Medical auditor jobs near me - 584 jobs

ABOUT MACHINIFY: In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify's AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We're reshaping healthcare payment through seamless intelligence. ABOUT THE OPPORTUNITY: Hiring Range: $78,000 - $84,000 The Medical Review Clinical Appeals Auditor - ALJ (SNF FOCUS) is responsible for conducting Appeals reviews of new evidence presented by auditee's, disputing all or part of the findings from medical review audit work completed by the medical review clinical audit team members, communicates and supports the identification of potential training opportunities or enhancements to training and/or concept review guideline materials and tools. This position also includes taking party status in Administrative Law Judge (“ALJ”) hearings. Responsible for performing some audit activity and consistently achieves or exceeds productivity goals and quality standards. Serves as subject matter expert, provides supplemental escalation support, and may perform special project activity as needed. Key Responsibilities Performs clinical reviews on medical records to maintain subject matter expertise, and additionally as needed to support business needs. Conducts Appeals reviews on medical review audit work completed by the medical review clinical and documentation audit team members, as new evidence is presented by auditees. Objectively and accurately documents Appeals results in accordance with department quality policies and procedures, scoring and reporting all Appeals results and routes the result appropriately within audit platform based upon how the Appeal review resulted in a full or partial upholding of the audit finding or with a full or partial overturn. Reviews audit documentation and conducts research, analyzes claims data, applies knowledge of client SOW, applicable concept guidelines, policies, and regulations as necessary to determine if audit result is accurate and includes complete details to support findings. Provides correction to narrative rationale to correspond with audit determination and flags patterns of concern to audit leadership for real-time intervention, preventing an accumulation of improper findings. Contributes to the continuous improvement feedback process and suggests any edits to documentation, enhancements review guidelines, and reporting as may be necessary in accordance with department process and audit leadership direction. May support findings during the appeals process, including taking party status in ALJ hearings. May perform primary audit activity as assigned by management. Monitors, tracks, and reports on all work conducted in accordance with Appeals process and management direction. May prepare reports for management that includes a variety of data and trends at the individual, department, and client program level, as well as date range or concept based/trended, or other characteristic that will provide valuable business insights. Consults with internal resources as necessary. Become subject matter expert for assigned business segment(s). Maintain current knowledge and changes that affect our industry and clients as it pertains to medical practice, technology, regulations, legislation, and business trends. Participates in and contributes to applicable department meetings. Successfully completes, retains, applies, and adheres to content in required training as assigned that includes but not limited to information security, anti-harassment and other compliance and policy/procedures training applicable for position. Proactively contributes to continuous improvement of activities and sets positive example. Contributes collaboratively to identifying opportunities for improvement of audit results and continuous improvement initiatives. May support training material/tools and best practices development. May identify/make recommendations to management for supplemental team/concept type training. May support training activities for new audit staff or provide supplemental training for existing staff as needed. Contributes to positive team environment that fosters open communication, sharing of information, continuous improvement, and optimized business results. Receives feedback and adjusts work priority as necessary. Serves as positive role model and example for other audit staff and conducts work in accordance with company policies, government regulations and law. Performs job duties with high level of professionalism and maintains confidentiality. Perform other incidental and related duties as required and assigned to meet business needs. Knowledge, Skills and Abilities Needed Demonstrated ability to perform claim payment audits with high quality and production results, as well as successful application of skills to conduct quality assurance review of audit work completed by others. Must be able to manage multiple assignments effectively, create documentation outlining findings, Appeals review results and/or documenting suggestions, organize and prioritize workload, problem solve, work independently and with team members. Experience with CPT/HCPCs/ICD-9/ICD-10/MS-DRG coding. Strong knowledge of medical documentation requirements and an understanding CMS, Medicaid and/or Commercial insurance programs, particularly the coverage and payment rules and regulations. Strong preference for experience performing utilization review for an insurance company, Tricare, MAC or organizations performing similar functions. Experience with utilization management systems or clinical decision-making tools such as Millimen Care Guidelines (MCG) or InterQual. Working knowledge of encoder Reimbursement policy and/or claims software analyst experience. Familiarity