129 jobs found in Georgia

Medical Coder and Abstractor ProSidian Consulting is looking for a talented professional ready to deliver real value to clients in a fast-paced, challenging environment. ProSidian Consulting is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian seeks a Medical Coder and Abstractor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The ProSidian Engagement Team Members work to provide health coding services to a branch of the United States Armed Forces'...

Job Description Job Description A Medical Coder for WellStreet Urgent Care is responsible for supporting all aspects of the Revenue Cycle for our Urgent Care Centers. Responsibilities • Coding for our Urgent Care Centers using our internal software • Knowledge of ICD-10 Coding and compliance • Experience using an encoder • Setting up insurance plans within our software • Working with the Revenue Cycle Management to identify & resolve issues related to coding and the process flow • Interfacing with clinic staff on billing & coding issues. • Comply with all legal requirements regarding coding procedures and practices • Conduct audits and coding reviews to ensure all documentation is accurate and precise • Assign and sequence all codes for services rendered • Collaborate with billing department to ensure all bills are satisfied in a timely manner • Communicate with insurance companies about coding errors and disputes • Contact physicians and other health care...

Job Description Job Description Description: Position Overview: We are currently seeking an experienced and certified Medical Biller & Coder to join our dynamic remote team. The ideal candidate will have a strong understanding of CPT, ICD-10, and HCPCS coding systems, billing practices, insurance follow-up, and compliance guidelines across multiple specialties. Responsibilities: Review and accurately assign diagnosis and procedure codes for medical services. Submit and follow up on claims to commercial payers, Medicare, and Medicaid. Verify insurance eligibility and obtain authorizations as needed. Resolve claim rejections, denials, and appeals in a timely manner. Communicate with providers and staff regarding coding queries and billing concerns. Maintain confidentiality and comply with HIPAA regulations. Requirements: Requirements: Minimum 2 years of medical billing and coding experience. Active certification (CPC, CCS, or equivalent) required. Experience with...

Coder - Certified Reporting to the coding manager, the medical coder is responsible for review clinical documentation to abstract and/or validate CPT and ICD-10 coding for inpatient and outpatient professional services. The coder will ensure that medical records are coded in an accurate and timely manner as well as work closely with physicians to consistently and accurately translate clinical documentation and medical records into ICD-10 and CPT codes. Through these efforts, the individual within this role will identify and report error patterns, resolve errors or issues associated with coding and billing processes, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors. Job Requirements: Certified Professional Coder (CPC) or Certified Coding Specialist- Physician Based (CCS-P) required; A minimum of two (2) years of coding experience, Prior experience in an academic institution preferred Knowledge of federal, state, and...

Job Description Job Description Description: Southeast Primary Care Partners is seeking a dedicated and detail-oriented Certified Coder to join our dynamic team. The successful candidate will play a crucial role in accurately coding healthcare claims for reimbursements, ensuring compliance with federal regulations, and contributing to the efficiency and effectiveness of our healthcare services. Certified Coder reviews medical records to assure proper billing. Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improve coding issues identified. Codes must meet QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Position Summary: Requirements: Key Responsibilities: Review patients' medical records to extract relevant information needed for billing and coding. Apply appropriate ICD-10, CPT, and HCPCS Level II code assignments to ensure accurate and timely billing. Work closely with healthcare...

Job Description Job Description Description: Seeking a detail-oriented and knowledgeable Provider/Coding Auditor Educator to support accurate and compliant coding practices across our provider network. This role will be responsible for performing audits of medical documentation and coding, educating providers on best practices, and ensuring adherence to industry guidelines and payer regulations. The ideal candidate is a certified coding professional with strong communication skills and a passion for education and compliance. This role requires flexibility to travel 50% of the time to various provider locations in the State of Georgia for onsite education and auditing support, as needed Requirements: Key Responsibilities Conduct prospective, concurrent, and retrospective coding audits for professional and/or facility services. Review medical documentation to ensure codes assigned (ICD-10-CM, CPT, HCPCS) are supported and meet regulatory and payer guidelines. Deliver coding...

Job Description Job Description About the Role We are seeking detail‐oriented and experienced Medical Billers' to join our administrative team. The ideal candidates will have strong knowledge of medical billing procedures, insurance claims processing, and patient account management. This role is essential in ensuring accurate billing, timely reimbursement, and excellent communication with patients and insurance providers. Responsibilities Prepare, review, and submit medical claims to insurance companies (electronic and paper). Verify patient insurance coverage and eligibility. Follow up on unpaid or denied claims and resolve discrepancies. Post payments, adjustments, and denials to patient accounts. Generate patient statements and handle billing inquiries. Maintain accurate records of billing activities and account statuses. Communicate with insurance companies, providers, and patients regarding billing issues. Ensure compliance with HIPAA, coding...

Job Description Job Description Medical Coder – Wound Care (Long-Term Care) About Us Pinnacle Wound Management is a physician-led wound care provider dedicated to improving healing outcomes for patients in skilled nursing and long-term care facilities. We partner with facilities to deliver advanced wound care at the bedside, supported by thorough documentation, EMR integration, and compliance with payer guidelines. We are seeking a Medical Coder with wound care experience to join our team. This role is critical in ensuring timely, accurate coding and billing for patient encounters and cellular tissue product usage across multiple facilities. Key Responsibilities Accurately review and code wound care services performed in long-term care and post-acute settings, ensuring compliance with ICD-10, CPT, HCPCS, and payer requirements Code independently without reliance on a provider superbill , using clinical notes and documentation as the source of truth...

