UNKNOWN

FEED

Updates the CDM annually based on changes published by the AMA (American Medical Association) via CPT guidelines; updates quarterly based on CMS (Centers for Medicare and Medicaid) guidelines for HCPCS codes (Healthcare Common Procedure Coding System). Performs job functions adhering to service principles with customer service focus of innovation, service excellence and teamwork to provide the highest quality care and service to our patients, families, co-workers and others.

Ann & Robert H. Lurie Children's Hospital of Chicago

Revenue Integrity Chargemaster Analyst

FULL_TIME

OTHER

At least one (1) of the following certifications is required: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist Physician-Based (CCS-P), Registered Health Information Admin (RHIA), Registered Health Info Tech (RHIT), Certified Clin Doc Spec (CCDS), Certified Doc Improvement Practitioner (CDIP) required. Effectively use coding and clinical documentation knowledge management, the electronic medical record functionality and technology to streamline and support staff in their coding, clinical documentation and revenue protection.

University of Wisconsin Medical Foundation

Coding & Revenue Integrity Education Specialist

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PART_TIME

Verifies patient coverage and demographic information, draws conclusions, and corrects billing errors or other Claim issues. Post charges into billing system within 24-48 hours and completes other billing functions under direction of supervisor.

0635-Big Bend Medical Group

Certified Professional Coder

Work with the Clinical Documentation Specialists on concurrent coding to generate the working Diagnosis Related Group (DRG), Geometric Mean Length of Stay (GMLOS), and provide information to the Coding Sequence (CDS) when a query needs to be generated from a coding or clinical clarity perspective. Work with the Clinical Documentation Specialists to generate compliant queries to send to the physicians when documentation needs further clarification to ensure clear compliant documentation and maximum reimbursement.

Nebraska Methodist Health System

Hospital Inpatient Coder

Maintain a working knowledge, and stay abreast of, CPT-4, ICD-10, HCPCS coding principles, modifier usage, medical terminology, governmental regulations, protocols and third party payer requirements pertaining to billing, coding and documentation. Impact - TOA's team members use our careers — whether in our clinics or our business office to make a positive difference in the community by building relationships and helping patients live their best life.

TOA Middle

Certified Coder

Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 110 Compensation Range: $61,000.00 - $85,400.00 The referenced pay range represents the minimum and maximum compensation for this job. With general direction of the Manager, with latitude for independent judgment: 30% In collaboration with the Manager, the Assistant Manager plays a key role in driving revenue cycle results by effectively managing the assigned functional area and serving as the team’s coding specialist.

University of Rochester

Supervisor, Medical Coding

Certified Coder - Surgery

High School (Required)CCA - Certified Coding Associate - American Health Information Management Association, Certified Coding Specialist- Hospital - Sarah Bush Lincoln, Certified Professional Coder-A - Sarah Bush Lincoln, Registered Health Information Technician (RHIT) - American Health Information Management Association or Registered Health Info Administrator (RHIA) - American Health Information Management Association - American Health Information Management Association Compensation . Coders - Hospital are responsible for technical coding includes the assignment of ICD-CM/PCS, CPT, and HCPCS codes, modifiers, selection of MD Diagnosis Related Groupings (MS-DRG), Ambulatory Payment Classification (APC), and coding for severity of illness.

Sarah Bush Lincoln Health Center

Coder Hospital-1

Completion of one of the following through AHIMA accredited programs: Certificate Coding Associate, Certificate Coding Specialist, Certified Professional Coder, Registered Health Information Technician, Registered Health Information Administrator. The Coder I position is responsible for accurate, coding, abstracting, claims filing, documentation review and claims denial processing working from the appropriate documentation in the medical record.

Lawrence Memorial Hospital

Coder

Meets continued education guidelines to maintain current AAPC CPC certification Exercises good judgement in escalating identified coding trends that may negatively impact productivity, quality or revenue to enhance clinical documentation to support codes billed, drive consistency across IPM, mitigate claim denials, expedite reprocessing of claims and maximize opportunities to enhance front end, coding-related claim edits to facilitate first pass resolution. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located in 40 U.S. states, Washington, D.C., Puerto Rico and the United Kingdom.

University Health Services Inc

HIM Coding Auditor

The Compliance Auditor is responsible for conducting compliance auditing, monitoring, and risk assessment activities to ensure organizational adherence to federal, state, accreditation, contractual, and organizational requirements. The Compliance Auditor identifies areas of regulatory risk, recommends corrective actions, evaluates the effectiveness of compliance controls, and supports continuous improvement efforts throughout the organization.

Mental Health Cooperative

Compliance Auditor

Under the direction of the Vice President of Compliance, and in close partnership with the Special Investigations Unit (SIU) Manager, the SIU Medical Record Audit Manager provides leadership and strategic direction for IEHP’s prepayment and post-payment medical record audit functions within the Fraud, Waste, and Abuse (FWA) framework. Prepayment Review Performance Lead end to end prepayment medical record review operations, including documented criteria for placing and releasing providers, turnaround compliance within claims payment timeframes, yield optimization, false positive monitoring, inventory aging, and scheduled reassessment and exit decisions.

YEAR

Inland Empire Health Plan

Manager, Special Investigations Unit Medical Record Audit

[AW]-iCims

Resolve Claims Manager and Epic edits to ensure correct coding of services provided, including review of documentation for correct coding, evaluation and management (E/M) leveling, diagnosis coding, bundling issues, and modifier usage. The role operates within a healthcare records or billing team and requires close liaison with clinicians, clinical coders, and administrative staff to resolve documentation queries.

