr

Day Kimball Health in Putnam, CT is seeking a Coder/Abstractor to perform comprehensive coding, abstracting, and charge posting under the supervision of the Coding, Reimbursement & Quality Assurance Supervisor. You will review records, ensure documentation supports billed services, and transmit codes to the Business Office, collaborating with Revenue Integrity and CDI teams to clarify and resolve denials. #J-18808-Ljbffr

Day Kimball Health in Putnam, CT is hiring a Certified Coder/Abstractor for our Ambulatory Care Unit. You will perform abstracting, diagnosis coding, and transmission to the Business Office, ensuring accurate documentation and posting through the record analysis. The role requires AHIMA RHIT/CCS or AAPC CPC/CPC-H certification within 6 months, two years of college with medical terminology training, and proficiency with multiple EMR systems. #J-18808-Ljbffr

Coder/AbstractorDay Kimball Health is hiring a Coder/Abstractor for our Ambulatory Location: Putnam, CT Shift: Day Shift, 40 HoursCoder/Abstractor Job SummaryUnder the general supervision of the Coding, Reimbursement & Quality Assurance Supervisor; performs all phases of abstracting, diagnosis coding, and transmission of diagnosis codes to the Business Office, charge capture and posting through record analysis.Coder/Abstractor Key ResponsibilitiesReviews medical records for completeness in order to abstract and code clinical data, such as diseases, operations, procedures, and therapies, using standard classification systems and DKH Facility Coding Guidelines. Documents all coding discrepanciesReviews for and enters charges for outpatient service locations as applicable related to documentation to ensure that the documentation supports the billed services.Works with Revenue Integrity, CDI, Denials Management, and Case Management departments to clarify account/coding issues to...