906 senior professional coder jobs found

Reviews claims in assigned work queues in Cerner Revenue Cycle including CMG Review and Ambulatory Edit failure work items.Analyzes coding edits, reviews timeline notes, reviews clinical documentation, including provider orders, progress notes, surgical and test results thoroughly to interpret and ensure documentation supports the posted charges.Determines appropriate action needed to resolve coding edits / issues and ensure clean claim submission.Performs coding functions, including Current Procedure Terminology (CPT), International Classification of Diseases, tenth revision, Clinical Modification (ICD-10-CM), documentation review, and claim denial review.Applies appropriate modifiers.Ensures charges / coding are in alignment with the American Medical Association (AMA),Medicare, and Commercial coding guidelines on all claims reviewed.Credits / updates charges and coding as needed.Ensures queues are worked timely and efficiently.Maintains Productivity and accuracy...

Job Description Job Description New Jersey’s largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural...

Overview New Jersey’s largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The position also supports prior...

New Jersey's largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural work. The position also supports prior...

Your job is more than a job Why a Great Place to Work: You're more than your job. Everyone is. And that's what makes you great at your job-all the little extras you bring to work every day, the things that make you you. At LCMC Health we value those things about you, because we know that all those little extras add up to extraordinary. And we've built a culture that supports and celebrates the extraordinary. You'll see it when you come to work here, in the spirit of our places and the faces of our people. And every patient we heal, every family we comfort, every life we improve is the outcome of countless little extras adding up to an extraordinary result. Join LCMC Health, and you'll find that our everyday makes it easy to live your extraordinary. Essential Function: 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...

Senior Vascular Surgery Professional Coder New Jersey's largest Vascular Surgery group dedicated solely to the diagnosis and management of diseases of the arteries and veins. The Group has been delivering care throughout New Jersey since 1963 and is home to some of the best Vascular Surgeons in the country. Consistently recognized by their peers and patients as the top group in the region, The Cardiovascular Care Group provides the highest quality care using the newest technologies in the setting of years of experience with outstanding results. Position Summary: We are seeking an experienced Senior Vascular Surgery Professional Coder with strong expertise in complex open and endovascular procedure coding, payer authorization workflows, and revenue cycle support. This role is responsible for accurate CPT, ICD-10-CM, and modifier assignment for a high-volume vascular surgery practice with extensive cardiovascular, endovascular, catheter-based, and imaging-guided procedural...

Shriners Children's is seeking a Senior Professional Coder with at least 7 years of experience in complex surgical coding. The role requires expertise in utilizing ICD-10 and CPT4 classification systems while working across various healthcare settings. Responsibilities include accurate coding, mentoring junior staff, and maintaining high quality standards. Benefits include medical coverage from day one, retirement plans with contributions, and additional perks for full-time employees, making this an excellent opportunity for experienced coders. #J-18808-Ljbffr

Your job is more than a job. Join LCMC Health, and you’ll find that our everyday makes it easy to live your extraordinary. Essential Function Apply the appropriate ICD-10-CM/PCS and CPT diagnostic and procedural codes and determine the MS‑DRG and APR‑DRG assignments for inpatient records across multiple specialties (cardiology, cardiothoracic surgery, trauma, orthopedics, general medicine and surgery, pediatrics, obstetrics, newborns, etc.). Apply ICD-10 diagnostic and CPT procedure codes for ambulatory records across multiple specialties (family medicine, internal medicine, cardiology [IR], cardiothoracic surgery, interventional radiology, trauma, orthopedics, general surgery, urology, gynecology, etc.). Navigate patient health records and other computer systems accurately to determine diagnosis, procedures, MS‑DRGs, APCs, and required modifiers. Validate charges by comparing charges with health‑record documentation as necessary. Communicate effectively with clinical staff,...

Join Our Caring Community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities: Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support coding accuracy...

Job Description Job Description Description: BASIC FUNCTION: JOB DESCRIPTION DEPARTMENT: Finance JOB TITLE: MEDICAL CODING SPECIALIST Responsible for correctly coding healthcare claims, in order to obtain reimbursement from insurance companies and government health care programs. All employees of FCHC must ensure service standards are delivered, including: FCHC Core • Demonstrates a commitment to FCHC mission and vision. • Demonstrates a positive attitude towards patients, employees, role, and the health center. • Demonstrates FCHC core values (accountability, courtesy, excellence, flexibility, integrity, respect). Customer Service and Professionalism • Smiles and makes appropriate contact, greets individuals upon entry into building and space. • Is customer service oriented to both internal (colleagues) and external (patients, clients, vendors, etc.) Customers. Treats patients, customers and colleagues with dignity and respect. •...

