66 payment integrity medical coder jobs found

**Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for educating providers on proper billing behavior and proper usage of procedure codes and/or modifiers who are identified as outliers in regards to billing Highmark for certain targeted codes; outreach may occur in various formats including written letters, emails, and consultations via telephone. Documents explanations from Provider Outliers to be used in the analysis of billing behavior and cost savings. **ESSENTIAL RESPONSIBILITIES** + Performs outreach via telephone or other means to identified Outlier Providers informing them of their inclusion as an Outlier; meaningfully discusses the Outlier Providers' billing practices and provides education on proper usage of procedure codes and/or modifiers. May also field incoming calls from providers. + Applies medical coding knowledge to determine applicable education for Outlier Providers on industry standards and guidelines as...

**Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for educating providers on proper billing behavior and proper usage of procedure codes and/or modifiers who are identified as outliers in regards to billing Highmark for certain targeted codes; outreach may occur in various formats including written letters, emails, and consultations via telephone. Documents explanations from Provider Outliers to be used in the analysis of billing behavior and cost savings. **ESSENTIAL RESPONSIBILITIES** + Performs outreach via telephone or other means to identified Outlier Providers informing them of their inclusion as an Outlier; meaningfully discusses the Outlier Providers' billing practices and provides education on proper usage of procedure codes and/or modifiers. May also field incoming calls from providers. + Applies medical coding knowledge to determine applicable education for Outlier Providers on industry standards and guidelines as...

**Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for educating providers on proper billing behavior and proper usage of procedure codes and/or modifiers who are identified as outliers in regards to billing Highmark for certain targeted codes; outreach may occur in various formats including written letters, emails, and consultations via telephone. Documents explanations from Provider Outliers to be used in the analysis of billing behavior and cost savings. **ESSENTIAL RESPONSIBILITIES** + Performs outreach via telephone or other means to identified Outlier Providers informing them of their inclusion as an Outlier; meaningfully discusses the Outlier Providers' billing practices and provides education on proper usage of procedure codes and/or modifiers. May also field incoming calls from providers. + Applies medical coding knowledge to determine applicable education for Outlier Providers on industry standards and guidelines as...

**Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for educating providers on proper billing behavior and proper usage of procedure codes and/or modifiers who are identified as outliers in regards to billing Highmark for certain targeted codes; outreach may occur in various formats including written letters, emails, and consultations via telephone. Documents explanations from Provider Outliers to be used in the analysis of billing behavior and cost savings. **ESSENTIAL RESPONSIBILITIES** + Performs outreach via telephone or other means to identified Outlier Providers informing them of their inclusion as an Outlier; meaningfully discusses the Outlier Providers' billing practices and provides education on proper usage of procedure codes and/or modifiers. May also field incoming calls from providers. + Applies medical coding knowledge to determine applicable education for Outlier Providers on industry standards and guidelines as...

**Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for educating providers on proper billing behavior and proper usage of procedure codes and/or modifiers who are identified as outliers in regards to billing Highmark for certain targeted codes; outreach may occur in various formats including written letters, emails, and consultations via telephone. Documents explanations from Provider Outliers to be used in the analysis of billing behavior and cost savings. **ESSENTIAL RESPONSIBILITIES** + Performs outreach via telephone or other means to identified Outlier Providers informing them of their inclusion as an Outlier; meaningfully discusses the Outlier Providers' billing practices and provides education on proper usage of procedure codes and/or modifiers. May also field incoming calls from providers. + Applies medical coding knowledge to determine applicable education for Outlier Providers on industry standards and guidelines as...

**Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** This job is responsible for educating providers on proper billing behavior and proper usage of procedure codes and/or modifiers who are identified as outliers in regards to billing Highmark for certain targeted codes; outreach may occur in various formats including written letters, emails, and consultations via telephone. Documents explanations from Provider Outliers to be used in the analysis of billing behavior and cost savings. **ESSENTIAL RESPONSIBILITIES** + Performs outreach via telephone or other means to identified Outlier Providers informing them of their inclusion as an Outlier; meaningfully discusses the Outlier Providers' billing practices and provides education on proper usage of procedure codes and/or modifiers. May also field incoming calls from providers. + Applies medical coding knowledge to determine applicable education for Outlier Providers on industry standards and guidelines as...

