455 payment integrity coder jobs found

A leading healthcare organization is seeking a Payment Integrity Coding Professional. This remote role focuses on utilizing coding guidelines to ensure correct claim payment. Ideal candidates will have AAPC or AHIMA Certification, strong communication skills, and the ability to work independently while collaborating across various departments. The position offers a competitive salary range of $65,000 - $88,600 annually, with beneficial perks like medical, dental, and vision coverage. #J-18808-Ljbffr

A leading healthcare organization is looking for a Payment Integrity Coding Professional to ensure correct claim payments while working collaboratively across departments. This remote role requires AAPC or AHIMA Coding Certification and at least three years of coding experience. Ideal candidates will demonstrate strong attention to detail, excellent communication skills, and the ability to manage multiple priorities effectively. The position includes a salary range of $65,000 to $88,600 annually, along with comprehensive benefits. #J-18808-Ljbffr

Overview Payment Integrity Nurse Coder RN III role at L.A. Care Health Plan . Responsibilities 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 include concept and cost avoidance development. This position trains and mentors Payment Integrity Nurse Coder, RN staff. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff. Performs quality audits to include validation of accuracy and completeness of ICD, Rev...

Payment Integrity Nurse Coder RN III (Job ID: 12330) Location: Los Angeles, 90017 Shift: Full Time Pay Range: $102,183.00 (Min.) – $132,838.00 (Mid.) – $163,492.00 (Max.) Job Description The Payment Integrity Nurse Coder RN III is responsible for investigating, reviewing, and providing clinical and/or coding expertise and judgment in the application of medical and reimbursement policies within the claim adjudication process. The role involves medical record review for Payment Integrity and Utilization Management projects, serving as a subject‑matter expert (SME), performing quality audits, validating coding accuracy and completeness, and guiding Payment Integrity initiatives, including concept and cost avoidance development. Additionally, the position trains and mentors Payment Integrity Nurse Coder, RN staff, acting as a resource and mentor for fellow employees. Qualifications At least 8 years of clinical RN experience. At least 3 years of experience in utilization...

A prominent healthcare institution in Los Angeles is seeking a Payment Integrity Nurse Coder RN III to review medical records and provide expertise in claim adjudication. The role requires extensive knowledge of coding and healthcare reimbursement. Ideal candidates will have substantial RN experience in clinical settings and a strong background in utilization management or clinical coding. This position offers a full-time shift and great compensation along with the opportunity to mentor other staff members. #J-18808-Ljbffr

divh2Senior Medical Coder/h2pAt Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for Americas 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 members complete health history, we ensure better care at a lower costdelivering the highest value to those who need it most./ppWere 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./ppAs part of the Office of the CEOs AI Ops initiative, youll combine deep subject matter expertise with an...

Coding Specialist Responsible for reviewing demographic and clinical medical records, assigning appropriate ICD-10-CM/PCS and CPT/HCPCS codes based on provider documentation and current coding guidelines. Works across multiple encounter types, including Observation/Outpatient in a Bed, Emergency Department, Urgent Care, Ambulatory Surgery, and Ancillary. Utilizes both manual and AI-assisted coding platforms to optimize accuracy, compliance, and throughput. Ensures data integrity for quality reporting, population health, and financial reimbursement purposes. Education Minimum: High school diploma or equivalent required. Preferred: Associate degree in Health Information Technology or related field. Certifications Required: Certified Coding Specialist (CCS), Certified Coding Specialist Physician (CCS-P), Certified Inpatient Coder (CIC), or Certified Outpatient Coder (COC) (AHIMA or AAPC). Preferred: Registered Health Information Administrator (RHIA) or Registered Health...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

A national healthcare organization is seeking a Coder Trainer I who will develop and conduct training programs for the Payment Integrity department. The role is fully remote and offers competitive pay ranging from $56,200 to $101,000 annually. Ideal candidates will have a bachelor's degree, coding experience, and prior training in virtual environments. The organization emphasizes workplace flexibility with various work schedules. Comprehensive benefits, including health insurance and tuition reimbursement, are also provided. #J-18808-Ljbffr

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. Position Purpose Responsible for developing and conducting a variety of training programs and auditing tools for the Payment Integrity department. The Coder Trainer I is fully remote. Candidates will be considered nationally. Responsibilities Conduct training needs analyses to determine specific training needs for Payment Integrity department staff Identify, select, and develop appropriate training programs, including the selection or design of appropriate training aids Evaluate effectiveness of training programs, including cost and benefit analyses Research, analyze and recommend external training programs Maintain records of training activities and employee progress Assist in auditing...

