232 nurse coder jobs found

Payment Integrity Nurse Coder RN III Salary Range: $102,183.00 (Min.) - $163,492.00 (Max.) L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Job Summary The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects. The position serves as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements. The position is also responsible for guidance related to Payment Integrity initiatives to...

TREND Health Partners is a tech-enabled payment integrity company. Our mission is to facilitate collaboration between payers and providers for mutual benefit and waste reduction, ultimately improving access to healthcare. We achieve this by aligning the common goals of payers and providers and fostering collaboration through a shared technology platform and seamless workflows. Joining TREND Health Partners means becoming part of a dynamic, growing organization that promotes a collaborative and innovative work environment. Our comprehensive compensation package includes competitive salaries, highly valued health insurance, a 401(k) plan with employer match, paid parental leave, and more. The Nurse Coder DRG Auditor’s primary responsibility is to review medical records and associated claim information to validate accuracy of DRG assignments and/or medical necessity for inpatient level of care. This role will apply coding and clinical principles based on industry standards and...

A healthcare technology firm is seeking a Nurse Coder DRG Auditor to validate coding accuracy and medical necessity of inpatient claims. The role involves applying industry standards and guidelines to perform DRG validations while collaborating within a team. Successful candidates will have an active RN license, relevant coding certifications, and experience in clinical practice. A competitive salary of $85,000 to $90,000 is offered, along with a comprehensive benefits package. #J-18808-Ljbffr

PERMA FAIR is seeking a Member Experience Clinical Coder & Medical Biller in Camden, New Jersey. This role involves reviewing and validating medical claims, ensuring coding accuracy, and maintaining compliance with medical coding standards. Candidates should have a nursing degree, an active nursing license, and at least 2 years of experience in the medical field. A competitive salary ranging from $115,000 to $150,000 is offered along with comprehensive benefits including medical insurance and a 401(K) plan. #J-18808-Ljbffr

Registered Nurse - Utilization Management/Coder RN Bienvivir All-Inclusive Senior Health ("Bienvivir") is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the provision of the Program of All-Inclusive Care for the Elderly ("PACE"). PACE is a unique managed care benefit for frail seniors (referred to as participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible. Bienvivir is currently accepting applications for the following position: REGISTERED NURSE - UTILIZATION MANAGEMENT / CODER The...

Trauma Registered Nurse Harborview Medical Center is seeking an experienced Trauma Registered Nurse interested in joining our Trauma Registry Team, specializing in Injury Severity Coding. Unit Description The trauma registry is a complex database utilized by trauma hospitals to guide process and quality improvement efforts. Important secondary uses of registry data include education and outreach programs, injury prevention initiatives, clinical care research and local and state policy development. The Harborview Trauma Registry Team reviews a wide variety of data points ranging from prehospital and referring provider care, emergency resuscitation and surgical interventions, and inpatient care activities through discharge. Duties Identify all the injuries of patients meeting trauma registry inclusion criteria and enter them into the trauma registry software. Assign Abbreviated Injury Scores (AIS) and ICD-9 (or ICD-10) diagnosis codes for each injury and calculating an Injury...

Overview Bienvivir All-Inclusive Senior Health ("Bienvivir") is a community-based, patient-centered, comprehensive health care delivery system that advocates and promotes quality of life, optimum independence, dignity, and choices in a nurturing environment for frail seniors. Since 1987, Bienvivir has served the frail seniors of El Paso, Texas through the Program of All-Inclusive Care for the Elderly ("PACE"). PACE is a unique managed care benefit for frail seniors (participants) age 55 and older who are certified by the state as needing nursing home level care and who reside in a PACE service area. PACE programs coordinate and provide comprehensive medical and support services so that participants can remain independent and stay in their homes for as long as safely possible. Benefits for Full and Part-time Employees We pay 100% of the MEDICAL monthly premiums for Employee Only coverage. We pay 100% of the DENTAL monthly premiums for Employee Only coverage. We provide an...

