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Jefferson is more than 65,000 people strong, dedicated to providing the highest-quality, compassionate clinical care for patients; making our communities healthier and stronger; preparing tomorrow's professional leaders for 21st-century careers; and creating new knowledge through basic/programmatic, clinical and applied research. Jefferson Health, nationally ranked as one of the top 15 not-for-profit health care systems in the country and the largest provider in the Philadelphia and Lehigh Valley areas, serves patients through millions of encounters each year at 32 hospitals campuses and more than 700 outpatient and urgent care locations throughout the region.

Thomas Jefferson University

Revenue Integrity Analyst II-1

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Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained. Customers include physicians, nurses, physician office staff, third party payors, central billing staff, staff from other departments and patients/patient families.

HOUR

Banner Health

Charge Capture Specialist Manual Entry

Collaborates with internal business partners, compliance, legal, provider and payment integrity teams, and external agencies to coordinate investigative activities, support corrective actions, recoveries, and case resolution efforts. 2+ years Fraud, waste, and abuse investigations, healthcare investigations, claims audits, payment integrity, healthcare compliance, law enforcement investigations, or a related investigative field required.

YEAR

Centene Corporation Group

SIU Investigator

Develop and maintain collaborative and liaison relationships with Blue Cross Blue Shield Association (BCBSA), Blue Cross Blue Shield (BCBS) Plans, HHS OIG, other carriers' anti-fraud professionals, law enforcement and regulatory agencies. May attend webinars and conferences like BCBSA, National Health Care Anti-Fraud Association (NHCAA), and Association of Certified Fraud Examiners (ACFE) to keep apprised of developments in health care fraud.

At the Blue Cross and Blue Shield Association (BCBSA), we provide business strategy, technical support and consulting expertise to 36 Blue Cross and Blue Shield companies across the nation, employing more than 1,000 of the best strategic thinkers in the industry.  We are a Brand manager that sets quality control standards for the 36 independent companies that use the Blue Cross and Blue Shield Brands, and we serve as a trade association that represents these Blue companies. It is through our involvement that the Blues companies share a united vision and strategy while also benefiting from the local strength of all member companies.

Blue Cross and Blue Shield Association

Investigator III

The Risk Adjustment Compliance Specialist, Principal is responsible for ensuring organizational compliance with laws related to Risk Adjustment across our Marketplace (ACA), Medicaid and Medicare Advantage lines of business. The Principal collaborates with internal teams and external partners to maintain the integrity of risk adjustment data and supports the development and implementation of compliance programs.

Risk Adjustment Compliance Specialist, Principal

The Billing Compliance Education Specialist oversees creation and implementation of documentation, coding, and billing compliance education for physicians, advanced practice professionals, residents, fellows, post-doctoral associates, medical students, and staff in accordance with the UF College of Medicine - Jacksonville Billing Compliance Plan. Collaborates with the Physician Billing Compliance Services auditing team by conducting one-on-one educational sessions with providers and/or billing/coding staff on remedial education needs identified in billing compliance audits.

University of Florida Health Science Center

Billing Comp Education Spec | Physician Billing | Hybrid Days | Full Time

ADAPTED_NOW

Recognized as one of the nation's Top 20 Rural and Community Hospitals and the only Texas hospital to earn this distinction, Peterson is also Magnet® designated for nursing excellence and has been named one of Modern Healthcare's Best Places to Work in Healthcare for six consecutive years. Responsible for reviewing the patient demographic information in the practice management system at the time of charge entry to ensure accuracy and to provide feedback to front office staff regarding patient registration.

Peterson Health

Physician Billing Specialist | Full Time

Peterson Health Jobs

The Ideation Team researches and produces new bill review content as well as enhances existing bill review content using sources such as ICD-10, AHA, AMA, CPT, AAPC, CMS and/or clinical research sources. This is a place for builders with a growth mindset who act with agility, embrace change, and use modern technology to shape smarter solutions, exceptional experiences, and the future of our industry for our clients, customers, and our culture.

Zelis

Expert Claims Product Analyst (Concept Ideation)

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The Supervisor partners with leadership on developing strategies to enhance efficiency and quality practices and to prioritize all internal, state, and federal government audits (CMS Improper Payment Measure (IPM), Contract-level Risk Adjustment Data Validation (CON RADV), and Department of Health and Human Services (HRADV) and auditor workflow. Oversee risk adjustment audit activity including monthly internal coding quality audits and all federal and state risk adjustment data validation audits including, but not limited to, Improper Payment Measure, Contract-level RADV, Department of Health and Human Services RADV (HRADV).

Capital District Physicians Health Plan

Supervisor, Risk Adjustment Quality Assurance and Auditing

Univera Healthcare

He/She should possess a strong knowledge base of ICD-10-CM, CPT and HCPCS coding, financial analysis techniques, costing, federal and state regulatory processes, insurance billing, third party payor requirements, outcome measurements, medical information management and practice patterns. This position is responsible for auditing, training and monitoring of medical information and the quality of coding and provider documentation for Premier HealthNet, Premier Health Specialists and Upper Valley Professional Corp collectively known as The Premier Physician Network (PPN).

