81 medical billing specialist i jobs found

A healthcare provider in Evansville is looking for a compassionate Authorization Benefit Specialist I to ensure timely pre-certifications for outpatient procedures. This role requires excellent communication and multitasking skills, with an emphasis on providing professional service to physicians. The ideal candidate will have a high school diploma and two to four years of experience in medical billing or a similar field. Flexible work schedules and various benefits are offered in a hybrid work environment. #J-18808-Ljbffr

A leading healthcare institution in New York is seeking a Faculty Group Practice Billing Representative I to manage medical billing tasks, including submitting claims and following up on unpaid balances. The ideal candidate will have experience in medical billing and accounts receivable, alongside a high school diploma or GED. This role involves effective communication with patients and providers to ensure accurate claims processing. Join us to be part of a collaborative team dedicated to enhancing patient experiences and achieving excellence in billing processes. #J-18808-Ljbffr

Overview THE POSITION: Under general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. Ideal Candidate The ideal candidate has specialized expertise in mental health billing, including CPT, ICD-10, and HCPCS coding for Medicare and Medi-Cal. They are skilled in the Medi-Cal Provider Manual and TAR process, ensuring timely, compliant submissions that support access to behavioral health services. They communicate effectively with peers, patients, and payers, resolve billing discrepancies, and address compliance issues in collaboration with the compliance office. They have experience in leading and training staff on Managed Care, Medicaid, Medi-Cal, Medicare, and Commercial Insurance, and ensure accuracy, efficiency, and regulatory adherence in all mental health billing operations. Medical Billing Specialist...

THE POSITION Under general direction (III, IV), performs and is responsible for billing and processing claims appropriately for timeliness in reimbursement and billing compliance with Medi-Cal, Medicare, and general insurance reimbursement requirements. IDEAL CANDIDATE The ideal candidate has specialized expertise in mental health billing, including CPT, ICD-10, and HCPCS coding for Medicare and Medi-Cal. Skilled in the Medi-Cal Provider Manual and TAR process, they ensure timely, compliant submissions that support access to behavioral health services. They communicate effectively with peers, patients, and payers, resolve billing discrepancies, and address compliance issues in collaboration with the compliance office. Experienced in leading and training staff on Managed Care, Medicaid, Medi-Cal, Medicare, and Commercial Insurance, they ensure accuracy, efficiency, and regulatory adherence in all mental health billing operations. Medical Billin g Specialist III ( $ 25.10 - $31.86...

A community health center in Milwaukee is seeking a coding specialist to review and code clinical data for billing and data collection. The ideal candidate will have at least 1 to 2 years of experience with ICD-10, CPT, and HCPCS coding. Strong teamwork, attention to detail, and communication skills are essential. This role offers opportunities for professional development and adherence to ethical coding standards. #J-18808-Ljbffr

Coder/Quality Review Analyst This position is responsible for timely and accurate quality review of both internal and vendor coding team members to assure compliance with coding guidelines and standards in addition to their foundation coding responsibilities. The position performs quality checks on coding and provides feedback to coders to assure the timely and accurate coding of medical charts for billing. This position also reviews and responds to coding-based denials for inpatient, hospital outpatient and professional fee claims and advises leadership on trends related to denials. In collaboration with HIM coding management, the coder/quality review analyst will assist with selection of coders and encounters to be reviewed, as well as education to be presented to the coder based on review outcomes. The coder/quality review analyst will also bring forward any issues related to documentation or systems as they are discovered during the review process. This position participates...

Overview Assists in the provision of an efficient and effective clinical coding service within Carle by providing accurate and timely auditing and coding education to providers and coding team members to include CPT EM coding, CPT Procedural Coding, ICD10CM and ICD10 PCS coding, as applicable. Assist Coding Audit and Education Supervisor in managing audits and audit schedules for providers and coding team members. Auditors work closely with HIM leadership and Compliance to assure Carle providers and coding team members are following all regulatory requirements for code assignment. Auditors help identify training needs through ongoing internal provider and staff audits and assist with remediation and reaudit post education. Auditors are responsible to produce coding education materials in formats such as power point or LMS educations systems. Responsibilities Provide regular coding audits to Carle medical staff and HIM coding team members specific to CPT E/M, CPT...

If you're ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview The Professional Fee Coder is part of a team which has full responsibility for the efficient and accurate flow of coded charges. Applies the appropriate diagnoses, surgical and procedural codes to individual patient health information for data retrieval, analysis and claims processing. Works closely with departments to optimize reimbursement, ensure charge capture, reduce late charges and provide feedback to providers. Provides physicians routine feedback on documentation and compliance standards. Resolves pre-bill edits and appropriate follow-up. Exercises judgment within generally defined practices and policies in selecting methods and techniques for obtaining solutions. Receives no instructions...

