24 ipa medical coder jobs found

Health Coder - Hcc & Risk Adjustment Burlingame, CA 94010 Overview Salary Range $42.79 - $48.75 Hourly Description The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. ESSENTIAL JOB FUNCTIONS: HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all...

The Healthcare Coder plays a critical role in supporting accurate and compliant coding for NEMS MSO operations with a focus on Medicare Risk Adjustment (RA) programs. This position ensures accurate capture of Hierarchical Condition Category (HCC) coding and improves risk adjustment scores by conducting chart audits, providing provider education, and supporting clinical documentation improvement (CDI) initiatives. The Healthcare Coder will collaborate closely with providers, clinical staff, and leadership to improve coding accuracy and compliance, directly impacting the organization's quality outcomes and financial performance. ESSENTIAL JOB FUNCTIONS: HCC Coding and Risk Adjustment (RA) Program Support Perform comprehensive review of patient charts to identify and validate diagnosis codes in alignment with HCC and risk adjustment guidelines. Ensure all coding adheres to CMS and ICD-10 guidelines, focusing on accuracy, completeness, and compliance. Conduct...

Position Purpose: The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines. Duties and Responsibilities: Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements. Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes. Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy. Collaborate with clinicians on the...

About Us: Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members. SUMMARY: The Junior Quality Improvement Coder is responsible for providing director support to all departmental QI initiatives. In this role, the Junior QI Coder will partner with the Director to collaborate with network providers and IPA’s to improve the quality of care through quality improvement activities that will include RAF, HEDIS, CMS Star Ratings and other health plan reporting. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Analyze data from contracted IPA network providers that allows for proper review of data to...

Position Purpose The Certified Medical Coder plays a crucial role in the Billing Department by ensuring precise and compliant coding of medical services. Under the guidance of the Billing Department Supervisor, the Coder will assign appropriate diagnosis and procedural codes for services provided by JWCH physicians, adhering to industry standards and legal requirements. This position involves validating and auditing coding practices to guarantee accuracy in billing, supporting optimal reimbursement, and maintaining adherence to regulatory guidelines. Duties and Responsibilities Serve as the primary liaison between providers and the Billing Department, effectively communicating to clarify diagnoses, procedures, coding, and documentation requirements. Recommend appropriate ICD-10-CM, CDT diagnosis codes, CPT codes, and HCPCS codes. Regularly review diagnosis and procedure coding within NextGen to ensure optimal billing accuracy. Collaborate with clinicians on the correct use of...

Location Address: 9521 San Mateo NE Albuquerque, NM 87113-2237 Compensation Pay Range: Minimum Offer $19.14 Maximum Offer $29.22 Now Hiring: IP Facility Coder with CCS - MEDICAL RECORDS CODING Summary: Codes any one of the following: inpatient and/or outpatient hospital records, ED records, Home Health & Hospice records and/or professional fee services for PMG specialty providers for the purpose of reimbursement, research and in compliance with Federal regulation according to diagnosis, operation and procedure using the ICD-9/10 CM and CPT-4 classification system. Ensures adherence to Hospital and Departmental Policies and Procedures Type of Opportunity: Full time Job Exempt: No Job is based: Reverend Hugh Cooper Administrative Center Work Shift: Varied Days and Hours (United States of America) Responsibilities: Reviews patients entire current medical record, assigning appropriate codes including CPT, ICD and MS-DRG (as defined by UHDDS guidelines and CMS) to...

Ann & Robert H. Lurie Children's Hospital of Chicago provides superior pediatric care in a setting that offers the latest benefits and innovations in medical technology, research and family-friendly design. As the largest pediatric provider in the region with a 140-year legacy of excellence, kids and their families are at the center of all we do. Ann & Robert H. Lurie Children's Hospital of Chicago is ranked in all 10 specialties by the U.S. News & World Report. Day (United States of America) Location 680 Lake Shore Drive Job Description Responsible for timely and accurate coding and abstracting of Inpatient visits. Codes and abstract patients following established coding guidelines and utilizing ICD-10 code sets. This position ensures that revenue cycle, customer service, quality, individual, and team goals are met. Essential Job Functions: Thorough review of inpatient encounter documentation for diagnoses, treatments, services. Performs daily...

