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The Coding Quality Specialist conducts coding quality reviews on internal and external coders to ensure diagnoses are appropriately and accurately assigned based upon clinical documentation, ICD-10-CM Official Guidelines for Coding and Reporting, AHA Coding Clinic Guidance, CMS program guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures. The Coding Quality Specialist will apply guidance provided for the medical record code abstraction primarily for Medicaid lines of business (Complete Code Capture), but may also include Medicare Advantage Risk Adjustment or Commercial Risk Adjustment.

Centauri Health Solutions Inc

Coder Quality Specialist - Remote, United States

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Must have comprehensive understanding of the contents of a typical medical chart, medical terminology and abbreviations, ICD 9 / ICD 10 coding conventions and guidelines, what constitutes adequate substantiation of a diagnosis, and appropriate providers, documents and facilities for proper code capture. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

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

HCC Coder - Remote AZ

Blue Cross Blue Shield of Arizona

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After work, you will find things to do in every season, including beaches, outdoor recreation, unique restaurants, world-class wineries, arts and entertainment. Under general supervision, according to established policies, procedures and protocols, codes all disease and operations according to accepted classifications.

Feed My People Food Bank

Certified Medical Coder

This position assists with the development of education/training materials, conducts and coordinates training and development of Health Information Management staff and other Banner staff as appropriate, including physicians/providers, and provides technical staff training in the usage of information systems components of the medical records database system. Must possess a current knowledge of business and/or healthcare as normally obtained through the completion of a bachelor's degree in business administration, healthcare administration or related field, plus advanced training in Health Information Management requirements and systems and in adult learning principles.

HOUR

Banner Health

Coder Educator Phys Pract

Other Completion of a CAHIIM Approved AHIMA/AAPC Accredited Coding Education and 3 years Coding Experience (Inpatient, Outpatient, Professional Fee, &/or Outpatient Physician Clinics) using ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS coding. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings.

CommonSpirit Health

Health Information Management Sr Coder

FULL_TIME

Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. Company Intro: At American Vision Partners (AVP) , we partner with the most respected ophthalmology practices in the country and integrate best-in-class management systems, operational infrastructure, and advanced technology to provide the highest quality patient care possible.

American Vision Partners

Certified Coder

[AW]-iCims

The HCC Coder II is a highly organized, team-oriented individual who possesses the ability to quickly understand and carry out verbal and written directions and can efficiently multi-task and work on special projects in addition to regular review of outpatient and inpatient charts. Perform a comprehensive review of outpatient and inpatient charts for documentation consistency and adequacy to identify all appropriate coding based on Centers for Medicare & Medicaid Services (CMS) HCC categories.

Arizona Priority Care

HCC Coder II

Manatal

ADAPTED_NOW

TTF is a search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health, consulting companies, and all other healthcare fields. The TTF Coding and HIM Division partners with healthcare organizations nationwide to match top talent in the Coding and HIM industry with organizations that want to hire the best talent.

TTF Search and Staffing

CPC Coder- Onsite

cBizSoft

TTF, LLC

The team combines clinical, technical, operational, financial, economic, and analytic expertise to help clients and counsel resolve complex matters involving payers, providers, pharmacies, and law firms. Exceptional executive communication skills, including the ability to explain complex technical, analytic, reimbursement, and damages issues to boards, C-suite clients, law firms, regulators, mediators, arbitrators, judges, and juries.

Ankura Consulting Group LLC

Senior Managing Director, Health Care and Life Sciences, Clinical Coder

We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. Our mission is to improve the quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation's top leading causes of death.

Optima Medical

E/M Coding Specialist (Remote)

GreenHouseAPI

Requests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Prepares draft narratives, graphs, flowcharts, etc. for use in presentations and audits; researches claims appeals and grievances using support systems to determine appeals and grievances outcomes.

Molina Healthcare Inc

Lead Specialist, Appeals & Grievances (Remote)

Our practices include Barnet Dulaney Perkins Eye Center, Southwestern Eye Center, Retinal Consultants of Arizona, M&M Eye Institute, Abrams Eye Institute, Southwest Eye Institute, Aiello Eye Institute, Moretsky Cassidy Vision Correction, Wellish Vision Institute, West Texas Eye Associates and Vantage Eye Center. Responsibilities: MAIN: Analyze daily financial exceptions from the charge capture audit reports to determine areas of leakage and partner with information technology and clinical service lines to rectify charge capture issues by assisting service lines to improve their ability to capture compliant charges.