with interpreting electronic medical records (EHR) Basic understanding of accounting principles for accounts payable and receivable as it relates to medical billing. Independent, out-of-the-box thinker; Performs successfully against work given in the form of objectives and projects; leads by example. Understands processes, procedures, and workflow; and demonstrated ability to identify areas of opportunity. Demonstrated ability to consistently apply sound judgment and good effective decision making. Understands Medical Review Audit and Quality Assurance objectives, activities, and key drivers in achieving operational goals. Ability to efficiently and effectively run reports, analyze information, identify meaningful trends, and identify potential solutions. Strong communication skills, both verbal and written; ability to communicate effectively and professionally at all levels within the organization, both internal external. Demonstrated ability to collaborate effectively in a variety of settings and topics. Excellent editing and proofreading skills. Ability to independently organization, prioritize and plan work activities effectively for self and others; develops realistic action plans with the ability to multi-task effectively. Excellent time management and delivers results balancing multiple priorities. Strong analytical skills; synthesizes complex or diverse information; collects and researches data; uses experience to compliment data. Leverages strong critical thinking, questioning, and listening skills to research and effectively resolve complex issues. Demonstrated ability to identify areas of opportunity and create efficiencies in workflows and procedures. Demonstrated ability to be proactive; identifies and resolves problems in a timely manner; develops alternative solutions. Ability to create documentation outlining findings and/or documenting suggestions. Strong general computer skills, including, but not limited to Desktop and MS Office applications (Intermediate Excel Skills), application reporting tools, and case management system/tools to review and document findings. Solid technical aptitude with demonstrated ability to quickly learn and adapt to new systems and tools. Ability to be flexible and thrive in a high pace environment with changing priorities. Adaptable to applying skills to diverse operational activities to support business needs. Self-starter with the ability to work independently in remote setting with minimum supervision and direction in the form of objectives. Serves as a positive role model; and demonstrates characteristics that align and contribute to a collaborative culture of continuous improvement and high performing teams. Required and Preferred Qualifications Active unrestricted RN license in good standing and diversified nursing experience providing direct care in an inpatient, skilled nursing or outpatient setting. Not currently sanctioned or excluded from the Medicare program by OIG. One or more years of experience in health care claims that demonstrates expertise in, ICD-9/ICD-10 coding, HCPS/CPT coding, bundled payment methodologies and/or medical billing experience for an Insurance Company or hospital or other appropriate medical provider required. 5+ years relevant experience in a provider or payer environment demonstrating breadth and depth of auditing knowledge/skills for the position. (less than 5 yrs. may be considered for internal candidates based upon demonstrated skills and results). Prior experience taking party status in ALJ hearings a plus. Prior experience in role with responsibility for conducting primary audit, utilization management or prior-authorization work, or review of audit work performed by others (QA function, appeals function, lead, supervisory role, etc.) Prior experience in payer edit development and/or reimbursement policy a plus. Prior experience working in remote setting preferred. WHAT WE OFFER: Machinify offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, HSA/FSA options, life insurance coverage, 401(k) savings plans, family/parental leave, paid holidays, as well as paid time off annually. For more information about our benefits package, please refer to our benefits page on our website or discuss with your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). Regularly sit/stand 8 or more hours per day. Occasionally lift/carry/push/pull up to 10lbs. Machinify is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. Must complete the Machinify Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. Other requirements may apply. All employees and contractors for Machinify may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Machinify's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Machinify is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Machinify will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Machinify's Human Resources team to discuss further. Our diversity makes Machinify unique and strengthens us as an organization to help us better serve our clients. Machinify is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED UNLESS EXPLICITY AGREED TO IN WRITING

This Sterilization Medical Device Auditor position is an excellent opportunity for recent retirees or consultants that have Sterilization experience in Ethylene Oxide or Radiation(Gamma, Electron Beam &/or X-ray). Our auditors enjoy traveling domestically and/or internationally, a flexible schedule (some auditors perform 1 or 2 audits a month, while others desire to audit every week), competitive compensation that includes a daily rate plus travel expenses, meeting new people and keeping in touch with technology and the latest developments, networking with other industry professionals. To learn more about this auditor position, please review these General Guidelines. Qualifications The ideal auditor candidate will possess the following criteria: Bachelor's Degree Minimum of 3 years hands-on sterilization work experience in Ethylene Oxide or Radiation (Gamma, Electron Beam &/or X-Ray) Knowledge of the Standards as they relate to Sterilization Minimum of 5 years auditing experience (not necessarily sterilization) Quality Assurance System experience (primarily ISO 13485 or 21CFR820)