Coding Specialist Responsible for timely and accurate coding and abstracting of Inpatient visits. Codes and abstract patients following established coding guidelines and utilizing ICD-10 code sets. This position ensures that revenue cycle, customer service, quality, individual, and team goals are met. Essential Job Functions: Thorough review of inpatient encounter documentation for diagnoses, treatments, services. Performs daily coding and abstracting utilizing ICD-10 Code sets and DRG Grouping systems. Validates MS-DRG and APR-DRG assignment for appropriateness to encounter Performs weekly coding of Inpatient Interim Bill Requests Review of Clinical Documentation Specialists notes and queries to ensure capture of queried conditions. Validates admission diagnosis assignment and coordinates correction with Case Management personnel when appropriate. Identifies documentation issues that may lead to incorrect coding, billing, and quality metrics. Communicates issues to...

Position Summary TheMedical Coder/Audit Specialist position is an exempt salaried position thatensures that AAAI's coding, documentation, and billing practices are accurate,compliant, and aligned with payer regulations. This role reduces risk exposure,strengthens revenue capture, manages payer portals, and supports providersthrough education and proactive auditing. This position supports timelysubmission of insurance claims to a wide variety of payers and functions as anintermediary between healthcare providers, clients, patients and healthinsurance companies. Must be certified from an accredited organization such as AAPC (CPC) (CCS) is required in coding and / or billing. Reports To: Medical PracticeAdministrator Principal Duties andResponsibilities 1.Revenue Protection & Growth Accurate Coding = Correct Reimbursement: Ensures all CPT/ICD-10 codes and HCPCS are properly supported, reducing underpayments. Audit-Driven Optimization: Identifies missed...

Working with Us Challenging. Meaningful. Life-changing. Those aren't words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You'll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible. Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Read more: careers.bms.com/working-with-us. The Regional Associate Director (RAD) is responsible for managing a team of...

Job Description Job Description Description: This position will perform collections and medical billing for various regional and national payers, including Federal, State, Third Party (HMO, PPO, IPA, TPA Indemnity) and Patient Billing. Qualified candidates must be able to (1) Review accounts for billing accuracy in order to maximize reimbursement. (2) Persuasive and tenacious follow-up on claims status (3) Appeal, and re-bill or forward claims for recalculation and / or adjudication as necessary. Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of Federal, State, PPO, HMO, and Indemnity Plans structure. Must meet or exceed the standard level of performance on assigned accounts. ESSENTIAL RESPONSIBILITIES: • Data entry, correct insurance assignment to patient accounts, insurance eligibility verification. Review/update demographics and patient information for accuracy. • Working knowledge of appropriate coding systems; CPT, ICD-9...

Job Description Primary Duties and Responsibilities The Specialist is responsible for resolving inquiries related to claims, eligibility, and authorization and working with multiple parties to ensure records are up to date. The Specialist will ensure first-call-resolution standards are followed and will refer and follow-up as per Hoag guidelines. Ensure accuracy, reports issues, and works to resolve. Ensure compliance and regulatory guidelines and health plan requirements are met. Documents actions taken following HIPAA guidelines. May assist in providing customer service, member services, and others in working with providers/billing offices when needed. Assist in identifying and reporting issues working with the management team to help minimize re-work and address front-end process issues. Performs other duties as assigned. Revenue Cycle May also maintains databases, audit information and works with patients to process patient payment. May follow up...

Current Employees: If you are currently employed at SOMC please log into UKG Pro to use the internal application process. Department: Health Information Management Shift/Schedule: Full Time (40 hrs/wk), Remote GENERAL SUMMARY Works under the supervision of the Health Information Reimbursement Manager. The primary job function of the HIM Coder Level I are to assign correct, ICD-10 and CPT codes to established diagnoses and procedures to outpatient (emergency room, same-day surgery, interventional radiology, observation and/or Urgent Care Center) and/or limited inpatient records. In some instances, may audit OP and /or IP records for charging accuracy. May be asked to add or delete charges for optimal reimbursement as well as compliance following coding and governmental guidelines. The level one coder has mastered a maximum of 2 work types. Performs other duties as assigned. QUALIFICATIONS Education: High School Diploma or successful completion of an...