Coder II Job Summary: The Coder II is proficient in three or more types of outpatient, Profee, or low acuity inpatient coding. The Coder II may code low acuity inpatients', one time ancillary/series, emergency department, observation, day surgery, and/or professional fee to include evaluation and management (E/M) coding or profee surgery. For professional fee coding, individuals in this job code will be proficient for inpatient and outpatient, for multi-specialties. The Coder II utilizes the International Classification of Disease (ICD-10-CM. ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS) including Current Procedural Terminology (CPT) and other coding references to ensure accurate coding. Coding references will be used to ensure accurate coding and grouping of classification assignment (e.g., MS-DRG, APR-DRG, APC etc.) The Coder II will abstract and enter required data. Essential Functions Of The Role: Analyzes and interprets documentation from medical...

Your job is more than a job The Coding Senior will be responsible applying the appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes and determining the MS-DRG and APR-DRG assignment of in patient records across multiple specialties (cardiology, cardiothoracic surgery, trauma, orthopedics, general medicine and surgery, pediatrics, obstetrics, newborns, etc.) or applying the appropriate ICD-10 diagnostic and CPT procedure codes for ambulatory records across multiple specialties (i.e. family medicine, internal medicine, cardiology [IR], cardiothoracic surgery, interventional radiology, trauma, orthopedics, general surgery, urology, gynecology, etc.). The Coding Senior may be assigned any of the coding functions of a Coding Specialist I. Your Everyday Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs assignment and all required modifiers. Validates...

Coder Trainee Position Purpose: All responsibilities of coder trainee, coder I, II plus the following: Monitors and responds to accounts on Pre-Bill edit and error reports. Assists with training other coders as requested. Performs PHC4 coding corrections; provides feedback to coders who made errors. Monitors the Daily Cirius Error report to ensure that there are 0 accounts exceeding the expected completion timeframe. Review and respond to the Pre-Bill Edit report issues to ensure timely billing. Assists with special projects as requested. Responsibilities: Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care and assign appropriate codes. Review appropriate documents in the patients' charts to accurately assign a diagnosis and/or procedure. Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG/APC/ASC or payment tier under the Prospective...

Powers Health is hiring a Coder I - Outpatient Diagnostics/Medical Necessity in our Health Information Department! Remote Alternating weekly schedule: M-F 7:00 am - 3:30 pm - flexible hours after training Job Description: Based on documentation in the medical record, responsible for accurate ICD-10-CM, CPT and HCPCS code assignment in accordance to industry standards such as Official Coding Guidelines, CPT Assistant, and the National Correct Coding Initiative. Reviews and analyzes outpatient documentation in the EMR and utilizes computerized-assisted coding software to accurately assign ICD-10-CM, CPT and HCPCS codes to appropriate diagnoses and procedures. Maintains or exceeds minimum coding accuracy and productivity standards per unit procedure. Possesses knowledge of Medicare medical necessity regulations, ABN, NCCI, OCE edits and proper modifier usage. Works closely with physicians, physician support staff, internal and external customers as it...

Job Description Job Description The Professional Review Specialist provides analysis of medical services to determine appropriateness of charges on multiple types of medical bills to determine appropriateness of medical care. This position will be in our Hartford, CT office during training, and once fully trained transitioned to a hybrid work arrangement. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned KNOWLEDGE & SKILLS: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of...

Hours of Work : Flexible 8 am - 4:30 pm Days Of Week : Monday through Friday Work Shift : Job Description : Remote or On-Site (Dallas, TX) Employment/Education History Requirements : Certifications : High school education or equivalent; some college credit; Bachelor's degree preferred. Certified Professional Coder ( CPC ) certification from AAPC or Certified Coding Specialist - Physician-based ( CCS-P ) certification from AHIMA with the appropriate level of experience for auditing and abstracting. Preferred : Certified Professional Medical Auditor (CPMA) certification from AAPC Experience/Knowledge : 2+ years of multispecialty auditing medical documentation experience for appropriate E&M level and CPT assignment or 4-5 years of multispecialty coding experience. Thorough knowledge of anatomy/medical terminology. Proficient with Microsoft Word and Excel. Experience with Epic preferred. Ability to communicate effectively via written and...

Position Summary MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. Position Summary: This job posting encompasses all available Physician coding roles, including Physician Coder I, Physician Coder II, and Physician Senior Coder positions. Applicants will be considered for the appropriate role based on current organizational needs, manager discretion, years of relevant experience, passing a coding assessment and how well they meet the qualifications outlined for each position. Accurately and efficiently accesses wide range specialty physician billing and Health Information Systems to secure and gather all necessary records to accurately code and bill professional physician and/or physician extender (mid-level) services. MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. At Orlando Health, we are ordinary people with extraordinary...

Avera Health Coder III Location: Sioux Falls, SD Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: $25.00 - $37.50 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Responsible for the timely and accurate assignment of diagnostic and procedural codes for most types of outpatient charts for multiple facilities within Avera Health, with a focus on the more complex and high-dollar cases. Accurate abstracting along with other reporting and editing function is also a major responsibility. The Coder III works independently to meet quality and production goals for the position. Varied amounts of time will be spent educating Coder I, III and III coders along with helping others with denials management. What You Will Do Review all aspects of a patient's clinical documentation in order to identify...