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...

Blue Cross and Blue Shield of Massachusetts Inc. is seeking a Clinical Appeals Nurse Reviewer in Hingham. This full-time role facilitates the coordination of provider appeals for denied services, requiring RN licensure and coding expertise. The ideal candidate will apply clinical judgment to review appeals and work closely with various teams to resolve claims disputes effectively. A comprehensive benefits package, including medical, dental, and retirement plans, is offered to eligible employees. #J-18808-Ljbffr

Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters involving research...

Ankura Job Opportunity Ankura is a team of excellence founded on innovation and growth. Practice Overview Ankura's Health Care Disputes, Compliance and Investigations practice advises outside counsel and their clients on a wide variety of legal and regulatory matters. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations. We work with Chief Compliance Officers to build and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside counsel during internal and externally driven investigations through the evaluation of medical records, the determination of medical necessity and appropriate medical coding, and the computation of financial impacts that may lead to repayments. We also provide investigative assistance in matters...

Description: Are you interested in building a career with other TOP PERFORMERS? Effingham Health System is committed to providing exceptional care and services in an environment that supports professional growth, diversity, and inclusion. Every team member's experience and work-life balance are a priority in our organization. EHS culture encourages and supports individuals in pursuing their career goals and well-being by providing work-life balance, flexible scheduling, career development, and all the benefits and perks you need for yourself and your family. New Grads are welcome to apply. Benefits Retirement plans 403 (b) and 457 Health insurance Dental Insurance Vision insurance Prescription Drug Plan Hospital Discount Flexible spending account Paid time off Extended Days off (Sick time) Employee assistance program Strive365 Wellness Program Basic Life insurance (Employer Paid) Voluntary Life insurance/Accident/Critical Illness Disability (LTD and STD) Tuition...

Position Summary The Member Experience Clinical Coder & Medical Biller serves as a key contributor to internal medical billing review, payment integrity, and claims adjudication. Responsible for reviewing, validating, and repricing claims on behalf of payers, providers, and claim audit partners to support accurate reimbursement and strengthen payment integrity for our self‑insured clients. Translate medical diagnoses, procedures and services into standardized coding while ensuring compliance with established guidelines and reimbursement methodologies. Collaborate closely with providers, Third-Party Administrators (TPAs), and other stakeholders to identify coding discrepancies, provide analysis, and communicate findings that drive informed decision‑making and optimal claim outcomes. Key Responsibilities Medical Coding & Documentation Review Receive, analyze, and verify patient medical records for accuracy, ensuring all required information is present for proper billing and...

Billing Specialist Job Summary: Post patient charges, includes checking coding, ABN documentation, and verification of patient demographics. Posts payments. Files appeals when necessary and assists in determining final claim status. Maintains accurate count of collections received each day. Maintain daily count of physician, procedure, nursing home, hospital and nurse visits. Job Duties: Submits claims to accounts as appropriate. Submits claims to carriers and intermediaries as appropriate. Checks coding to insure accuracy and medical necessity. Insures information is appropriate for client or insurance billing. Assists in follow-up on payment and billing errors. Send medical records requested by insurance companies. Send monthly deposit reports to accounting. Fill out paperwork for patient/insurance refunds. Help answer the phone and make appointments. Perform other duties as assigned by supervision. Other duties as assigned by Director associated with clinic specialty....

Consulting Team Member We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways. At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today! This job works as a consulting team member on client or internal assignments. Handles escalated coding related projects, new services, regulatory updates and overall coding quality. Provides coding education to various groups such as coders, billers, nurses, physicians, etc. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability...

Recovery Resolutions Supervisor Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. You dream of a great career with a great company - where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our...