Overview The Health Information Management Coder Inpatient Level 2 provides timely and accurate clinical and administration data to ensure optimal reimbursement for inpatient, rehab and/or skilled nursing coding to support the facility needs. Primary patient contact is only social. Demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to providing Extraordinary Care for Every Generation. Responsibilities Contributes to organization success targets for patient satisfaction. Formulates and uses effective working relationships with all members of the HIM department, physicians, external customers, patients, and other department staff members. Adheres to current coding rules, regulations and requirements for inpatient coding, DRG/APR-DRG assignment, rehab coding, skilled care coding, CMG assignment,...

Job Description Responsibilities • Reports to: Manager, Coding • The radiation oncology coder will be responsible to abstract orders, charges and related diagnoses from radiation oncology records to ensure services billed are consistent with the record documentation • The coder will ensure compliance with all the clinical billing and coding regulations and will work with the faculty and staff to ensure accurate documentation of billable services • The coder will determine and input appropriate ICD-10 CM and other codes for all radiation therapy procedures and analyze and validate that all charges are interfaced with the appropriate ICD10 and CPT codes • The coder will be become efficient with the record and verify system ARIA where they will review the department daily charges for accuracy prior to interface from ARIA to EPIC • Is always compassionate and empathetic for both patients and team members; makes eye contact, smiles and or greets every individual using the...

About the job Medical Coder Company Overview: Confident Staff Solutions is a leading staffing agency in the healthcare industry, specializing in providing top talent to healthcare organizations across the country. Our team is dedicated to helping healthcare facilities improve patient outcomes and achieve their goals by connecting them with highly skilled and qualified professionals. Overview: We are offering a HEDIS course to individuals looking to start working as a HEDIS Abstractor. Once the course is completed, we will connect you with hiring recruiters looking to hire for the upcoming HEDIS season. HEDIS Course: Includes - Medical Terminology - Introduction to HEDIS - HEDIS Measures (CBP, LSC, CDC, BPM, CIS, IMA, CCS, PPC, etc) - Interview Tips September 05, 2025 Self-Paced Course HEDIS Enrollment - Confident Staff Solutions

POSITION DESCRIPTION :The Compliance Auditor / Educator serves as the subject matter expert and as a point of contact for IHA offices and Revenue Department for proper coding procedures and workflow for existing medical services.Provides professional expertise and education in CPT, ICD and HCC coding.The Compliance Auditor / Educator is responsible for professional development of educational materials, clinical case studies, guidelines and job aides to provide direction and guidance across IHA departments and offices for coding and documentation regulations.This role is also responsible for responding to compliance-related coding and documentation issues via the event reporting system and managing them to proper resolution.Performs medical record integrity audits and conducts one-on-one meetings with Providers for corrective educational guidance.ESSENTIAL JOB FUNCTIONS :Develops and leads audit projects for medical record integrity, service line or issues-related audits, identifies...

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, and leadership programs And more Work Location: Atlanta, GA Description The Senior Compliance Auditor - Healthcare Provider provides expert leadership in evaluating and strengthening the organization's compliance program across clinical, billing, privacy, and operational domains. This role leads complex, risk-based compliance audits to ensure adherence to federal and state healthcare...

Collections And Medical Billing Specialist This position will perform collections and medical billing for various regional and national payers, including federal, state, third party (hmo, ppo, ipa, tpa indemnity) and patient billing. Qualified candidates must be able to (1) review accounts for billing accuracy in order to maximize reimbursement. (2) persuasive and tenacious follow-up on claims status (3) appeal, and re-bill or forward claims for recalculation and / or adjudication as necessary. Must possess detailed knowledge of all medical benefit levels and have a thorough understanding of federal, state, ppo, hmo, and indemnity plans structure. Must meet or exceed the standard level of performance on assigned accounts. essential responsibilities: data entry, correct insurance assignment to patient accounts, insurance eligibility verification. Review/update demographics and patient information for accuracy. working knowledge of appropriate coding systems; cpt, icd-9 and...