Coder III Responsible for the timely and accurate assignment of diagnostic and procedural codes for most types of inpatient charts for across multiple facilities within Avera Health with a focus on the more complex and high-dollar cases. Accurate abstracting, along with other reporting and editing functions to meet quality and production goals for the position, with occasional guidance from other professional staff. Provide mentorship and training to Coder I, II, and III's along with helping others with denials management. What You Will Do: Review all aspects of a patient's clinical documentation in order to identify the appropriate sequence of ICD-10-CM diagnosis and PCS procedure codes for assigned patient charts across Avera's facilities. Understand the basics of ICD-10-CM and PCS codes in depth, and be willing to update that knowledge through research or other educational opportunities. Coder III - In patient is distinguished by specific services lines which could include...

HIM Certified Coder The HIM Certified Coder is responsible for accurate and timely coding of hospital inpatient, hospital outpatient and/or professional fee encounters using appropriate ICD10/ICDPCS, CPT, or HCPCs codes and appropriate coding software such as computer assisted coding and encoders as a means to ensure compliant billing of Carle claims. HIM Certified Coder is responsible for understanding and applying all regulatory coding guidelines, such as National and Local Coverage Determinations and application of CPT modifiers. HIM coder is also responsible for understanding and applying coding knowledge to resolve billing edits related to coding. HIM coder uses Carle electronic medical record systems to review clinical encounters. Qualifications: Certifications: Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC); Certified Outpatient Coder (COC) - American Academy of Professional Coders (AAPC); Certified Inpatient Coder (CIC) - American...

Position Summary MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. Position Summary: This job posting encompasses all available Physician coding roles, including Physician Coder I, Physician Coder II, and Physician Senior Coder positions. Applicants will be considered for the appropriate role based on current organizational needs, manager discretion, years of relevant experience, passing a coding assessment and how well they meet the qualifications outlined for each position. Accurately and efficiently accesses wide range specialty physician billing and Health Information Systems to secure and gather all necessary records to accurately code and bill professional physician and/or physician extender (mid-level) services. MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. At Orlando Health, we are ordinary people with extraordinary...

Position Summary MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. Position Summary: This job posting encompasses all available Physician coding roles, including Physician Coder I, Physician Coder II, and Physician Senior Coder positions. Applicants will be considered for the appropriate role based on current organizational needs, manager discretion, years of relevant experience, passing a coding assessment and how well they meet the qualifications outlined for each position. Accurately and efficiently accesses wide range specialty physician billing and Health Information Systems to secure and gather all necessary records to accurately code and bill professional physician and/or physician extender (mid-level) services. MUST LIVE IN APPROVED STATE TO BE CONSIDERED: AL, AZ, CO, GA, FL, ID, IL, MA< MI, NV, NM, NC, PA, SC, TX, VA, and WA. At Orlando Health, we are ordinary people with extraordinary...

Coder I, Professional It's more than a career, it's a calling WI-Turville Bay Worker Type: Regular Job Highlights: This is a full time day shift Coder I, Professional position for SSM Health Cancer Care located at 1104 John Nolen Dr. in Madison, WI. The schedule is 8:00 a.m. to 4:30 p.m. Monday through Friday for a total of 40 hours per week. Ideal applicants will be ROCC certified (Radiation Oncology Certified Coder), have knowledge of ICD10 and CPT. Experience with pre-authorization and reviewing documentation to confirm it supports the coding is also helpful. Job Summary Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures. Job Responsibilities and Requirements Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow-up steps. Identifies all billable services. Reviews all...

Certified Medical Coder (Professional Review Specialist I) The Professional Review Specialist analyzes medical services and billing across various claim types to evaluate the accuracy of charges and the medical necessity of care provided. This is a remote role. Essential Functions & Responsibilities: Identify the necessity of the review process and communicate any specific issues of concern to the claims examiner/client and or direct reporting manager Collect supporting data and analyze information to make decisions regarding appropriateness of billing, delivery of care and treatment plans Appropriately document work and final conclusions in designated computer program Additional duties as assigned Knowledge & Skills: Thorough knowledge of ICD Diagnoses and Procedure Codes, and C.P.T., as well as an understanding of medical terminology Knowledge of applicable fee schedule and or applicable U&C Guidelines Proficient in Microsoft Office applications...

Coding Specialist I Your job is more than a job The Coding Specialist I will be responsible applying the appropriate ICD-10-CM/PCS and CPT (charging) diagnostic and procedural codes for outpatient and/or inpatient encounters, ancillary encounters ambulatory/ provider-based clinics. Your Everyday Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs, APCs, CPT/HCPCs assignment and all required modifiers. Validates charges by comparing charges with health record documentation as necessary. Communicates effectively with clinical staff, physicians and office staff and Clinical Documentation Improvement Specialist regarding documentation issues or needs related to Inpatient, Outpatient, or Ambulatory coding. Identifies concerns and notifies appropriate leadership for resolution. Responsible for providing resolution to moderate to complex problems. Tracks issues (i.e. missing...