40 sr clinical coder jobs found

Job Title: Sr. Clinical Coder Location: 100% Remote Duration: 6+ months (Contract to Hire) Shift: 5x8 Hour Shifts, Monday-Friday Job Summary: Conducts retrospective medical claim reviews and adjudication for coding determinations. Provides coding-related information to medical directors, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and the claims subcontractor as needed. Serves as the designated recipient for factual network provider claim review requests, develops determination letters, and supports both non-clinical and clinical staff on coding and retrospective medical claims review processes. Key Responsibilities: Perform claims coding reviews using current coding guidelines. Conduct focused claims reviews as requested by management and summarize findings. Identify and report potential fraudulent or quality issues. Serve as a resource for staff on ICD-10-CM, HCPCS, and CPT coding. Research TRICARE...

Company Overview Syneos Health® is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success. We translate unique clinical, medical affairs and commercial insights into outcomes to address modern market realities. Our Clinical Development model brings the customer and the patient to the center of everything that we do. We are continuously looking for ways to simplify and streamline our work to not only make Syneos Health easier to work with, but to make us easier to work for. Whether you join us in a Functional Service Provider partnership or a Full-Service environment, you’ll collaborate with passionate problem solvers, innovating as a team to help our customers achieve their goals. We are agile and driven to accelerate the delivery of therapies, because we are passionate to change lives. Discover what our 29,000 employees, across 110 countries already know: WORK HERE MATTERS EVERYWHERE Why Syneos Health: We are passionate about...

Overview Syneos Health® is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success. We translate unique clinical, medical affairs and commercial insights into outcomes to address modern market realities. Our Clinical Development model places the customer and patient at the center of everything we do. We continuously simplify and streamline our work to be easier both to work with and to work for. Location: USA–NY–New York. Job Responsibilities Must reside in North America with no sponsorship needs to be considered for this position. Proven record of lead experience in multicenter large studies. Experience in liaison with sponsor counterparts on coding conventions, specifications, and coding decision process. Analytical experience in trend analysis in QC and consistency findings. Lead experience in coding QC process. Experience in coding resource management, pricing, bidding and coding tool development preferred. Assist...

The Senior Clinical Coder serves as a subject matter expert in medical coding and DRG validation, playing a critical role in ensuring coding accuracy, regulatory compliance, and appropriate reimbursement across inpatient and outpatient services. In this role, you will conduct detailed retrospective claims reviews, provide expert-level coding analysis, and support cross-functional teams including medical directors, claims operations, and quality management. This position is ideal for a highly analytical professional who thrives in a fast-paced, remote environment and is passionate about accuracy, compliance, and continuous improvement in healthcare operations. Duties & Responsibilities Serve as a subject matter expert for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding Perform DRG validation and retrospective medical claims reviews Analyze inpatient and outpatient claims for coding accuracy and reimbursement determinations Prepare clear, detailed determination letters and...

A healthcare provider is seeking a Sr Coding Specialist to accurately apply coding conventions in a clinical environment. Responsibilities include reviewing claims, correcting coding errors, and mentoring other coding staff. Candidates should have a high school diploma, five years of coding experience, and relevant certifications like CCS or CPC. Strong communication skills and proficiency in ICD coding are essential for this role, as well as the ability to work in a fast-paced environment. #J-18808-Ljbffr

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 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 patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group assignments as applicable. Assign Altegra Health Flagged...

Join to apply for the Health Information Management Inpatient Coding Auditor Sr. FT, Days, - Remote role at Prisma Health . Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for leading coding teams, coder training, work queue management, performing prebill and second-level coding reviews utilizing auditing software and documents findings to improve CC/MCC capture, Risk Variable capture, HAC/PSI, HCC and Quality Indicator validation. Uses knowledge of coding and compliance guidelines to identify potential documentation, coding and reimbursement issues and report these to coding leadership. Employ critical thinking skills to alert coding leadership to any trends identified in their reviews and to make suggestions for continual process improvement. Reviews and responds to inpatient denials as needed. Performs Inpatient coding by assigning ICD-CM and ICD-PCS codes as well as DRG assignment. Essential Functions All team members are expected to be...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Sr. Certified Coder Clinical Document-Coding Mgmt The Sr. Certified Coder will: In accordance with established coding principals and guidelines assigns appropriate diagnosis and procedure codes to all applicable records - (concurrently/discharge) on patient units. Collaborates with coding supervisor for managing workflow and distribution of discharged records to non-senior coding staff. Responds to inquiries from fellow coders, regarding coding questions or concerns. Collaborates with clinical documentation nursing specialists to ensure quality documentation practices. Assists physicians, hospital personnel and others as needed with coding and billing inquiries. Reports discharged not final billed (DNFB) problems to coding supervisor. Requirements: Knowledge of coding systems, medical terminology, anatomy and physiology required. A minimum of five (5) years of inpatient coding experience required. Strong interpersonal and decision-making skills required....

Join to apply for the Sr Coder role at Dignity Health 1 day ago Be among the first 25 applicants Position Summary The Senior Coder (Sr. Coder) acts as the lead coder for their designated team. This position will train staff on department policies, procedures, systems, and correct coding requirements. The Sr. Coder additionally will monitor staff workload, audit coders, fill in for out-of-office coders, and make recommendations to Physician Coding leadership to improve team efficiency. Responsibilities This position is remote. Train all new coders on department policies, procedures, and correct coding principles. Provide routine education, training, and auditing to their designated coding teams. Analyze coder's workload and make recommendations to ensure timely completion of all work. Research and guide coders and staff on coding-related questions or concerns. Create and update coder job aids for accurate coding of all services. Assist with provider education and...