Facility Medical Coder II - Remote Position, Must Reside in South Carolina Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from medical records for complete and accurate statistical documentation. Minimum Qualifications Minimum Education: High School Diploma or Equivalent Minimum Years of Experience: 3 Years of Experience in Facility Coding Covering Multiple Services (Combination of DRG and OP Services or Multiple OP Services), which they successfully met quality and productivity standards. Required Certifications/Licensure: At least one active certification (RHIA/RHIT//CCS/CCS-P//CPC/CPC-H/COC//CIC) Required Training: Experience working in a combination of the following areas: ED, OPS, or IP; Completion of courses in Anatomy, Physiology, and Medical Terminology; Must be computer literate and have experience with Microsoft applications (i.e.,...

Scheduled Hours 40 Position Summary Position reviews medical record documentation to determine appropriate billing codes and necessary documentation. Job Description Primary Duties & Responsibilities: Reviews the documentation in the record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patients conditions and treatment. Codes evaluation and management to appropriate CPT code and codes diagnosis to appropriate ICD-9 code. Meets with physicians to review documentation, resolve coding and secure signature of all unsigned dates of service, tagging files for follow up. Acts as lead person and assists coders with IBC staff with medical terminology and policy interpretation as required. Assists with efforts to increase physician awareness of documentation requirements. Prepares case reports and initiates follow-up for billing process. Working Conditions: Normal office environment. Typically...

Coding Position This level 2 coding position provides support to the Enterprise Coding Department for coding of physician's fees and/or facility fees. This position requires experience in coding and requires certification with AAPC or AHIMA. Function/Duties of Position Coding Review clinical documentation of services to be coded in EPIC, and any other source of documentation available to ensure compliance with the Center for Medicare and Medicaid Services (CMS). Assign correct CPT, ICD-10-CM, and HCPCS codes for facility and/or professional charges, which could include E&M services; diagnostic services; procedural services; facility services; and/or Charge Routers and Charge entry. Establish and maintain procedures and other controls necessary in carrying out all procedure and diagnostic coding and insurance billing activity for applicable work queues assigned in facility and/or professional services at OHSU. Monitor activity for compliance with federal and/or state...

Remote Coding Professional This is a remote position We are seeking a highly motivated and dedicated coding professional to join our team. The ideal candidate must have at least 5 years of coding experience for physician practices, with various surgical specialties, with a focus in orthopedic surgeries, as well as E/M. The position requires one to be resourceful, organized, and extremely driven. The ideal candidate will bring deep expertise in surgical and outpatient coding, strong knowledge of payer guidelines, and proven experience working with denials related to orthopedic and neurosurgical services. Key Responsibilities: Resolve Claim Edits and Denials by reviewing clinical documentation, identifying root causes, correcting coding or modifier issues, and submitting appeals or corrected claims as needed. Review and Assign Accurate CPT, ICD-10-CM, and HCPCS Codes for orthopedic and neurosurgical procedures, including inpatient and outpatient surgeries and office visits....

Job Description Job Description PYA is seeking a Professional Coding Auditor/Consultant to join its high-performing and privately-owned firm with a dynamic culture and a strong national reputation. This individual will support PYA’s Revenue Integrity team in a professional coding auditor role . RESPONSIBILITIES: Responsible for the accurate review of PYA clients’professional fee coding per industry coding audit standards, support of the management team with project management tasks, support of the verbal and written reporting to the client, and conducting provider coding and documentation education ( generally, conducted remotely ). Coding auditing of complex services rendered by physician and non-physician practitioners using current coding guidelines, with attention to Medicare, medical necessity, and NCD/LCD requirements. Professional coding auditing expertise in multiple specialties is required, including...

Job Description Job Description Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses...

Assembler Language Coder Location- Remote Clearance- IRS MBI This program requires US Citizenship Description of Assignment: Work in an Agile team to support back-end mainframe systems and provide interfaces to front-end systems. This means that they can develop mainframe applications (with databases and mainframe systems): Work with development teams and product managers to ideate software solutions. Analyze existing software as well as incoming business rules and conversion details, producing application requirements and detailed design documents. Working knowledge of mainframe tools including TSO, JCL, Control-M Develop and manage well-functioning databases and applications. Write effective interfaces to system applications and services. Troubleshoot, debug and upgrade software and assist in defect resolution. Create security and data protection settings. Build features and applications with a high...

Overview Be inspired. Be rewarded. Belong. At Emory Healthcare. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship and leadership programs And more! Description The Professional Coding Compliance Auditor develops and executes audit, monitoring, and education for professional billing, coding and documentation programs that confirm compliance, identifies reimbursement implications, and provides billing providers with relevant and timely information regarding audit results and risk areas. Principal duties and responsibilities: Prepares and oversees...

Vendor Compliance Auditor JOB SUMMARY: This role is responsible for auditing the quality of incoming loads, ensuring compliance with established standards, and identifying any deviations. SUPERVISORY RESPONSIBILITIES: None ESSENTIAL FUNCTIONS: Responsibilities: Observe the quality of loads on arrival Review loads for violations Identify and document root causes through tablet procedures Communicate violations by gathering up to 30 photographs using multiple angles if necessary Validate information prior to reporting violations QUALIFICATIONS: education and/or experience: High school diploma knowledge, skills and abilities: Demonstrated interpersonal and communication skills (written and verbal) Attention to detail Familiarity with pallet building standards Demonstrated commitment to safety standards physical requirements: Ability to work in a warehouse environment (concrete floors, changing temperatures) Ability...

Coding Auditor Sr CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through homecare and community-based services. The CareBridge Coding Auditor Sr is responsible for auditing coders that diagnosis data collected from physician and hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), 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...

DRG Coding Auditor Principal 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. Alternate locations may be considered. 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 Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case...