Responsibilities Remote Opportunity Independence Physician Management (IPM), a subsidiary of UHS, was formed in 2012 as the physician services unit of UHS. IPM develops and manages multi-specialty physician networks and urgent care clinics which align with UHS acute care facilities. It also provides select services for the Behavioral Health division of UHS. Through continuing growth, IPM operates in 11 markets across six states and the District of Columbia. Our leadership team, practitioners, and teams of healthcare professionals are collectively dedicated to improving the health and wellness of people in the communities we serve. To learn more about IPM visit Physician Services - Independence Physician Management - UHS. POSITION OVERVIEW Coder Certification Required . The Coder provides coding services and support to assigned IPM Markets/Billing Entities, as required, utilizing clinical documentation in multiple electronic health record (EHR) systems. Applies...

Job Description This is a remote position. BizTek People is hiring for the role of CERTIFIED UROLOGY CODER for our client in Lansing, Michigan Hospital Billing - Remote Coder CERTIFIED UROLOGY CODER Must have own equipment and urology coding experience Certifications Required GED Certified Professional Coding Certificate (AAPC), current with required continuing education CUC Skills & Experience Required 1 year of diagnostic and procedure coding experience Experience working in a multi-physician practice Working knowledge of CPT and ICD-10-CM Knowledge of computer billing systems, programs, and applications Detailed knowledge of medical records, anatomy, physiology, and disease processes Physician electronic filing experience covering all insurance carriers Job Details Provide procedure and diagnostic coding based on documentation in patient medical records Responsible for coding daily activities to support the revenue cycle...

Job Description Title: Medical Coder - Hematology/Oncology Clinic Duration: 12 Weeks Location: 100% Remote Job Description Review documentation of professional services in EPIC, obtain copies of chart notes, reports (i.e., admission/discharge records, patient medical records) and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services' (CMS) documentation of professional services and assign correct CPT, ICD-9-CM, and HCPCS codes. Utilizes ICD-9-CM, ICD-10, CPT codebook and Coding Clinic references to verify code specificity and follow ICD-9-CM Official Guidelines for Coding and Reporting and AMA Official Guidelines for CPT. Enter billing information into EPIC Resolute. Establish and maintain procedures and other controls necessary in carrying out all insurance billing activity. Monitor activity for compliance with federal and/or state laws regarding correct coding set forth by CMS and Oregon Medical...

Quality and Compliance Auditor Intervala is a full-service electronics manufacturing services (EMS) provider, delivering high-quality, complex printed circuit board assemblies, cable and harness assemblies, and electromechanical systems. We partner with customers in diverse industriesincluding industrial, medical, transportation, and defenseto bring innovative products to life. At Intervala, we combine advanced technology, engineering expertise, and a collaborative culture to ensure reliability, flexibility, and exceptional customer service. Responsible for conducting systematic audits of the Quality Management System (QMS) to ensure compliance with ISO 13485:2016 (Medical Devices) and AS9100D (Aerospace) standards. Supports a high-precision contract manufacturing environment specializing in Printed Circuit Board Assemblies (PCBA), full-box builds, and complex cable and harness assemblies. Primary guardian of compliance for high-reliability Electronic Manufacturing Services...

Job Summary This position will perform collections and medical billing for various regional and national payers, including Federal, State, Third Party (HMO, PPO, IPA, TPA Indemnity) and patient billing. Qualified candidates must review accounts for billing accuracy to maximize reimbursement, pursue tenacious follow‑up on claim status, appeal, re‑bill or forward claims for recalculation, and possess detailed knowledge of all medical benefit levels and federal, state, PPO, HMO and indemnity plan structures. Candidates must meet or exceed performance standards on assigned accounts. Essential Responsibilities Data entry and correct insurance assignment to patient accounts, verify insurance eligibility, and review/update demographics and patient information for accuracy. Apply appropriate coding systems (CPT, ICD‑9, HCPCS, coverage, LCD/NCD) and understand reimbursement associated with such codes. Process, validate payer requests and processed claims via correspondence, remittance...