48 cpc certified professional coder jobs found in Worcester, MA

Job Description Job Description Seeking a Claims Reconsideration Coder for a temporary to permanent hire position with a prestigious insurance company in RI. This position is immediately available for the successful candidate. Experience is preferred; however, consideration will be given to newly certified applicants who have passed the certification exam and can present their certification number. This is a full-time position working 37 1/2 hours weekly, and offers a comprehensive benefits package when/if hired permanently. Responsibilities include, but are not limited to: Responsible for all aspects of Claim Reconsideration Requests and Contracted Provider Administrative Appeals including reviewing, resolving, adjusting, and development of written communication to providers Independently abstract and interpret of all medical notes required to determine if the services billed are supported for reimbursement using current industry standard coding, CMS guidelines, plan...

*May be eligible for hybrid work option for the right candidate within RI, CT, MA* Job Summary: Responsible for accurate coding of all Integra Community Care Network, LLC, and Women & Infants claims generated through inpatient services, outpatient services, outpatient professional services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS as well as other specialty systems as required by diagnostic category. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic for HCPCS), and CPT Assistant published by American Medical Association /ICD-10-CM Official Guidelines, CPT-4 manual, HCPCS and CMS coding guidelines. As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Coders may assist in...

*May be eligible for hybrid work option for the right candidate within RI, CT, MA* Job Summary: Responsible for accurate coding of all Integra Community Care Network, LLC, and Women & Infants claims generated through inpatient services, outpatient services, outpatient professional services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS as well as other specialty systems as required by diagnostic category. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic for HCPCS), and CPT Assistant published by American Medical Association /ICD-10-CM Official Guidelines, CPT-4 manual, HCPCS and CMS coding guidelines. As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Coders may assist in...

Join to apply for the Outpatient Coder II role at UMass Memorial Health . Position Details Exemption Status: Non-Exempt Schedule: Monday through Friday, 7:30 AM - 4:00 PM, Day Shift, 8 Hours Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) Job Description Interprets clinical and diagnostic documentation to process outpatient charges. Assigns ICD-CM, CPT codes, and modifiers according to official guidelines. May assign ICD-PCS codes based on account type. Responsibilities Review medical records and analyze documentation to assign appropriate codes and modifiers. Verify documentation supports assigned codes. Resolve issues related to incomplete or missing documentation. Participate in coding audits and performance management. Maintain a coding accuracy rate of at least 95%. Attend training and in-services annually. Assist in training staff on coding practices. Report backlog or documentation issues to...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Schedule Details: Monday through Friday Scheduled Hours: 40 hours Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5470 ED Coding and Revenue Capture Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless...

Codes a variety of medical records using CPT, HCPCS and ICD-10 codes for office, outpatient, inpatient, surgical, hospital ancillary, nursing facility, urgent care, ambulatory surgery center and other charges for physicians and other providers of pro Surgical, Medical, Coder, Remote, Health, Healthcare, Benefits

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Schedule Details: Monday through Friday Scheduled Hours: 7:30 AM - 4:00 PM Shift: Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available; a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver—regardless of their title or responsibilities. We are committed to exceptional patient care, academic excellence, and leading-edge research. Our team of over 16,000 employees works together as one health system to heal our patients, community, and each other. Every individual plays an important role every day. Job Description Interprets a wide...

Are you an internal caregiver, student, or contingent worker/agency worker at UMass Memorial Health? CLICK HERE to apply through your Workday account. Exemption Status: Non-Exempt Schedule Details: Monday through Friday Scheduled Hours: 730 - 400 Shift: 1 - Day Shift, 8 Hours (United States of America) Hours: 40 Cost Center: 99940 - 5458 Coding Services Union: SHARE (State Healthcare and Research Employees) This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process. Everyone Is a Caregiver At UMass Memorial Health, everyone is a caregiver - regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 16,000 employees, working together as one health system in a relentless pursuit of...

We are seeking a driven product-focused engineering manager for our MATLAB to C code compiler (MATLAB Coder). You will work with marketing to set product direction and then work with your team to execute the plan. Responsibilities Work with marketing to set product direction. Drive execution of the plan with your own team of engineers. Coordinate internal feature requests, and support cross-team initiatives. Mentor your team and provide technical direction. Contribute directly to the product through your own personal coding (30% of your time). Minimum Qualifications A bachelor's degree and 7 years of professional work experience (or equivalent experience) is required. 2 years management experience is required. Additional Qualifications Strong communication and interpersonal skills. Experience leading software projects developed in C++. Experience with Agile methodology. Knowledge of compiler implementation. Flair for software engineering....