Job Description Job Description Roles and Responsibilities Qualified candidates will have a background in analyzing complex managed care provider contracts that impact medical claims reimbursement. This role will require strong attention to detail and the ability to interpret complex provider contract reimbursement structures both institutional and professional. Candidates must be able to collaborate with their peers, outside vendors and customers in order to interpret the intent of the managed care contract to build within our software application. Within the above, this Coding position will be able to keep abreast on various coding methodologies including but not limited to RBRVS, DRG, APC, ASP and AWP updates that will need to be applied to our repricing software application for analytics. This position will also review analytics to ensure the integrity of analytics. Interpret provider rate exhibits, including professional fee schedules and facility/hospital rates...

Responsibilities: Position Summary : Responsible for assigning diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM and ICD-10-PCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Queries physicians as needed, to clarify documentation to ensure accurate code assignment. Organizes and prioritizes work to meet deadlines and goals. Maintains and expands knowledge of coding and sequencing guidelines to ensure coding compliance and accuracy. Responses to audits, provides consultation on projects, and be the primary point of contact for CDI and other team members when the supervisor/manager is not available. Position Responsibilities & Functions Assigns and sequences codes for the inpatient record using ICD-10-CM and PCS codes as...

Job Description Coder IV Facility HB, Inpatient Facility Coding 40 hours per week, day shift JOB SUMMARY: Responsible for assignment, review, and correction of ICD CM/PCS codes (Inpatient) and ICD-10-CM/CPT, Evaluation and Management codes (Outpatient) in the WakeOne health information system and the review/editing of associated facility charges. Performs audit, quality review and improvement assignments as directed for Inpatient and Outpatient respective facility charges and reports on findings. Identifies and assists management with the resolution of coding quality or process issues. Data reported is used for statistical, financial and billing purposes and to meet licensure requirements. EDUCATION/EXPERIENCE: Minimum of five years' of coding experience in an academic medical center or an equivalent combination of coding experience and education with demonstrated competency of knowledge base. Coding QA background or similar experience preferred. Satisfactory completion...

Department/Unit: Health Information Services Work Shift: Weekend_Day (United States of America) Salary Range: $21.78 - $34.85 *Fully Remote - NY State Residents Only* This position provides growth opportunities with an established coding career ladder. Start with Albany Med and grow with Albany Med! The successful candidate must have a medical coding credential through AHIMA or AAPC to apply. Responsibilities: Optimize hospital reimbursement by collecting and classifying diagnostic and procedural information from physicians and medical records. Code diagnostic and operative information from the record using ICD-10-CM/PCS and CPT4 classification systems. Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. Select Diagnosis Related Group (DRG) for each inpatient case. Optimize hospital...

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. The Outpatient Coding Compliance Auditor conducts audits of outpatient facility and/or professional services coding to validate the integrity of ICD-10-CM diagnoses, CPT, HCPCS, modifiers and/or professional Evaluation and Management(E/M) codes assigned for all specialties and chart types. The Auditor validates assigned codes for accuracy based on medical record documentation and established...

Overview: To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day. Under the general direction of the OP Coding Supervisor, the Home Care Coder is responsible to review Plans of Care and other medical documentation to assign and sequence ICD-10-CM diagnostic codes for home care services. Work may include, but is not limited to: application of appropriate coding practices, prioritizing assigned coding tasks to meet AR goals, resolving claim edits/rejections and/or denials and payment discrepancies due to coding related activities, handling individual coding workload, and collaborating with clinical and billing team members for missing and/or inaccurate information in order to code accurately. EEO/AA/Disability/Veteran Responsibilities: 1....

