7647 specialist jobs found

Job Overview The Revenue Cycle Management Specialist – CPC Required supports the accurate and efficient management of the revenue cycle for behavioral health, outpatient, surgical, or a combination of these practice settings. This position combines hands-on medical billing and revenue cycle responsibilities with coding expertise to help ensure accurate claim submission, appropriate reimbursement and compliance with coding and payer requirements. Key Responsibilities Manage full-cycle medical billing, including insurance verification, charge entry, claims submission, payment posting, denial management and patient collections. Review CPT, ICD-10-CM, HCPCS codes and modifiers for accuracy and appropriate claim submission. Identify and resolve coding-related claim errors, rejections and denials. Ensure timely and accurate claims submission to commercial payers, Medicaid and Medicare. Conduct eligibility checks and pre-authorizations as needed. Follow up on...

OVERVIEW : The Billing & Coding Specialist works collaboratively with the billing team to support all functions of the billing department, ensuring the maximization of receivables and maintaining optimal cash flow.  This role requires advanced knowledge of OB/GYN coding and billing practices.  The Billing & Coding Specialist is responsible for maintaining compliance with office policies, procedures, and all applicable regulatory requirements.   The ideal candidate demonstrates a friendly and professional demeanor, strong interpersonal skills, and the ability to remain composed during high-pressure situations. This role requires the ability to work independently, apply critical thinking to resolve complex billing issues, and manage sensitive financial conversations with patients in a respectful and understanding manner. KEY RESPONSIBILITIES: Serve as the subject matter expert for all billing, coding, and documentation questions. Review provider...

Job Position: Independent Medical Reviewer   Reports To:   Chief, Clinical Business Operations  Department:  AppealMasters  Employment Status:  • 1099 Independent Contractor (Remote)  • This remote contractor role requires a minimum commitment of ten appeals per week  (approximately 15–20 hours weekly). Contractors are responsible for providing their own  equipment and maintaining a secure home office environment.  Position Summary  We are seeking an experienced Inpatient Hospital Coder – Denial Appeals Specialist to  review, analyze, and write compelling appeals for coding and DRG-related denials. This  position requires a strong understanding of inpatient coding guidelines, MS-DRG assignment,  clinical documentation, payer policies, and reimbursement principles.  The ideal candidate will have mid-level inpatient coding experience and the ability to translate  complex coding and clinical information into clear, concise, and well-supported appeal  arguments. The primary...

I. JOB SUMMARY/RESPONSIBILITIES Performs review of physician and other health care provider services by QMC and QEC providers to ensure services are coded with appropriate CPT and ICD-9 codes. Conducts education, training, and continuously monitors QMC and QEC providers related to PATH guidelines, coding and documentation of professional services rendered, in accordance with government, insurer, and other regulatory agency standards.  Effective October 2014, ICD-10 codes shall be required. II. TYPICAL PHYSICAL DEMANDS: Essential: sitting, stooping/bending, finger dexterity, seeing, hearing, speaking, lifting, and carrying usual weight of 5 pounds, repetitive arm/hand motions, static gripping of an object for prolonged periods, frequent gripping of an object.  Occasional: standing, walking, kneeling, climbing stairs, squatting, twisting body, lifting weight up to 10 pounds, pushing/ pulling usual weight of 2 pounds up to 5 pounds, reaching above, at and below shoulder level....

Required: Active coding certification (apprentice designation not accepted for this role). SCOPE/GENERAL PURPOSE OF JOB: The Senior Coding Specialist is responsible for abstracting all E/M, CPT, HCPCS, ICD-10-CM, modifier, units from the medical record documentation.  Other responsibilities include accurately entering data into coding/billing software and/or Excel reports.  Performing accurate coding using applicable guidelines and facility protocols and communicating with staff and/or providers as needed.  Provide written feedback of coding results as needed in the form of comments, summary of findings and recommendations.  Ensure compliance with federal and state laws, regulations and standards related to health information and coding principles.  Communicate with your direct manager as needed (i.e. schedule changes, daily assignments/work volume, coding questions, etc.)   ESSENTIAL DUTIES AND RESPONSIBILITIES: ·         Assign ICD-10 CM...

Children’s Orthopaedic and Scoliosis Surgery Associates, LLP (COSSA) is seeking an experienced Medical Billing Specialist to join our pediatric orthopaedic practice. This position focuses on insurance accounts receivable, denial resolution, and obtaining accurate, timely payment for physician services. You will work independently on assigned accounts, with support from an established billing team. We value people who investigate problems, follow through, share knowledge, and help prevent recurring billing issues. Responsibilities Research and resolve outstanding insurance balances using payer portals and direct communication with insurance representatives. Review electronic claim rejections and denials, determine the appropriate corrective action, and submit corrected claims, reconsiderations, and appeals. Investigate underpayments using payer policies, contracts, and fee schedules. Prepare appeal letters supported by relevant...