About Premier Health Partners <a href="http://www.premierhealthpartners.org/home.aspx" target="_blank">Premier Health Partners</a> (PHP) is a large health system serving southwest Ohio communities by improving the quality, affordability, and accessibility of health care. PHP Mission and Legacy for Better Health Care The <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=760" target="_blank">PHP Mission and Legacy</a> has always been to provide the most comprehensive, affordable and accessible health services and products for the betterment of health care in southwest Ohio. When you know more about our mission, vision, and values, and read about the success stories in our history; you’ll know why we’re the first choice for patients, physicians and employees in southwest Ohio. PHP Hospitals Our members include more than 65 member locations throughout southwest Ohio, including four hospitals: <ul> <li><a href="http://www.goodsamdayton.org/" target="_blank">Good Samaritan Hospital Dayton</a></li> <li><a href="http://www.miamivalleyhospital.org/" target="_blank">Miami Valley Hospital</a></li> <li><a href="http://www.atriummedcenter.org/" target="_blank">Atrium Medical Center</a></li> <li><a href="http://www.uvmc.com/" target="_blank">Upper Valley Medical Center</a></li> </ul> PHP Health Centers As part of our mission to bring quality health care closer to the people we serve, we’ve expanded our services through comprehensive health centers: <ul> <li><a href="http://www.goodsamdayton.org/gshdefault.aspx?id=11560" target="_blank">Good Samaritan North Health Center</a> in Englewood</li> <li><a href="http://www.miamivalleyhospital.org/mvhdefault.aspx?id=12738" target="_blank">Miami Valley South Hospital</a> in Centerville</li> </ul> How to Donate or Volunteer Find out <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=806" target="_blank">how to donate or volunteer</a> to impact the quality of health care at PHP and our member organizations. PHP has foundations to which you can make donations to improve the health care technology and facilities available to your community. You can also help by volunteering at our hospitals or health centers. PHP Vendor and Supplier Information Whether you’re currently a vendor working with PHP or a supplier interested in joining our partnership, you’ll find helpful information in our <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=824" target="_blank">vendor and supplier section</a>. Serving the Community PHP is dedicated to <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=762" target="_blank">serving the community</a> by making it our priority to bring quality, affordable health care choices closer to you. To make this happen, PHP created <a href="http://www.premiercommunityhealth.org/" target="_blank">Premier Community Health</a>, a non-profit organization dedicated to creating a healthier community through prevention, early detection, and disease management. <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=766" target="_blank">PHP’s investment</a> in the 23 communities we serve includes building health service centers, bringing health programs to the community, as well as being one of the largest employers in the area. We also are committed to helping the <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=770" target="_blank">under-served</a> of our community by providing financial aid, free services, and pre ions to people in need. We also believe in being a good neighbor by getting involved in numerous <a href="http://www.premierhealthpartners.org/moreaboutus.aspx?id=772" target="_blank">community programs and charities</a>. And, as part of our effort to build healthier communities, we have implemented a system-wide <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=822" target="_blank">ban on tobacco</a>. <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=762" target="_blank">Learn more about how we serve the community</a>. Awards and Recognition <a href="http://www.premierhealthpartners.org/aboutus.aspx?id=820" target="_blank">Read About Our Awards and Recognition</a>.

Premier Health Partners

CODING ANALYST

FULL_TIME

Independently performs coding of patients' inpatient records to ensure accurate assignment of physician, professional fee, surgical, and other hospital-based services using the most appropriate CPT, ICD-10, and HCPCS codes in accordance with CMS, Coding Clinic, and other regulatory guidelines. Demonstrated knowledge of anatomy and physiology, medical terminology, disease process, reimbursement methodologies (DRGs, HCCs, APCs), and the conventions, rules and guidelines for current coding classification (ICD10-CM, CPT and HCPCS).

Northbay Healthcare

Ambulatory Professional Fee and Hospitalist Coder (On-Site, Hybrid, Remote)

Flu Protocol: All employees working directly with patients, the community or working in a health center will be required to have the flu shot or wear a mask during patient/community contact or while in the health center from November 1 – April 30 each year (Flu Season). This role supports abortion care through direct clinical triage, patient education, and follow-up, ensuring timely and empathetic support to those navigating abortion services.

Planned Parenthood of the Rocky Mountains

Certified Medical Coder

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The Coder I is responsible for abstraction and assigning valid CPT, ICD-10, HCPCs codes and modifiers to ensure appropriate reimbursement in accordance with federal state, and private health plans as well as organization and regulatory guidance. With more than 12,000 team members—physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals—UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day.

