14 medical coder jobs found in Toledo, OH

Senior Medical Coder At Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for America's seniors. We prioritize preventive care while leveraging data and technology through the Clover Assistant, a powerful tool that helps physicians make informed health recommendations. By giving doctors a holistic view of each member's complete health history, we ensure better care at a lower costdelivering the highest value to those who need it most. We're building a modern operating model for medical codingone that connects Risk Adjustment, Payment Integrity, and Quality (STARS/HEDIS) into a single, data-driven system. This is a rare opportunity to work at the center of that transformation: ensuring compliant, high-quality coding today while helping design the workflows that will define how a plan of the future operates. As part of the Office of the CEO's AI Ops initiative, you'll combine deep subject matter expertise with an...

A leading academic health institution is seeking a detail-oriented Medical Coder to focus on outpatient and inpatient pathology services billing. This role involves coding with ICD-10-CM and collaborating with medical staff to ensure accurate submissions. The ideal candidate should have extensive coding experience and strong skills in medical terminology. This full-time position offers flexibility with a fully remote option. Join the team and contribute to high-quality healthcare delivery. #J-18808-Ljbffr

Medical Coder Outpatient We are seeking a detail-oriented and knowledgeable professional coder to join our healthcare team. The ideal candidate will be responsible for accurately translating complex surgical procedures into standardized medical codes using ICD-10-CM, CPT, and HCPCS coding systems. The coder plays a crucial role in ensuring that our documentation is precise and in compliance with regulatory standards. This position demands a keen eye for detail, a deep understanding of medical terminology, and the ability to maintain patient confidentiality and data integrity. The professional coder will work closely with providers, medical staff, and billing departments to streamline coding processes and optimize reimbursement procedures. Michigan Medicine improves the health of patients, populations, and communities through excellence in education, patient care, community service, research, and technology development, and through leadership activities in Michigan, nationally,...

The Department of Pathology is seeking a detail-oriented and experienced individual to join its team as a Medical Coder ? Outpatient (Non-Certified). This role focuses on coding and billing functions for outpatient and inpatient pathology services, requiring a strong set of skills, proficiency in medical terminology, and the ability to adapt to meet departmental needs. This position also involves the complex task of handling prior authorizations for high-level Molecular Testing. The role includes a variety of complex tasks and may serve as a resource for resolving coding and billing issues. Work is performed under general supervision. Mission Statement Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally. Our mission is guided by our Strategic Principles and has three critical...

ICD-10 Coding Specialist You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Must be willing to travel to NYC twice a year for required meetings. Position Purpose: The focus of this position is to establish processes to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review. Analyze moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance. Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues. Provide...

Note: Please only apply to the specific job posting for which you have experience in the specialty. Duplicate applications will not be considered. Job Summary We are seeking a detail-oriented and knowledgeable Medical Biller and Coder for Dermatology Department to join our healthcare team. The ideal candidate will be responsible for managing the billing process, ensuring accuracy in medical coding, and facilitating timely payments from insurance companies and patients. A strong understanding of medical terminology, coding systems, and collections is essential for success in this role. Responsibilities Process medical billing claims accurately and efficiently using appropriate coding systems such as ICD-10 and ICD-9. Review patient records to ensure all necessary information is included for billing purposes. Verify insurance coverage and benefits prior to submitting claims to ensure proper reimbursement. Follow up on unpaid claims and conduct medical collections as necessary....

Coding Specialist III Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). JOB SUMMARY: The Coding Specialist III will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the needs of hospital data retrieval for billing and reimbursement. Coding Specialist III validate MSDRG and/or APC calculations in order to accurately capture the diagnoses/procedures documented in the clinical record. Coding Specialist III performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and...

Coding Position This level 2 coding position provides support to the Enterprise Coding Department for coding of physician's fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA. Function/Duties of Position Coding Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS). Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry. Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU. Monitor activity for compliance with federal and/or state...

Job Title: Lead Inpatient Coder How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. The Lead Inpatient Coder serves as a key expert in ICD-10-CM, ICD-10-PCS, and DRG assignment, providing specialized knowledge and guidance to the Inpatient Coding team. This role is responsible for addressing complex coding questions, reviewing, and resolving external audit findings, and contributing to coding improvement initiatives. Additionally, the Lead Inpatient Coder plays a critical role in delivering ongoing education and training to the coding team, helping to minimize...

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...

DRG Coding Auditor Principal _Virtual: _ _ ​_ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

PURPOSE OF THIS POSITION This position is responsible for all medical claims including pre-billing and follow up activities for delayed claims by ensuring, through various activities, that claims are clean and should be paid promptly by insurers without requiring further intervention. This staff member performs all pre-claim submission activities, including verifying existing information is accurate, determining when additional data is needed, and collecting necessary details to ensure claims are complete. Additionally, this individual follows departmental productivity and quality control measures that support the organization’s operational goals. This position promotes revenue integrity and accurate reimbursement for the organization by ensuring timely and accurate billing, timely payer follow-up activities and collection of accounts. JOB DUTIES/RESPONSIBILITIES Duty 1: Maintains a thorough understanding and education of federal and state regulations and payer specific policies...

Review and check certain inpatient records to make sure the coding is correct and follows rules for ICD-10 codes. This includes checking the DRG groups, Present on Admission indicators, Severity of Illness, Risk of Mortality, Hospital-Acquired Conditions, and Patient Safety Indicators according to guidelines set by the Centers for Medicare & Medicaid Services and the American Hospital Association. Provide ongoing feedback and training to the staff in the Coding unit. General Characteristics: Excellent customer service when working with Coding/CDI staff, clinicians, and other Michigan Medicine employees. Strong knowledge of ICD-10 coding and understand the Official Coding Guidelines well. Ability to review clinical documents to decide what information is needed for accurate DRG, POA, SOI, and ROM scores. Communicate effectively with the Coding/CDI team to ensure good outcomes. Write appropriate questions to the clinical care team following AHIMA Query Policy. Skilled in...

A healthcare organization in Ann Arbor is seeking a Subject Matter Expert in medical coding. This role involves reviewing surgical operative notes, assigning appropriate CPT and diagnosis codes, and ensuring documentation accuracy. Candidates should have a high school diploma or GED, relevant certifications, and at least 2 years of professional coding experience. The position offers flexible remote work options and opportunities for career growth. #J-18808-Ljbffr