UCSF Medical Center

Patient Records Abstractor 2

The Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to ensure compliance with coding practices through comprehensive record reviews for medical, behavioral, transportation, and other healthcare providers. • Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates findings effectively to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, and state regulators.

CVS Health offers a world of promising job opportunities across a diverse range of careers in everything from corporate and pharmacy roles to retails positions. No matter where you work at CVS Health, your unique skills, talents and abilities are welcome and valued. We recognize and reward greatness and want our employees to know their work is making a difference in the lives of millions. Join us today. Together we can continue making innovative, high-quality health and pharmacy services safe, affordable and accessible – for all.

CVS Health

Special Investigation Unit (SIU) Manager

The investigator analyzes claims, encounter, enrollment, medical record, and provider data; conducts interviews, field investigations, and on-site audits, when necessary; prepares detailed investigative reports; and collaborates with compliance, legal, operational stakeholders, regulatory agencies, and law enforcement. Responsibilities: The SIU Fraud Investigator is responsible for identifying, investigating, and resolving allegations and indicators of fraud, waste, and abuse (FWA) involving providers, vendors, members, and other parties participating in Elderplan’s product lines.

Metropolitan Jewish Health System

Fraud Investigator

The HCC/RAF Coding Specialist serves as a key resource supporting providers and clinical teams by ensuring patient conditions are accurately reflected in the medical record in accordance with CMS Hierarchical Condition Category (HCC) and MassHealth DxCG guidelines. Our network includes Baystate Medical Center, Baystate Children's Hospital, Baystate Noble Hospital, Baystate Franklin Medical Center, Baystate Wing Hospital, Baystate Medical Practices, and Baystate Home Health & Hospice .

Baystate Health

Registered Nurse - HCC/RAF Coding Specialist

In terms of professional development, Everforth Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Education: Must possess current knowledge of Healthcare/Coding as normally obtained through the completion of a bachelor's degree in healthcare administration or related field, or equivalent experience in a related field.

HOUR

StratAcuity Staffing Partners Inc

Risk Adjustment Audit Reviewer

The Revenue Cycle Manager ensures services are appropriately supported by documentation, claims and encounters are submitted accurately and timely, outstanding revenue is actively managed, reimbursement discrepancies are identified and resolved, and Revenue Cycle activities comply with payer, contractual, regulatory, and organizational requirements. Through programs such as Enhanced Care Management (ECM), Community Supports (CS), Community Health Worker (CHW) services, Behavioral Health, and other community-based healthcare programs, PHG works collaboratively with health plans, providers, community organizations, and other partners to support whole-person care.

Pacific Health Group

Revenue Cycle Manager

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Under the guidance of the Manager of GAU, collaborates with the designated GAU Reporting Analyst and GAU Manager to generate reports for including but not limited to CMS, EOHHS, OHIC audits, and participates in the compiling of all grievance, appeal, and complaint records selected for on-site audits. Builds effective and successful interdepartmental relationships with all areas of the company and utilizes good communication and customer service skills in responding to internal and external inquiries about the grievance, appeal and complaint process while being able to respond quickly regarding the status.

Neighborhood's employees come from a diverse background but all are committed to creating a more equitable health care system. Our array of experiences allows us to have a broad perspective and great creativity in facing whatever challenges arise. Unlike many other health insurance companies, we have nearly 30 nurses and social workers on staff. This structure speaks to our focus on active and compassionate care management for our members; we know that people who are alienated from the health care system require additional advocacy, outreach and support. 

Neighborhood offers an exceptional compensation package to employees. We annually review base salaries/benefits and adjust as appropriate.

Neighborhood Health Plan of Rhode Island

Grievance and Appeals Coordinator (44913)

This role is responsible for developing, delivering, and evaluating provider-focused coding and documentation education programs that promote accurate clinical documentation, compliant coding practices, and optimal charge capture. OneOncology is positioning community oncologists to drive the future of medical care through a patient-centric, physician-driven, and technology-powered model to help improve the lives of everyone living with cancer and other diseases.

Certified Professional Coder Jobs in the United States

Revenue Integrity Chargemaster Analyst Ann & Robert H. Lurie Children's Hospital of Chicago

Coding & Revenue Integrity Education Specialist University of Wisconsin Medical Foundation

Certified Professional Coder 0635-Big Bend Medical Group

Hospital Inpatient Coder Nebraska Methodist Health System

Certified Coder TOA Middle

Supervisor, Medical Coding University of Rochester

Certified Coder - Surgery TOA Middle

Coder Hospital-1 Sarah Bush Lincoln Health Center

Coder Lawrence Memorial Hospital

HIM Coding Auditor University Health Services Inc

Compliance Auditor Mental Health Cooperative

Manager, Special Investigations Unit Medical Record Audit Inland Empire Health Plan

Patient Records Abstractor 2 UCSF Medical Center

Special Investigation Unit (SIU) Manager CVS Health

Fraud Investigator Metropolitan Jewish Health System

Registered Nurse - HCC/RAF Coding Specialist Baystate Health

Risk Adjustment Audit Reviewer StratAcuity Staffing Partners Inc

Revenue Cycle Manager Pacific Health Group

Grievance and Appeals Coordinator (44913) Neighborhood Health Plan of Rhode Island

RCM Coding Education Specialist OneOncology Inc

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