UofL Health

Coder I, ED, Remote

Collaborates and coordinates with various Sanford Health leaders to ensure coding integrity and accurate data collection is achieved to support a seamless continuum of care, supporting provider compensation models, compliant processes, optimal reimbursement and efficient revenue cycle functions. Responsible for operational budget and strategic initiatives and formulation of Sanford Health"s coding operating model and enhancement of coding related services throughout the system in order to drive and meet the goals of revenue services.

Sanford Health

Senior Director Coding

Within the first year, success will mean establishing strong relationships with assigned providers and clinical leaders, independently managing audits and deadlines, and becoming a respected coding and documentation resource. This full-time, fully remote opportunity is designed for an experienced coding professional ready to move beyond production coding into a consultative role focused on provider auditing, individualized education, and complex coding research.

Commonwealth of Virginia

Coding Quality Educator

EXL harnesses the power of data, analytics, AI, and deep industry knowledge to transform operations for the world's leading corporations in industries including insurance, healthcare, banking and financial services, media and retail, among others. EXL never requires or asks for fees/payments or credit card or bank details during any phase of the recruitment or hiring process and has not authorized any agencies or partners to collect any fee or payment from prospective candidates.

ExlService Holdings Inc

Outpatient Auditor II

Heartflow is the first AI-driven non-invasive integrated heart care solution across the CCTA pathway that helps clinicians identify stenoses in the coronary arteries (RoadMapAnalysis), assess coronary blood flow (FFRCT Analysis), and characterize and quantify coronary atherosclerosis (Plaque Analysis). The flagship product-an AI-driven, non-invasive cardiac test supported by the ACC/AHA Chest Pain Guidelines called the Heartflow FFRCT Analysis-provides a color-coded, 3D model of a patient's coronary arteries indicating the impact blockages have on blood flow to the heart.

HeartFlow

Field Reimbursement Manager - Southwest

Under the direction of Payment Integrity leadership, the Data Mining Ideation Specialist is responsible for identifying and developing data mining audit concepts that promote payment accuracy across Medicaid, Medicare, and Commercial lines of business. The Data Mining Ideation Specialist collaborates with audit, analytics, and operations teams to develop new overpayment recovery opportunities, define data selection parameters, validate audit results, and support ongoing quality and education initiatives.

MedReview

Data Mining Ideation Specialist

partner JazzHR

Position Overview: Responsible for activities which improve the accuracy of facility outpatient clinical documentation coding and charging, including education with the clinical departments and coding staff and root cause correction to support accurate charging and coding in compliance with policies. Demonstrated ability to utilize official coding/billing resources including CPT/HCPCS references, OPPS Manual, NCCI Manual, NUBC Manual, etc. to determine applicable charges/codes as documented in the health record.

Sutter Health has a long history in California. Some of our facilities have been providing care in the communities we serve for more than 100 years. Today, we’re proud to partner with more than 12,000 doctors to care for more than 3 million people.
We’re inspired by our Northern California community and work tirelessly to deliver top-rated, affordable healthcare. Doctors, hospitals, care teams and employees in the Sutter Health network are always looking for new, meaningful ways to care for you and your loved ones. We believe that every moment matters when it comes to helping you live a longer, healthier and happier life.
Our not-for-profit network delivers top-rated, personalized care in more than 100 Northern California communities. Recently ranked among the Top 15 Health Systems in the nation by Truven Health Analytics™, our team of more than 50,000 doctors, employees and volunteers partner to spread innovation, improve access to healthcare services and put our patients’ needs first—all to achieve the highest levels of quality, access and affordability.

Certified Professional Coder Jobs in the United States

Revenue Integrity Analyst II-1 Thomas Jefferson University

Charge Capture Specialist Manual Entry Banner Health

SIU Investigator Centene Corporation Group

Investigator III Blue Cross and Blue Shield Association

Risk Adjustment Compliance Specialist, Principal Blue Cross and Blue Shield Association

Billing Comp Education Spec | Physician Billing | Hybrid Days | Full Time University of Florida Health Science Center

Physician Billing Specialist | Full Time Peterson Health

Expert Claims Product Analyst (Concept Ideation) Zelis

Supervisor, Risk Adjustment Quality Assurance and Auditing Capital District Physicians Health Plan

Supervisor, Risk Adjustment Quality Assurance and Auditing Univera Healthcare

CODING ANALYST Premier Health Partners

Ambulatory Professional Fee and Hospitalist Coder (On-Site, Hybrid, Remote) Northbay Healthcare

Certified Medical Coder Planned Parenthood of the Rocky Mountains

Coder I, ED, Remote UofL Health

Senior Director Coding Sanford Health

Coding Quality Educator Commonwealth of Virginia

Outpatient Auditor II ExlService Holdings Inc

Field Reimbursement Manager - Southwest HeartFlow

Data Mining Ideation Specialist MedReview

Charge Audit Analyst Sutter Health

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