Community Health Systems is one of the nation's leading healthcare providers. Developing and operating healthcare delivery systems in 43 distinct markets across 15 states, CHS is committed to helping people get well and live healthier. CHS operates 77 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. Summary: As a member of the HIM Central Services coding team, provides Inpatient coding assistance for a set of HIM Central Services supported CHS hospitals. Reviews patient records and assigns accurate codes for each diagnosis and procedure. Applied knowledge of medical terminology, disease processes, and pharmacology. Demonstrates data quality and integrity skills. This individual will be required to make independent decisions regarding accurate ICD-10-CM & PCS code assignments which...

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.** The Outpatient Coding Compliance Auditor conducts audits of outpatient facility and/or professional services coding to validate the integrity of ICD-10-CM diagnoses, CPT, HCPCS, modifiers and/or professional Evaluation and Management(E/M) codes assigned for all specialties and chart types. The Auditor validates assigned codes for accuracy based on medical record documentation and established...

Job Description Job Description Orthopedic Associates (OA) is recruiting a Therapy Certified Professional Coder to join our company. OA is a privately-owned, regional leader in comprehensive orthopedic care. Since 1985, patients have placed their trust in our specialized care of the hand and upper extremities, spine, shoulder, elbow, hip, knee, foot and ankle, trauma, total joint and sports medicine. With over 30 providers, Orthopedic Associates provides patient care at multiple locations throughout the Miami Valley region. OA is an innovative, progressive, fast-paced practice- always one step ahead in the industry. Our Vision To be the region’s most respected leader in comprehensive orthopedic care. Our Mission To enhance the lives of our patients by providing individualized, state of the art, compassionate orthopedic care. We are seeking a motivated candidate who demonstrates Honor,...

Job Description Job Description Job Summary: The Coding Team Leader is responsible coding quality and education for Health Information Management department. The team leader will also be responsible for daily monitoring of all coding edits, denials, and billing holds (DNFC/DNFB). Actively involved in the dissemination of coding requirements and updates to appropriate stakeholders; works closely with the Revenue Cycle Department to understand reasons for denials, root cause analysis, and feedback to providers; develops and implements coding training plans for the organization, including preparation and delivery of training, to improve the accuracy, integrity and quality of patient data, and to improve the quality of provider documentation within the body of the medical record to support code assignment. Job Responsibilities include: - Assign codes to diagnoses and procedures using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) Codes. -...

Job Description Job Description Job Description Job Title: Health Information Coder Department: Health Information Management Reports To: HIM Coding Manager Job Summary: The Coding Team Leader is responsible coding quality and education for Health Information Management department. The team leader will also be responsible for daily monitoring of all coding edits, denials, and billing holds (DNFC/DNFB). Actively involved in the dissemination of coding requirements and updates to appropriate stakeholders; works closely with the Revenue Cycle Department to understand reasons for denials, root cause analysis, and feedback to providers; develops and implements coding training plans for the organization, including preparation and delivery of training, to improve the accuracy, integrity and quality of patient data, and to improve the quality of provider documentation within the body of the medical record to support code assignment. Job Responsibilities include: - Assign codes...

Job Description Job Description Job Description This position is available as a remote position.  Cheyenne Regional Medical Center was founded in 1867 as a tent hospital by the Union Pacific Railroad to treat workers injured while building the transcontinental railroad. Today, we are the largest hospital in the state of Wyoming, employing over 2,000 people, and treating over 350,000+ patients from southeastern Wyoming, western Nebraska, and northern Colorado. We pride ourselves on patient and employee experience by living our core values of I ntegrity, Cari n g, Compa s sion, Res p ect, Serv i ce, Teamwo r k and E xcellence to  I.N.S.P.I.R.E.  great health. Our team makes a difference every day by providing trusted healthcare expertise through a passionate and  I.N.S.P.I.R.E.(ing)  approach with a personal touch. By living our values, we aim to achieve our goal of becoming a 5-star rated hospital, providing critical support and resources to our community and the...