Coding Specialist Performs coding/DRG and abstracting functions for medical records, quality assessment and billing purposes. Codes all Huntsville Hospital medical records with ICD-10-CM/PCS and CPT-4 codes. Abstracts key data elements according to medical record review criteria. Performs coding quality assurance as needed. Education/Certification HS/GED required. Prefer post high school education in anatomy, physiology and pathophysiology Require CCS certification (certified coding specialist) Experience ICD-10-CM/PCS or CPT coding experience in hospital or physician's office preferred. Additional Skills/Abilities Must have excellent communication skills with the ability to work in a fast paced environment, requiring prioritizing and changing tasks frequently and quickly. Must be able to maintain confidentiality. Must be able to use computer, word processing and spreadsheet software, fax machine, and copy machine. Highlights of our hospitals Huntsville Hospital...

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and...

Clinical Informaticist / Clinical Coder Are you looking for a career that will make an impact? The Leidos Military and Veterans Health Solutions Operation has an opening for a Clinical Informaticist / Clinical Coder to join the Operational Readiness Directorate at the Naval Health Research Center in San Diego, CA. This position will provide support to the Epidemiology and Data Management Support Department and involves clinical coding and data abstraction to support research on the physical and mental health of military personnel to improve overall health and readiness. The person in this position will work closely with department professionals in records management, information technology, and research teams to ensure alignment of clinical coding with research needs. Are you ready for unique and exciting work? This is a full-time position in San Diego. The candidate for this position must be located within commuting distance of San Diego to work on-site at the Naval Health...

Job Title Newport News, Virginia This position is remote work eligible for candidates residing in the following states: FL, GA, ID, KS, KY, MS, NC, OK, SC, SD, TN, VA. Hours: Labor Pool (as needed) Overview Ensures high quality documentation that is thorough, accurate and complete to ensure correct reimbursement capture. Assigns diagnostic and procedure codes to simple record types up to highly complex record types. Contributes to the proper management of health information through consistent and accurate code assignment processes adhering to all regulatory coding principles, rules and regulations. What You Will Do Organizes and prioritizes assigned work to ensure that work is completed within the assigned time frame. Reviews charts and entire medical records, assigning ICD and CPT code combinations to each data element. Audits for documentation opportunities and queries clinical staff to fill in any gaps to clarify confusing, incomplete or conflicting information and...

Overview If you're looking for a schedule that fits your lifestyle, check out PAM Health - and ask us about our comprehensive benefits package! Some things that our hospital can offer YOU as a full-time employee: Medical Benefits: EPO/HDHP/HSA options, including prescription coverage, Rx 'n Go, and Teladoc Comprehensive dental and vision benefits Employee Assistance Program, including counseling, legal, and financial service Flexible spending (FSA) and health savings (HSA) accounts Life and Disability insurance benefits Education/In-Service Opportunities including continuing education and tuition assistance Supplemental benefits: Accident, critical illness, cancer, pet, and identity theft protection insurance options Auto, Home, Cell Phone, and Gym Membership discount offerings Personal Travel Discounts Employee Bonus Referral Program 401(k) plans and discretionary employer match Generous Paid Benefit Time Responsibilities This...

Inpatient/Outpatient Coder At Ashe Memorial Hospital, we are driven by our mission: "To meet the needs of the community by delivering patient-centered, high quality health care." Ashe Memorial Hospital is proud to have been voted Ashe's Best Place to Work in 2022, 2023, 2024, and 2025. Join a team recognized throughout the community for excellence in healthcare, including awards for Best Hospital, Best Surgeon, Best Physician, Best Nurse, and Best Medical Practice. This is your opportunity to make a meaningful difference in a close-knit mountain community. Position Details Position: Inpatient/Outpatient Coder Schedule: Full-Time Location: On-site at Ashe Memorial Hospital in Jefferson, NC Remote Work: This is a remote or hybrid position Supervisory Responsibilities: None Travel Requirements: None Compensation: Pay commensurate with experience Position Summary The Inpatient/Outpatient Coder is responsible for accurately coding diagnoses, procedures, and...