Medical Billing Specialist

As a Senior Government Consultant I - Program Integrity Specialist, you will play a vital role as a core team member providing expert insights on complex projects for clients, which are primarily state Medicaid and Children's Health Insurance Program (CHIP) agencies and related state agencies responsible for Medicaid and CHIP fee-for-service and managed care programs. Participate in and lead client projects related to fraud, waste, and abuse prevention; compliance monitoring; risk assessment; and external audit coordination; Coordinate project priorities, client needs, subcontractor/vendor collaboration, deliverable development, workgroup activity, and leadership reporting.

YEAR

Marsh & McLennan Companies Inc

Senior Government Consultant I - Program Integrity Specialist

As a Senior Government Consultant I – Program Integrity Specialist, you will play a vital role as a core team member providing expert insights on complex projects for clients, which are primarily state Medicaid and Children’s Health Insurance Program (CHIP) agencies and related state agencies responsible for Medicaid and CHIP fee-for-service and managed care programs. Participate in and lead client projects related to fraud, waste, and abuse prevention; compliance monitoring; risk assessment; and external audit coordination; Coordinate project priorities, client needs, subcontractor/vendor collaboration, deliverable development, workgroup activity, and leadership reporting.

Marsh McLennan

The Coding Manager will additionally identify, evaluate, and implement automated workflows and AI-driven opportunities to enhance efficiency and accuracy within the coding department ESSENTIAL FUNCTIONS Supervises the daily activities and performance of the professional services coding staff. JOB SUMMARY The Coding Manager for Professional Services is a Certified Professional Coder (CPC) responsible for the leadership, supervision, and performance of the professional services coding team across the HonorHealth Network.

HonorHealth

Professional Coding Manager

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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 Inc

Field Reimbursement Manager - Southwest

OTHER

Complies with the Veterans Affairs Community Care Network (CCN) and TRICARE T-5 contracts; DHA and TRICARE program guidelines and pertinent Federal regulatory requirements; assists supervisors with FWA trending and reporting requirements; coordinates and assists with investigations and prosecutions by federal agencies interfaces directly with Veterans, Military members and family (as warranted), providers, subcontractors, and other TriWest departments on FWA issues; assist supervisor with the education and training of TriWest, subcontractor, and provider personnel on current FWA matters; prepares appropriate responses to provider compliance issues and complaints referred to Program Integrity by other TriWest departments or external referrals. The PI Investigator t is responsible for the identification, analysis, case development, and reporting of suspected fraud, waste and abuse (FWA) cases as defined by the Department of Veterans Affairs (VA), the Healthcare Finance Administration (HCFA) and the Department of Defense, Defense Health Agency for the TRICARE program; requests and reviews issue-related medical claims and records for FWA and/or administrative and clerical error(s).

TriWest Healthcare Alliance

Program Integrity Investigator

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Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential Centers of Medicare & Medicaid Services (CMS), Health and Human Services (HHS) audits and medical record retrieval efforts. Pay Transparency: The base pay for this role is: $82,717 - $108,566 per year You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses.

Remote Medical Coder Jobs in Phoenix, AZ

Coder Quality Specialist - Remote, United States Centauri Health Solutions Inc

HCC Coder - Remote AZ Blue Cross and Blue Shield Association

HCC Coder - Remote AZ Blue Cross Blue Shield of Arizona

Certified Medical Coder Feed My People Food Bank

Coder Educator Phys Pract Banner Health

Health Information Management Sr Coder CommonSpirit Health

Certified Coder American Vision Partners

HCC Coder II Arizona Priority Care

CPC Coder- Onsite TTF Search and Staffing

CPC Coder- Onsite TTF, LLC

Senior Managing Director, Health Care and Life Sciences, Clinical Coder Ankura Consulting Group LLC

E/M Coding Specialist (Remote) Optima Medical

Lead Specialist, Appeals & Grievances (Remote) Molina Healthcare Inc

Medical Billing Specialist American Vision Partners

Senior Government Consultant I - Program Integrity Specialist Marsh & McLennan Companies Inc

Senior Government Consultant I - Program Integrity Specialist Marsh McLennan

Professional Coding Manager HonorHealth

Field Reimbursement Manager - Southwest Heartflow Inc

Program Integrity Investigator TriWest Healthcare Alliance

Risk Adjustment Auditor Oscar Health

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