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. This position is on the surgical coding team. This role will work on Ambulatory work queues and E&M leveling. Job Summary Summary: Responsible for ensuring proper coding compliance, documentation accuracy, and adherence to coding guidelines and regulations. Does this position require Patient Care? No Essential Functions: Assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information. -Ensure compliance with coding guidelines, including those outlined by the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other regulatory bodies. -Analyze medical records, including physician notes, laboratory results, radiology reports, and operative reports, to extract pertinent information for coding purposes. -Maintain a high level of accuracy and quality in coding assignments to ensure proper reimbursement and minimize claim denials. -Utilize coding software, encoders, and electronic health record systems to facilitate the coding process. -Support coding compliance efforts by participating in coding audits, internal or external coding reviews, and documentation improvement initiatives. -Maintain accurate records of coding activities, including tracking productivity, coding accuracy rates, and any coding-related issues or challenges. Qualifications Education High School Diploma or Equivalent required or Associate's Degree Medical Billing and Coding preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred Experience Medical Coding Experience 3-5 years required Knowledge, Skills and Abilities - In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing. - Familiar with coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations. - Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes. - Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding. - Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff. - Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment. Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $21.78 - $31.08/Hourly Grade 4 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: 0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

The Profee Auditor is responsible for assigning ICD-10 and/or CPT/HCPCS codes as appropriate and abstracts pertinent information from patient records. Minimum Requirements: + Must hold at least one of the following certifications: RHIA, RHIT, CCS, CCS-P, CPC, CPC-H (COC) and have a preferred minimum of 2 years relevant coding experience + Must be at least 18 years of age + Must have experience in Profee Auditing Benefits At Amergis, we firmly believe that our employees are the heartbeat of our organization and we are happy to offer the following benefits: + Competitive pay & weekly paychecks + Health, dental, vision, and life insurance + 401(k) savings plan + Awards and recognition programs *Benefit eligibility is dependent on employment status. About Amergis Amergis, formerly known as Maxim Healthcare Staffing, has served our clients and communities by connecting people to the work that matters since 1988. We provide meaningful opportunities to our extensive network of healthcare and school-based professionals, ready to work in any hospital, government facility, or school. Through partnership and innovation, Amergis creates unmatched staffing experiences to deliver the best workforce solutions. Amergis is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

Job Posting We are dedicated to providing exceptional care to every patient, every time. St. Luke's Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship St. Luke's Hospital for over a decade has been recognized for “Outstanding Patient Experience” by HealthGrades. Position Summary: Performs data quality reviews on patient records to validate coding appropriateness, missed secondary diagnoses and procedures, and ensures compliance with all coding related regulatory mandates and reporting requirements. Monitors Medicare and other payer bulletins and manuals and reviews the current OIG Work Plans for coding risk areas. Responsible for promoting teamwork with all members of the healthcare team. Performs all duties in a manner consistent with St. Luke's mission and values. This position is 40hrs/week and 100% remote. Education, Experience, & Licensing Requirements: Education: Associate degree in Health Services Experience: 5 years of production coding experience or 5 years coding auditing experience. ICD-10-CM (including coding conventions and guidelines), CPT-4 (including coding conventions and guidelines), HCPCS, NCCI edits, and APC experience. Cerner and 3M/Solventum experience. Licensure: RHIA, RHIT, or CCS certification Benefits for a Better You: Day one benefits package Pension Plan & 401K Competitive compensation FSA & HSA options PTO programs available Education Assistance Why You Belong Here: You matter. We could not achieve our mission daily without the hands of our team. Our culture and compassion for our patients and team is a distinct reflection of our dynamic workforce. Each team member is focused on being part of something much bigger than themselves. Join our St. Luke's family to be a part of making life better for our patients, their families, and one another.

Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery. We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients. Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and Virginia. As an equal opportunity employer, we celebrate diversity and are committed to an inclusive environment for all employees and patients. Day in the Life of a Medical Coding Auditor Conducting audits of claims and patient records to identify incorrect coding. Audits will be performed for both provider and coder coding accuracy with required documentation in accordance with current coding guidelines. Developing, implementing, and coordinating corrective action proposals and plans. Tracking completion of internal and external Plans of Correction. Preparing reports of findings and any compliance issues identified with audits, including monthly summary reports for the Crossroads executive team and quarterly reports for the Chief Compliance Officer. Attending and reporting at weekly team calls with Manager of Medical Coding Compliance Audits, Director of Medical Coding Compliance and Chief Compliance Officer. Attending weekly meetings with other auditors. Reporting coding patterns identified within the audit process to management and identifies corrective measures to compliance problems. Assisting the Manager of Medical Coding Compliance Audits with training and education of providers, coders, and centers (OBOTs and OTPs) on medical coding compliance. Responsible for maintaining current knowledge of coding guidelines and relevant federal regulations through the use of current CPT-4, HCPCS II, and ICD-10 materials, the Federal Register, and other pertinent materials. May interact with providers and/or center administrators from time to time regarding billing and documentation policies, procedures, and conflicting/ambiguous or non-specific documentation. Provide coding and compliance updates to all staff. Collaborates with interdepartmental or cross-functional teams for assigned projects and provides departments with identified coding issues and updates to ensure timely and accurate reimbursement. Determines method of completing daily workload and priorities to ensure that all responsibilities are carried out in a timely manner. Assisting with pulling records requested by payers related to payer audits and review of such records to identify any issues. Other duties and responsibilities pertaining to medical coding compliance monitoring as requested by the Director of Medical Coding Compliance Director of Medical Coding Compliance. Schedule, Travel, & Work Authorization Employees must work 8-hour shifts Monday through Friday and may clock in as early as 6:30 AM EST, but no later than 9:00 AM EST. Employees may not clock out before 4:00 PM EST. Education and Licensure Requirements Certified Professional Coder (CPC), Certified Coding Specialist- Professional (CCS-P) or Certified Professional Medical Auditor (CPMA) High School diploma, GED or equivalent. Minimum of 5 years of coding experience. Minimum of 2 years of auditing experience. Experience in auditing healthcare provider documentation to identify correct ICD-10-CM, CPT, and/or HCPCS codes preferred. An excellent understanding of Mental Health / Opioid Addiction medical terminology preferred. An excellent understanding of ICD-10-CM coding classification and CPT/HCPCS coding. Computer literate adept skill level on MS Office applications. Good organizational and communication skills. Task oriented and ability to meet designated deadlines and productivity standards. Strong, well-developed interpersonal skills. Experience in Mental Health or Addiction Medicine a plus. Position Benefits Medical, Dental, and Vision Insurance PTO Variety of 401K options including a match program with no vesture period Annual Continuing Education Allowance (in related field) Life Insurance Short/Long Term Disability Paid maternity/paternity leave Mental Health Day Calm subscription for all employees Position Benefits Have a daily impact on many lives. Excellent training if you are new to this field. Mileage reimbursement (if applicable) Crossroads matches the current IRS mileage reimbursement rate. Community events that promotes belonging and education. Includes but not limited to community cook outs, various fairs related to addiction treatment and outreach, parades, addiction awareness for schools, and holiday events. Opportunity to save lives everyday!

We exist to create positive change for people and the planet. Join us and make a difference too! Job Title: QMS Auditor Do you believe the world deserves excellence? BSI (British Standards Institution) is the global business standards company that equips businesses with the necessary solutions to turn standards of best practice into habits of excellence. Our Medical Devices (or Regulatory Services) team ensures patient safety while supporting timely market access for our clients' medical device products globally. BSI is an accredited ISO 13485 Certification Body recognized in many global markets Essential Responsibilities: * Analyze quality systems and assess ISO 13485, CE Marking and MDSAP schemes. * Prepare assessment reports and deliver findings to clients to ensure client understanding of the assessment decision and clear direction to particular items of corrective action where appropriate * Recommend the issue, re-issue or withdrawal of certificates, and report recommendations in accordance with BSI policy, procedures and prescribed time frame. * Maintain overall account responsibility and accountability for nominated accounts to ensure an effective partnership, whilst ensuring excellent service delivery and account growth. * Lead assessment teams as required ensuring that team members are adequately briefed so that quality of service is maintained and that effective working relationships are sustained both with Clients and within the team. * Provide accurate and prompt information to support services, working closely with them to ensure that client records are up to date and complete and that all other internal information requirements are met. * Coach colleagues as appropriate especially where those members are inexperienced assessors or unfamiliar with clients' business/technology and assist in the induction and coaching of new colleagues as requested * Plan/schedule workloads to make best use of own time and maximize revenue-earning activity. Education/Qualifications: * Associate's degree or higher in Engineering, Science or related degree required * Minimum of 4 years experience in the medical device field including at