Description Do you want to join an organization that invests in you as an Inpatient Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Introduction Every role has an impact on our patients’ lives and you have the opportunity to make a difference. We are looking for a dedicated Inpatient Coder like you to be a part of our team. Benefits Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans...

Join to apply for the Hospital Inpatient Coder role at HCA Healthcare Description Introduction Do you want to join an organization that invests in you as an Inpatient Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Benefits Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

divh2Senior Medical Coder/h2pAt Clover Health, we are committed to providing high-quality, affordable, and easy-to-understand healthcare plans for Americas 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 members complete health history, we ensure better care at a lower costdelivering the highest value to those who need it most./ppWere 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./ppAs part of the Office of the CEOs AI Ops initiative, youll combine deep subject matter expertise with an...

Description Do you want to join an organization that invests in you as an Inpatient Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Introduction Benefits Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free counseling services and resources for emotional, physical and financial wellbeing 401(k) Plan with a 100% match on 3% to 9% of pay (based on...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Coding Team Member We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. At CHS, our coding team recognizes your individual talents, encourages professional development, and provides opportunity for career advancement. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 14 states, CHS is committed to helping people get well and live healthier. CHS operates 70 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Job Summary As a member of the 100% US Based HIM Central Services coding team, the Coder IP provides inpatient coding assistance for a set of HIM Central Services-supported CHS...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Coding Team Member We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. At CHS, our coding team recognizes your individual talents, encourages professional development, and provides opportunity for career advancement. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 14 states, CHS is committed to helping people get well and live healthier. CHS operates 70 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Job Summary As a member of the 100% US Based HIM Central Services coding team, the Coder IP provides inpatient coding assistance for a set of HIM Central Services-supported CHS...

DRG Coding Auditor 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. 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 is responsible for auditing inpatient medical records and generating high quality recoverable claims for the benefit of the company, for all lines of business, and its clients. Also responsible for...

Remote Certified Coder Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in: CMS HCC Risk Adjustment HEDIS Medical Record Reviews (Accreditation) And more Job Description These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Responsibilities: Abstract pertinent information from...

Coding Team Member We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. At CHS, our coding team recognizes your individual talents, encourages professional development, and provides opportunity for career advancement. Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 40 distinct markets across 14 states, CHS is committed to helping people get well and live healthier. CHS operates 70 acute-care hospitals and more than 1,000 other sites of care, including physician practices, urgent care centers, freestanding emergency departments, occupational medicine clinics, imaging centers, cancer centers and ambulatory surgery centers. Job Summary As a member of the 100% US Based HIM Central Services coding team, the Coder IP provides inpatient coding assistance for a set of HIM Central Services-supported CHS...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...

Inpatient/DRG Validation Coding Auditor The Inpatient/DRG Validation Coding Auditor performs documentation and coding audits for all acute inpatient services for clients. Identifies coding errors, compliance, and educational opportunities, and optimizes reimbursement by ensuring that the diagnosis/procedure codes and supporting documentation accurately support the services rendered and comply with ethical coding standards/guidelines and regulatory requirements. Performs independent reviews, interprets medical records, and applies in-depth knowledge of coding principles to determine billing/coding/documentation issues and quality concerns. Demonstrates high level of expertise in researching requirements necessary to make compliant recommendations. Has an extensive understanding of reimbursement guidelines, specifically related to DRG (MS, APR, Tricare, etc.) payment systems. Conducts DRG (ex. MS, APR, Tricare) coding and clinical reviews to verify the accuracy of coding, DRG...