Job Summary MathWorks has a hybrid work model that enables staff members to split their time between office and home. The hybrid model provides the advantage of having both in-person time with colleagues and flexible at-home life optimizations. Learn More: https://www.mathworks.com/company/jobs/resources/applying-and-interviewing.html#onboarding. We are seeking a driven product-focused engineering manager for our MATLAB to C code compiler (MATLAB Coder). You will work with marketing to set product direction and then work with your team to execute the plan. MathWorks nurtures growth, appreciates diversity, encourages initiative, values teamwork, shares success, and rewards excellence. Responsibilities Work with marketing to set product direction. Drive execution of the plan with your own team of engineers. Coordinate internal feature requests, and support cross-team initiatives. Mentor your team and provide technical direction. Contribute directly to the product through...

Join to apply for the Claims Reconsideration Coder role at Neighborhood Health Plan of Rhode Island 2 weeks ago Be among the first 25 applicants Join to apply for the Claims Reconsideration Coder role at Neighborhood Health Plan of Rhode Island Position Overview The Claims Reconsideration Coder (CRC) is a multidisciplinary Certified Professional Coder accredited through the American Academy of Professional Coders or Certified Coding Specialist accredited through American Health Information Management Association. This role will evaluate medical record documentation by abstracting the pertinent information that supports the services billed to allow a determination for payment or denial on claim submissions that meet the criteria for a medical note review. Relies on sound review methods applied to the content of the medical notes, benefits, payment policies, clinical medical policies, NCCI edits, CMS, coding manuals (CPT, HCPC, ICD-10), and other industry supported resources...

Job Posting Description To be considered a qualified candidate, you must be a seasoned and strong surgical coder with understanding of CCI edits and guidelines along with all the surgical modifiers, teaching attestations, and global periods and with experience writing appeals and NOC letters. Surgical coder candidates should have the skillset to work independently on their assigned surgical specialties. Additionally as requested to work collaboratively with team members to cross train and assist in other surgical-specialties. The Physician Specialty Coder will be responsible for: Performing ICD-10 review and complex CPT Coding Validation or ASA coding for assigned surgical specialty departments. Establishing and maintaining working relationships with Physicians to communicate and resolve specific case issues, as well as general questions and or coding principles. Developing and maintaining professional skills. Participating in professional organizations and staying abreast...

Responsibilities: Primary coding resource for assigned products and studies. ccurately codes assigned data fields including, but not limit ed to, adverse events using MedDRA and concomitant medications using WHO Drug in accordance with company coding conventions and ATC. Effectively performs coding related functions for assigned studies. Prepare and manage coding assignments for new studies and collaborate with clinical team representatives on approach to coding strategy for assigned products and oversight of assigned studies including sign off document as it impacts medical coding review, product approval, analysis of coded data for safety review and signal detection and patient safety. Identifies when terms or drug names are inadequate, ambiguous or unclear for coding purposes and direct query generation in such aspects. lso, identify and resolve coding discrepancies, and review coding listings for accuracy and consistency. Participate in...

Working under the supervision of the Central Billing Department Supervisors will share the responsibilities of being accessible to physicians, staff and patients regarding billing questions; assures that all billing functions are completed in a timely fashion and develops billing goals. Responsible for accurately coding provider's outpatient and inpatient visits based on the documentation provided and abstracting accurate and complete patient care data to ensure optimum and timely reimbursement. Applies knowledge of specialized information specific to coding and medical terminology according to all coding guidelines Reports to: Revenue Cycle Supervisor Manages: N/A Education/Training: High school diploma or equivalent Licenses/Certification: • CPC or AHIMA coding certification Required Qualifications and Skills: Minimum of 1-2 years of medical billing experience in either charge, payment or follow-up work Minimum of 1-2 year of coding experience for primary care,...

Summary: Under the general supervision of the Coding Manager and according to established procedures, accountable for assignment of diagnoses and procedures using ICD10 CM/PCS and CPT Codes. Requires knowledge of all aspects of hospital coding and strong understanding of coding guidelines. Abstracts required data into hospital information system. Ensure records are coded in an accurate and timely manner. Interprets a wide variety of clinical and diagnostic documentation, including complex medical treatment to identify diagnoses, complications, comorbidities and procedures associated with inpatient care. Education: In addition to the skills normally obtained through completion of a High School education, a Bachelor or Associates Degree is preferred. Licensure: One of the following is required: •Certified Coding Specialist (CCS) •Registered Health Information Technician (RHIT) •Registered Health Information Administrator (RHIA) Experience: Three years of experience as a hospital...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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...