least 2 years must be hands-on medical device design, manufacturing, testing or clinical evaluation experience. * The candidate will develop familiarity with BSI systems and processes as they go through the qualification process. * Knowledge of business processes and application of quality management standards. * Good verbal and written communication skills and an eye for detail. * Be self-motivated, flexible, and have excellent time management/planning skills. * Can work under pressure. * Willing to travel on business intensively. * An enthusiastic and committed team player. * Good public speaking and business development skill will be considered advantageous. The salary for this position can range from $98,100 to $123,860 annually; actual compensation is based on various factors, including but not limited to, the candidate's competencies, level of experience, education, location, divisional budget and internal peer compensation comparisons. BSI offers a competitive salary, group-sponsored health and dental, short-term and long-term disability, a company-matched 401k plan, company paid life insurance, 11 paid holidays and 4 weeks paid time off. #LI-REMOTE #LI-MS1 About Us BSI is a business improvement and standards company and for over a century BSI has been recognized for having a positive impact on organizations and society, building trust and enhancing lives. Today BSI partners with more than 77,500 clients in 195 countries and engages with a 15,000 strong global community of experts, industry and consumer groups, organizations and governments. Utilizing its extensive expertise in key industry sectors - including automotive, aerospace, built environment, food and retail, and healthcare - BSI delivers on its purpose by helping its clients fulfil theirs. Living by our core values of Client-Centricity, Agility, and Collaboration, BSI provides organizations with the confidence to grow by partnering with them to tackle society's critical issues - from climate change to building trust in digital transformation and everything in between - to accelerate progress towards a better society and a sustainable world. BSI is an Equal Opportunity Employer dedicated to fostering a diverse and inclusive workplace.

We exist to create positive change for people and the planet. Join us and make a difference too! Job Title: QMS Auditor Do you believe the world deserves excellence? BSI (British Standards Institution) is the global business standards company that equips businesses with the necessary solutions to turn standards of best practice into habits of excellence. Our Medical Devices (or Regulatory Services) team ensures patient safety while supporting timely market access for our clients' medical device products globally. BSI is an accredited ISO 13485 Certification Body recognized in many global markets Essential Responsibilities: Analyze quality systems and assess ISO 13485, CE Marking and MDSAP schemes. Prepare assessment reports and deliver findings to clients to ensure client understanding of the assessment decision and clear direction to particular items of corrective action where appropriate Recommend the issue, re-issue or withdrawal of certificates, and report recommendations in accordance with BSI policy, procedures and prescribed time frame. Maintain overall account responsibility and accountability for nominated accounts to ensure an effective partnership, whilst ensuring excellent service delivery and account growth. Lead assessment teams as required ensuring that team members are adequately briefed so that quality of service is maintained and that effective working relationships are sustained both with Clients and within the team. Provide accurate and prompt information to support services, working closely with them to ensure that client records are up to date and complete and that all other internal information requirements are met. Coach colleagues as appropriate especially where those members are inexperienced assessors or unfamiliar with clients' business/technology and assist in the induction and coaching of new colleagues as requested Plan/schedule workloads to make best use of own time and maximize revenue-earning activity. Education/Qualifications: Associate's degree or higher in Engineering, Science or related degree required Minimum of 4 years experience in the medical device field including at least 2 years must be hands-on medical device design, manufacturing, testing or clinical evaluation experience. The candidate will develop familiarity with BSI systems and processes as they go through the qualification process. Knowledge of business processes and application of quality management standards. Good verbal and written communication skills and an eye for detail. Be self-motivated, flexible, and have excellent time management/planning skills. Can work under pressure. Willing to travel on business intensively. An enthusiastic and committed team player. Good public speaking and business development skill will be considered advantageous. The salary for this position can range from $98,100 to $123,860 annually; actual compensation is based on various factors, including but not limited to, the candidate's competencies, level of experience, education, location, divisional budget and internal peer compensation comparisons. BSI offers a competitive salary, group-sponsored health and dental, short-term and long-term disability, a company-matched 401k plan, company paid life insurance, 11 paid holidays and 4 weeks paid time off. #LI-REMOTE #LI-MS1 About Us BSI is a business improvement and standards company and for over a century BSI has been recognized for having a positive impact on organizations and society, building trust and enhancing lives. Today BSI partners with more than 77,500 clients in 195 countries and engages with a 15,000 strong global community of experts, industry and consumer groups, organizations and governments. Utilizing its extensive expertise in key industry sectors - including automotive, aerospace, built environment, food and retail, and healthcare - BSI delivers on its purpose by helping its clients fulfil theirs. Living by our core values of Client-Centricity, Agility, and Collaboration, BSI provides organizations with the confidence to grow by partnering with them to tackle society's critical issues - from climate change to building trust in digital transformation and everything in between - to accelerate progress towards a better society and a sustainable world. BSI is an Equal Opportunity Employer dedicated to fostering a diverse and inclusive workplace.