Job Description Job Description Become part of Arizona Community Physicians (ACP), Arizona's largest and most successful physician-owned medical group. ACP is a patient-centered organization consisting of over 900 employees. Our group includes 180 providers in the specialties of family medicine, internal medicine, geriatrics, pediatrics, endocrinology, rheumatology, dermatology, and gynecology. We are located in 54 locations of varying sizes in Tucson, Oro Valley and Green Valley. Our dynamic group offers lots of opportunities for professional growth and personal satisfaction. Job Summary Perform chart audits for multiple providers using expertise in ICD-10, CPT and HCPCS coding, Medicare guidelines and RAF and HCC identification. Minimum Qualifications Education: CPC certification is required. The coder is expected to enroll in continuing education courses to maintain certification. Work Experience: Two years of coding experience using ICD-10 or equivalency. Two years...

Job Description Job Description Become part of Arizona Community Physicians (ACP), Arizona's largest and most successful physician-owned medical group. ACP is a patient-centered organization consisting of over 900 employees. Our group includes 180 providers in the specialties of family medicine, internal medicine, geriatrics, pediatrics, endocrinology, rheumatology, dermatology, and gynecology. We are located in 54 locations of varying sizes in Tucson, Oro Valley and Green Valley. Our dynamic group offers lots of opportunities for professional growth and personal satisfaction. HCC Coder – Abacus Health Job Summary Performs pre-visit patient chart review to find Hierarchical Condition Category and Risk Adjustment Factor (HCC/RAF) coding opportunities for multiple Primary Care providers using expertise in ICD-10 coding practices, Medicare Guidelines and Value Based principles. Responsibilities Performs chart reviews as required. Demonstrates high level of organizational...

The University of Texas MD Anderson Cancer Center is ranked the nation's top hospital for cancer care by U.S. News & World Report's "Best Hospitals." MD Anderson's mission is to eliminate cancer in Texas, the nation and the world through exceptional programs that integrate patient care, research and prevention. Oncology nursing excellence is a central pillar in MD Anderson's worldwide reputation for cancer care. As a Magnet Recognized hospital, we provide our patients with excellent oncology nursing care. Our values are caring, integrity, discovery, safety and stewardship. KEY FUNCTIONS SUPERVISION OF RESEARCH PERSONNEL Provides direct supervision over assigned clinical research nursing, clinical coordinator, data coordinator, and other clinical research personnel. Participates with new employee hiring process oversees the ongoing development and orientation program for staff in alignment with applicable position descriptions. Assigns workload as relates to protocol...

Company Name: The Little Clinic Position Type: Seasonal/Temporary FLSA Status: Non-Exempt Position Summary Possess a thorough working knowledge of the revenue cycle management process including; ICD-9, ICD-10, CPT-4, and HCPS Billing. Responsibilities include ensuring that reimbursement is maximized through accurate and appropriate coding. Accountable for staying abreast of government policies and procedures as it relates to coding to ensure that company conforms to applicable guidelines and regulations. Demonstrate the company's core values of respect, honesty, integrity, diversity, inclusion and safety. Essential Job Functions Abstract clinical information from medical records to document, assign, and sequence ICD-9 and/or CPT-4 and HCPS coding where appropriateAudit, review, and correct claims with inaccurate or missing CPT or ICD-9 codesPerform qualitative analysis of medical records for documentation consistency and adequacyParticipate in audit of medical records to...

Job Description Job Description Cleveland Area Hospital is an independent facility half an hour west of Tulsa, Oklahoma. The hospital offers emergency, laboratory, radiology, inpatient care, outpatient infusion, and nurse care services, a fully equipped rehabilitation center, and a thriving seven-provider primary care clinic. The organization is transitioning to a Regional Healthcare Provider, under consistent leadership for the past 8 years. The Hospital and Clinic have been on a consistent trajectory of growth and progress over the past 8 years, and patient volumes and revenues have doubled in that time. We are on course to continue this growth, and we would like the opportunity to share more about our success with dedicated individuals who are interested in joining a team that is growing and a facility that is expanding. As an independent, self-managed, non-profit healthcare system governed by a local board of trustees, the organization successfully empowers team...