Medical Billing/Office manager position at Ear Bar Pay: $30.00 - $35.00 per hour Job description: Job Summary We are seeking a dedicated and experienced Medical Billing Specialist/office manager to oversee the daily operations of new innovative ENT specialty practice focused on ears. The ideal candidate will possess strong leadership skills and a comprehensive understanding of medical office management, including experience in clinical settings and utilization management. This role is pivotal in ensuring efficient workflow, maintaining high standards of patient care, and managing administrative functions effectively. The ideal candidate will also be responsible for managing the entire billing process, ensuring accurate and timely submission of claims, and facilitating smooth communication between healthcare providers, insurance companies, and patients. Your expertise will help optimize revenue cycles, improve patient satisfaction, and uphold the highest standards...

About Synergy Health Partners Synergy Health Partners provides healthcare revenue cycle, billing, credentialing, and managed care support services. Our team works with healthcare organizations to improve reimbursement, resolve outstanding insurance accounts, and support efficient revenue cycle operations. Position Summary We are seeking an experienced Revenue Cycle Specialist with hands-on medical insurance AR experience. This position focuses on payer follow-up, denial resolution, appeals, corrected claims, and recovery of outstanding insurance balances in a high-volume environment. The role also includes inbound patient calls , so excellent customer service and professional communication skills are important. Responsibilities Work insurance AR and aging accounts Follow up with Medicare, Medicare Advantage, Medicaid, and commercial insurance payers Research unpaid, underpaid, rejected, and denied claims Review EOBs and ERAs and...

Medical Billing, Revenue Cycle & Administrative Specialist Urban Pain Institute – Anchorage, Alaska Remote Position – Alaska, West Coast & Mountain Time Zone Urban Pain Institute, an interventional pain management practice based in Anchorage, Alaska, is looking for an experienced, highly organized Medical Billing, Revenue Cycle & Administrative Specialist to join our team. This is a remote position for an experienced professional who understands medical billing, insurance requirements, denials and appeals, prior authorizations, credentialing, and the administrative processes necessary to ensure the practice is reimbursed appropriately and remains compliant with insurance requirements and applicable laws. The ideal candidate is extremely organized, detail-oriented, proactive, and persistent, and is comfortable working independently while also coordinating with our clinical and administrative staff. Medical Billing, Revenue Cycle &...

Hospital for Special Care is currently seeking an experienced Inpatient Coding Specialist to join our team. This is an excellent opportunity for a coding professional who enjoys working with complex medical records, collaborating with clinical teams, and using their expertise to support accurate documentation, coding, and reimbursement.  What You'll Do ·   Accurately code inpatient accounts and assign appropriate ICD-10-CM/PCS, CPT, modifiers, and DRGs in accordance with current coding guidelines. ·   Review medical records, identify documentation needs, and collaborate with HIM, physicians, clinical staff, and other departments to resolve coding questions, edits, and denials. ·   Monitor outstanding accounts and coding reports to ensure timely and accurate completion of inpatient records. ·   Utilize the Electronic Medical Record, 3M HDM, and clinical documentation tools to support efficient and accurate coding. ·   Serve as a coding resource and educator...

About Bridge Bridge is the fastest, most compliant way to scale insurance billing nationwide. We enable virtual care companies to go in-network nationally in as little as 30 days, without the operational lift. Our platform handles payer contracting, credentialing, real-time benefit verification, medical coding, claim submission, denial management, and compliance in a single integrated solution. Backed by leading investors including General Catalyst, Andreessen Horowitz, Thrive Capital, Khosla Ventures, Greenoaks, and Mischief, we're scaling rapidly. The Role We are seeking a detail-oriented and experienced RCM Coding Specialist with CPC (Certified Professional Coder) certification to join our Revenue Cycle Management team. This role is responsible for accurate and timely medical coding in accordance with current coding guidelines, payer requirements, and company standards. The ideal candidate has strong analytical skills, in-depth knowledge of CPT, ICD-10, and...

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. Risk Adjustment Coding Specialists are an important part of the Team at Virtix Health. The HCC Coding Team Member will review medical records to abstract ICD-10 codes, specifically those that map to HCCs, RxHCCs, and ESRD models. Coders will follow Medicare guidelines, ICD-10-CM guidelines as well as client specific requirements. Equipment provided along with Encoder software with access to AHA Coding Clinic This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:...