Remote - Inpatient Coder II Inpatient Coding PRN Status Day Shift Pay: $24.74 - $37.11 / hour Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. This position is responsible for assigning ICD-10-CM and ICD-10-PCS codes for inpatient and LTACH services. This assignment is based on evaluation of the documentation in the medical record and utilization of coding guidelines, Coding Clinic, anatomy and physiology. This position works under the supervision of the Manager and is employed by Mosaic Health System. Codes complex diseases, procedures and diagnoses using the ICD-10-CM/PCS classification systems, in accordance with Official Coding Guidelines, CMS guidelines, PPS guidelines and organizational compliance standards. Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation. Completes complex coding assignments for reimbursement, research and compliance with Federal and State regulations. Researches coding guidelines. Reviews and appeals coding denials. Educates/Communicates with providers, querying providers to ensure that optimal clinical documentation is provided to demonstrate the severity and details of the patient's illness in the medical record. Coordinates/Communicates with departments including clinical departments, Quality Improvement, Care Management, Patient Financial Services to ensure accuracy and timeliness of coding. Ensures data accuracy by responding to coding edits received. Cross-trained and able to complete one type of outpatient facility coding in addition to inpatient coding. Example: Emergency Department, Observation, Referral. Mentors and assists with training coders. Completes analysis by utilizing reports, record reviews, etc. Other duties as assigned. Must have coding education. Associate's Degree or higher in Health Information Management / Medical Records required. CCS - Certified Coding Specialist, RHIA - Registered Health Information Administrator, or RHIT - Registered Health Information Technician required. Three years experience in coding in an acute care setting required.

Job DescriptionDescription: About the Company NextStep Technology Inc. is seeking a Medical Records Analyst. The medical records analyst is primarily responsible for review of health information. The MRA reviews the medical records for specific criteria and validation of specific code year sets submitted from selected organizations to government and commercial client. The position requires review of protected health information and must maintain strict confidentiality when addressing or referring to such records. The incumbent must have the ability to use a variety of office equipment, computer software, the ability to use sound and professional judgement, and to work independently. The candidate(s) will be hired as an employee up to 40 hours per week (flexible scheduling). This is a remote position About the Role The medical records analyst is primarily responsible for review of health information. Responsibilities Analyze protected health information according to project specific rules. Participates in the Intake Process of records. Assigns ICD-9/10-CM codes according to the guidelines as defined by the AMA. Discusses project related discrepancies with Team Lead(s). Maintain coding credentials and continuing education or Possess and maintains a current and comprehensive understanding of coding rules, changes, and guidelines as defined by the AMA. Other duties as assigned Requirements: Must possess a minimum of one (3-6) years of experience in abstracting and ICD-9/ICD-10 coding of general acute hospital (inpatient and outpatient) and physician medical records by applying ICD-9/ICD-10 Coding Guidelines for inpatient and outpatient settings and related Official Coding Clinics. ICD9 proficiency required. Knowledge in anatomy and physiology, pathology of disease and medical terminology required. Ability to write appropriate correspondence and effectively communicate with other members of NS personnel, clients, and customers as necessary. Must be able to work independently with little or no supervision and use professional judgment as detailed in the AHIMA Code of Ethics. Passing score on a administered coder assessment must be achieved before further consideration. Required Skills Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), or CCS (Certified Coding Specialist).

For one of our ongoing project, we are looking for a Business analyst experienced on Cerner / Oracle EMR EHR. This is a 100% Remote role and can be done on a Part Time or Full time Basis. Only Local Wisconsin residents will be considered. Job Description Good understanding of Scheduling and Registration, HIM, Provider, Pharmacy, lab and · Nursing Workflows is needed. B.A. shall have experience with the ability to understand and document business requirements for reporting in a HIPAA regulated environment. Good business process mapping and process capture through Visio flow diagrams is also required. Experience in change management systems. Knowledge of vendor-based application release cycle and ticket management. Ability to identify integration points. Knowledge of reporting and dashboard maintenance. Experience in process improvements and I.T. systems integration. Ability to work with cross-functional teams. Ability to work with business teams and good communication and presentation skills. Experience in User Acceptance Testing (UAT), running regression tests on systems, and · identifying, designing, and optimizing new and existing test cases. JIRA tool experience. (nice to have) Experience with SQL, PL SQL and CCL code writing. Existing knowledge of Discern Reporting Portal (Static and Interactive Reporting) Existing Knowledge of Business Objects Reporting Solution.