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. Specifications: High school graduation plus active certification as a Certified Coding Specialist (CCS) with evidence of additional education in Medical Terminology and Anatomy & Physiology required. Minimum of 2 year’s experience in a hospital inpatient or outpatient setting required. Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and...

Job Summary : Responsible for accurate coding of all outpatient services, procedures, diagnoses, and conditions, working from the appropriate documentation in the medical record. - Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS, as well as other specialty systems as required by diagnostic category. - All work must be carried out in accordance with the rules, regulations, and coding conventions of the American Hospital Association (Coding Clinic), ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS, and CMS coding guidelines. - As needed, Coders may assist and serve as a resource for data integrity for other employees requiring clarification and assistance in coding. Requirements: Must have at least three (3) years of hospital or surgical center coding experience within the last five years. Certification: This position requires certification as a Certified Coding Specialist (CCS) and/or five (5) years of compensatory experience. Completion of classes in medical...

Datavant is a data platform company and the world’s leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world’s leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you’re stepping onto a high-performing, values-driven team. Together, we’re rising to the challenge of tackling some of healthcare’s most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for 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 position can be fully remote based on the work activity. A certification as a Certified Coding Specialist (CCS) is required for this position. Job Summary: Responsible for accurate coding of all outpatient services, procedures, diagnoses, and conditions, working from the appropriate documentation in the medical record. Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS as well as other specialty systems as required by diagnostic category. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS and CMS coding guidelines. As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Requirements: Must have at least three (3) years hospital or surgical center coding experience within the last five years. Certification: This position requires certification as...

This position can be fully remote based on the work activity. A certification as a Certified Coding Specialist (CCS) is required for this position. Job Summary: Responsible for accurate coding of all outpatient services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record. - Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS as well as other specialty systems as required by diagnostic category. - All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCSand CMS coding guidelines. - As needed, Coders may assist and be a resource for data integrity for other employees who need clarification and assistance in coding. Requirements: • Must have at least three (3) years hospital or surgical center coding experience within the last five years • Certification: This position requires...

Responsible for accurate coding of all outpatient services, procedures, diagnoses, and conditions, working from the appropriate documentation in the medical record. - Classification systems include ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS, and other specialty systems as required by diagnostic category. - All work must be carried out in accordance with the rules, regulations, and coding conventions of the American Hospital Association (Coding Clinic), ICD-9-CM/ICD-10-CM, ICD-10 PCS, CPT, HCPCS, and CMS coding guidelines. - Coders may assist and serve as a resource for data integrity for other employees requiring clarification and assistance in coding. Requirements: At least three (3) years of hospital or surgical center coding experience within the last five years. Certification as a Certified Coding Specialist (CCS) and/or five (5) years of compensatory experience. Completion of courses in medical terminology, anatomy and physiology, ICD-9, ICD-10, CPT coding conventions, and...

Summary: Responsible for reviewing patient medical records after a visit and translating the information into codes that insurers use to process claims from patients. Duties include confirming treatments with medical staff, identifying missing information and submitting information to insurers for reimbursement. Participates in peer review to ensure accuracy and timeliness standards are maintained. Resolve complex coding questions that arise from team. Does this position require Patient Care? No Essential Functions: Evaluates medical record documentation and coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support outpatient visits and to ensure that data complies with legal standards and guidelines. -Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10 and CPT codes. -Provides technical guidance to...

When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives. The OP Coder Project Specialist will review outpatient records and accurate, timely, and compliant assignment of ICD-10-CM, CPT, HCPC, and modifiers to ensure the correct APC assignment. The OP Coder Project Specialist will work closely with the Coding leadership, and OP Coding Validators to ensure coding uniformity, consistency, and accuracy with ICD-10-CM, CPT, Official Coding Guidelines, Federal and State regulations, the American Hospital Association coding guidelines and its publication Coding Clinic. The OP Coder Project Specialist is also responsible for meeting or exceeding quality and quantity expectations while performing coding functions to support timely coding and billing. Job Description: Essential Duties & Responsibilities: Professional Coding Responsibilities: Provides review and/or coding of any professional services including but...