Overview Title: Sr. Specialty Physician Coder – Interventional Radiology Location: Fountain Valley, CA / Predominantly Remote Department: Document Improvement Status: Full-Time Shift: Days (8hr) Pay Range*: $35.46/hr - $51.46/hr At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary Under the direction of the Coding Compliance Manager, the Senior Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the...

Ankura is a team of excellence founded on innovation and growth. Practice Overview: Ankura's Health Care team is a recognized leader in health care disputes, compliance, and investigations. We combine unparalleled clinical, technical, and operational expertise with financial, economic, analytic skills. Our clients and their legal counsel rely upon us to successfully resolve complex matters. Ankura's health care team is comprised of clinicians, certified coders, revenue cycle, and operations professionals. Our practice leaders each have over 25 years of health care and consulting experience. The Ankura team has a mastery of the data and information systems used by providers, payers, and CMS. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute. Our clients include the largest...

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 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 patient medical...

Sr. Manager/Associate Director, US Medical Information Dermatology/IAI Incyte is a biopharmaceutical company focused on the discovery, development, and commercialization of novel medicines to meet serious unmet medical needs in oncology and inflammation and autoimmunity. Incyte is committed to the rigorous pursuit of research and development excellence to improve the lives of patients, make a difference in health care, and build sustainable value. The Company strives to discover and develop first-in-class and best-in-class medicines-advancing a diverse portfolio of large and small molecules. Job Summary The Sr. Manager/Assoc. Dir., Medical Information is responsible for providing accurate, timely, unbiased, and up-to-date medical information to internal and external customers. The position will be responsible for the creation and maintenance of written scientific content, including medical information response letters (MIRLs), frequently asked questions (FAQs), and product...

Coder II Do you want to join an organization that invests in you as a Coder II? 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. You contribute to our success. Every role has an impact on our patients' lives and you have the opportunity to make a difference. We are looking for a dedicated Coder II like you to be a part of our team. Job Summary and Qualifications As a Coder II, you will be responsible for reviewing and coding for home health and hospice utilizing clinical notes (i.e., H&P, recent Discharge summary progress notes, F2F notes, etc.). You will document recommendations for coding and OASIS edits. You will work with team lead and/or denials team to resolve coding related issues. You will serve as a key promoter of the Home Health and Hospice & Family Care and is responsible for setting the tone of Parallon coding as a service organization,...

Title: Sr. Specialty Physician Coder - Interventional Radiology Location: Fountain Valley, CA / Predominantly Remote Department: Document Improvement Status: Full-Time Shift: Days (8hr) Pay Range*: $35.46/hr - $51.46/hr At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare.Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability.Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary Under the direction of the Coding Compliance Manager, the Senior Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and...

Title: Sr. Specialty Physician Coder – Interventional Radiology Location: Fountain Valley, CA / Predominantly Remote Department: Document Improvement Status: Full-Time Shift: Days (8hr) Pay Range*: $35.46/hr - $51.46/hr At MemorialCare Health System, we believe in providing extraordinary healthcare to our communities and an exceptional working environment for our employees. Memorial Care stands for excellence in Healthcare. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration and accountability. Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full potential in an environment of respect, innovation and teamwork. Position Summary Under the direction of the Coding Compliance Manager, the Senior Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for...

Responsibilities Join the Southwest Healthcare Team! About Us: Creating Health and Harmony, Southwest Healthcare is a comprehensive network of care with convenient hospital and ambulatory care/outpatient locations here to serve the Southern California community. With over 7,000 passionate providers and healthcare employees, our shared goal is to provide convenient access to a wide range of healthcare services in a way that benefits you, your family, and the entire community. Southwest Healthcare is comprised of five acute care hospitals and several non-hospital access points, including: Corona Regional Medical Center, Palmdale Regional Medical Center, Southwest Healthcare Rancho Springs Hospital, Southwest Healthcare Inland Valley Hospital and Temecula Valley Hospital, Temecula Valley Day Surgery, A+ Urgent Care Centers, Apex Heart Specialists, and Riverside Medical Clinics. We've won various awards throughout our region and focus on career development and promotion....

Working with Us Challenging. Meaningful. Life-changing. Those aren't words that are usually associated with a job. But working at Bristol Myers Squibb is anything but usual. Here, uniquely interesting work happens every day, in every department. From optimizing a production line to the latest breakthroughs in cell therapy, this is work that transforms the lives of patients, and the careers of those who do it. You'll get the chance to grow and thrive through opportunities uncommon in scale and scope, alongside high-achieving teams. Take your career farther than you thought possible. Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives. Read more: careers.bms.com/working-with-us. The WW Medical Learning Team plays a critical role in ensuring that...

Introduction Do you want to join an organization that invests in you as a Trauma Surgical Profee 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 financial wellbeing 401(k) Plan with a 100% match on 3% to 9% of pay (based on...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Senior auditor responsible for clinical or physician compliance topics. Assigned the most complex clinical/documentation/coding/billing reviews. Provides guidance to other auditors within AHN on audit approach and analysis. Responsible for creating and overseeing orientation of auditors. Leads all hospital or physician audits/investigations, auditing support and responses related to external audit activity. ESSENTIAL RESPONSIBILITIES: Establishes and implements orientation for all members of the AHN audit compliance team. Evaluates the progress of team members including review of reports and audit activities. Works with senior management responsible for AHN-wide case management/physician programs to develop processes that meet Medicare and 3rd party payor requirements. Provides guidance to staff auditors on audit topics and reports. (20%) Conducts educational sessions for...