The Medical Coder 3 (inpatient and ambulatory surgery) abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 - CM/PCS and CPT codes to patient records according to established procedures. Works with coding databases and confirms DRG assignments. Familiar with standard concepts, practices, and procedures within a particular field. Relies on instructions and pre-established guidelines to perform the functions of the job. This position relies on guidelines and some experience and judgment to complete job and works under general supervision. Responsibilities * Coding/Abstracting * Assists the Business Office and external agencies in clarification of coding regarding reimbursement issues. Handles all requests in a timely fashion. * Quality/Performance * Corresponds with other areas of the HIM department to ensure the necessary components are available for accurate coding and the highest quality of the patient's medical record. * Maintains an accuracy rate of not less than 93% based on internal and/or external review and a productivity standard per 8 hour day, engages in problem identification and solving, and assists in data gathering and chart auditing as necessary. * Demonstrates competencies in the service to our patients/customers of all ages by obtaining information in terms of customer needs. Speaks in a positive, professional manner about co-workers, physicians, and the facility. * Attends meetings as required and strives to improve the quality of meetings by taking an active role in meeting topics. Participates in educational programs, in-services, and training sessions in an effort to share his/her own expertise with others and further the quality of education and personal growth provided to new personnel, volunteers, and interning students. * DRG Coding Confirm APC Assignment * Determines the appropriate sequencing of diseases, diagnoses, and surgeries. The Coder accurately assigns appropriate codes to patient records using ICD-9-CM system and CPT-4 guidelines. * Other Duties as Assigned * Performs other duties as assigned or requested. Qualifications Experience - RHIT/RHIA plus 5 years of acute care coding experience, or RHIT/RHIA with ICD-10 curriculum plus 3 years of acute care coding experience, or 7 years acute care coding experience; CCS substitutes for 1 year of acute care coding experience Education - High School or equivalent

This salary range may be inclusive of several career levels at Valley Medical Center and will be narrowed during the interview process based on several factors, including (but not limited to) the candidate's experience, qualifications, location, and internal equity. The position description is a guide to the critical duties and essential functions of the job, not an all-inclusive list of responsibilities, qualifications, physical demands, and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the organization. TITLE: Coder/Abstractor III JOB OVERVIEW: Responsible for hospital inpatient coding and abstracting based on documentation and coding guidelines within established productivity standards for all accounts assigned. Resolves coding related edits and denials and provides ongoing feedback and education to physicians and clinicians. Responsible for following up on all accounts unable to code due to missing/incomplete documentation or charges. DEPARTMENT: Health Information Management HOURS OF WORK: As assigned RESPONSIBLE TO: Manager, Health Information Management PREREQUISITES: * Associate or bachelor's degree in HIM, required. * RHIA, RHIT, or CCS required. * 3 or more years exclusively in inpatient hospital coding experience, required. * Demonstrated advanced ability to use and understand DRG, ICD-10-CM, and ICD-10-PCS coding methodologies. * Advanced knowledge of anatomy, physiology, pharmacology, disease processes and medical terminology * Ability to communicate in writing and verbally in the English language in an effective manner. Effective communication includes ability to spell accurately and write legibly. QUALIFICATIONS: * Ability to research authoritative citations related to coding, compliance, and additional reporting needs. * Ability to carry out assignments independently, follow procedures, and exercise good judgment. * Excellent customer service skills, including telephone interactions. * Proficient data entry skills. * Proven ability to interact with physicians and support staff. * Attention to detail and excellent organizational skills are essential. * Knowledge of Medicare, Medicaid, and third-party coding and billing requirements. * Successful completion or pre-hire coding test. UNIQUE PHYSICAL/MENTAL DEMANDS, ENVIRONMENT AND WORKING CONDITIONS: Must be able to prioritize and multi-task. Must possess ability to work independently, with a minimum of direction, and take initiative in problem solving. Must be able to interact professionally and effectively with a wide variety of people, including operations staff, providers, the public, and departments in VMC. Must be able to function effectively in an environment with frequent interruptions and multiple tasks. Requires manual and finger dexterity and vision corrected to normal range. Requires ability to travel several miles to various sites on any given day. PERFORMANCE RESPONSIBILITIES: * Generic Job Functions: See Generic Job Description for Administrative Partner. * Essential Responsibilities and Competencies: * Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, leading to the assignment of the correct Medicare Severity-Diagnosis Related Group, (MS-DRG) or All Patient Refined Diagnosis Related