Xtensys is looking for a Senior Inpatient Coder in Ithaca, NY. In this role, you'll ensure the accuracy and integrity of clinical coding and lead audits to enhance coding quality. Your expertise will impact financial integrity and patient care outcomes across health systems. Ideal candidates will have at least five years of coding experience, relevant certifications, and strong communication skills. This remote position offers a collaborative work environment with opportunities for professional growth. #J-18808-Ljbffr

Humana is seeking a Senior Market Consultation Professional (Nurse Medical Coder) to enhance quality in risk adjustment programs. The role involves coding accuracy, documentation assessments, and training delivery. Ideal candidates possess an active RN license, CPC certification, and experience in medical coding. This position is primarily remote but may require occasional travel to Humana's offices. The successful candidate will work closely with clinical teams to ensure compliance and quality standards. #J-18808-Ljbffr

Humana Inc is seeking an IPA Consultative Coder in North Las Vegas. In this hybrid role, you will work with a multidisciplinary team to enhance documentation accuracy and support high-quality care delivery. Your responsibilities include educating clinic staff, conducting audits, and ensuring coding accuracy. Ideal candidates should have 3+ years of risk adjustment coding experience and relevant certifications. Join us to make an impactful difference in our senior-focused care community. #J-18808-Ljbffr

Humana Inc in Frankfort is seeking a Senior Market Consultation / Partnership Professional to support the Clinical Support Team initiatives. This role is crucial in promoting accurate and compliant documentation and coding practices that enhance program quality in risk adjustment. The ideal candidate will need a valid RN license, be a certified coder, and possess strong knowledge in ICD-10-CM coding guidelines. This position allows for remote work with occasional office travel and offers a competitive salary range of $86,300 - $118,700 annually along with comprehensive benefits. #J-18808-Ljbffr

Humana is seeking a Senior Market Consultation / Partnership Professional (Nurse Medical Coder) to support Clinical Support Team initiatives. This role includes reviewing medical records for accurate ICD-10-CM coding and ensuring compliance with documentation standards. The ideal candidate will have an active RN license, be a certified coder, and possess strong analytical skills to enhance risk adjustment practices. This position also offers competitive remote work opportunities. #J-18808-Ljbffr

Humana Inc. is looking for a Senior Market Consultation / Partnership Professional (Nurse Medical Coder) to support Clinical Support Team initiatives. The role involves ensuring accurate documentation and coding practices across risk adjustment. Primary responsibilities include performing medical record reviews, validating diagnosis coding, and collaborating with clinical teams to improve documentation standards. An active RN license and a CPC are required, with an emphasis on excellent communication skills and data analysis proficiency. This position offers a competitive compensation ranging from $86,300 to $118,700 per year and is eligible for a bonus incentive plan. #J-18808-Ljbffr

Humana Inc. is seeking a Senior Market Consultation / Partnership Professional (Nurse Medical Coder) to enhance documentation and coding practices across risk adjustment. The ideal candidate will perform medical record reviews, validate coding compliance, and drive partnerships to improve standards. Applicants should have an active RN license (BSN preferred) and certifications in coding. Strong knowledge of ICD-10-CM coding guidelines is essential. This position is remote but may require occasional travel. #J-18808-Ljbffr

Join Our Caring Community Humana's Primary Care Organization is a leading senior-focused, value-based care provider with 400+ centers across 15 states under the CenterWell and Conviva brands. As an IPA Consultative Coder, you will collaborate with a multidisciplinary team to support the delivery of high-quality, cost-effective care in the communities we serve. In this role, you will work closely with providers and clinic teams to enhance documentation accuracy, identify opportunities for improvement, and reinforce coding and documentation best practices. This is a hybrid position that requires occasional travel within the assigned market. Responsibilities Deliver coding and documentation education to providers and clinic staff within IPA clinics. Be a consultative resource and ongoing support for providers in assigned clinics. Conduct documentation audits to identify gaps, trends, and opportunities for improvement. Perform quarterly chart reviews to support coding...

Description Job Summary The Sr Billing Compliance Auditor serves as the liaison responsible for monitoring and auditing NCPS coding and documentation functions for professional fee services. Conducts independent ongoing reviews of vendor and provider-coded professional fee services to ensure practices meet federal requirements. Works closely with NCPS to communicate monitoring/auditing results and provide feedback to support necessary actions taken accordingly. Functions as the subject matter expert for professional fee coding and documentation, and partners with NCPS administrators to ensure consistent, compliant, and accurate coding practices. Job Specific Duties Conducts audits of NCPS professional fee encounters to validate accuracy of CPT, HCPCS, ICD-10-CM, and modifier assignment. Serves as the coding, documentation, and billing expert for NCPS, ensuring focused expertise on pediatric, Fl AHCA / Medicaid, and CMS regulatory requirements. Monitors professional fee...