Group, (APR-DRG). * Responsible for final coding and DRG accuracy on all inpatient accounts. * Maintains confidentiality of protected health information. * Reviews coding-based edits, corrects errors, and educates clinic and medical staff on appropriate use of ICD-10-CM and ICD-10-PCS codes. * Demonstrate advanced competency with ICD-10-CM and ICD-10-PCS code assignment for diagnoses and procedures for hospital requirements. * Collaborates with Clinical Documentation Specialists, HIM deficiency team, and members of the medical staff to ensure completeness of documentation in the charts so that appropriate codes, and ultimately the correct Diagnosis Related Group (DRG,) may be assigned. * Codes all records based on documentation, being careful to follow strict coding guidelines, payer regulations, and ethics. * Ensure compliance with all Federal and State guidelines regarding correct coding initiatives. * Meets productivity coding standards as outlined in the productivity policy. * Participates in coding meetings to enhance knowledge and coding compliance skills. * Communicates effectively with Revenue Cycle team and hospital departments in relationship to coding or charging concerns and the submission of claims. * Reviews coding-based payment denials, identifies patterns, corrects errors, and educates clinic and revenue cycle staff on appropriate coding procedures when services are denied due to inappropriate diagnosis or procedure coding. * Provides immediate telephone support to clinic, medical, and revenue cycle staff who have coding questions. * Assists with new provider orientation on VMC's coding, audit process and documentation standards. * Apprises management of concerns as appropriate, including backlogs and time available for additional tasks. * As necessary, negotiates a work improvement plan with management to raise work quality and quantity to standards. * Maintains appropriate CEU's annually as required for certification. * Adheres to policies and procedures as required by VMC. * Performs all job functions in a manner consistent with Valley's expectations as defined in Valley Values. * Completes additional projects and duties as assigned. Created: 1/21 Revised: 8/22 Grade: OPEIU - O FLSA: NE CC: 8490 Job Qualifications: PREREQUISITES: * Associate or bachelor's degree in HIM, required. * RHIA, RHIT, or CCS required. * 3 or more years exclusively in inpatient hospital coding experience, required. * Demonstrated advanced ability to use and understand DRG, ICD-10-CM, and ICD-10-PCS coding methodologies. * Advanced knowledge of anatomy, physiology, pharmacology, disease processes and medical terminology * Ability to communicate in writing and verbally in the English language in an effective manner. Effective communication includes ability to spell accurately and write legibly. QUALIFICATIONS: * Ability to research authoritative citations related to coding, compliance, and additional reporting needs. * Ability to carry out assignments independently, follow procedures, and exercise good judgment. * Excellent customer service skills, including telephone interactions. * Proficient data entry skills. * Proven ability to interact with physicians and support staff. * Attention to detail and excellent organizational skills are essential. * Knowledge of Medicare, Medicaid, and third-party coding and billing requirements. * Successful completion or pre-hire coding test.

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $55,895.80 - $83,843.71 The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. Essential Duties and Responsibilities * Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. * Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines. * Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. * Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. * Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. * Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim. * Comply with comprehensive internal coding policies and procedures that are consistent with requirements. * Attends coding meetings and roundtable sessions. * Participates in daily huddles and LEAN problem-solving activities. * Focused with no distractions while working and participating in meetings. * Ensures camera on while attending Teams calls. * Assists with organizing the shared drive for the medical coding department. * Other duties as assigned by manager. Qualifications * High School Diploma/G.E.D. - required * Prior experience in hospital medical coding - preferred * Prior experience with 3M 360 and EPIC system - preferred * Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency) * Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency) * Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency) * Excellent written and verbal communication skills. (High proficiency) * Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency) * Detail-oriented and efficient while maintaining productivity. * Coding certification / credential through AHIMA or AAPC and be in good standing. - required Equivalent combination of relevant education and experience may be substituted as appropriate. Physical Demands * Standing - Occasionally * Walking - Occasionally * Sitting - Constantly * Lifting - Rarely * Carrying - Rarely * Pushing - Rarely * Pulling - Rarely * Climbing - Rarely * Balancing - Rarely * Stooping - Rarely * Kneeling - Rarely * Crouching - Rarely * Crawling - Rarely * Reaching - Rarely * Handling - Occasionally * Grasping - Occasionally * Feeling - Rarely * Talking - Frequently * Hearing - Frequently * Repetitive Motions - Frequently * Eye/Hand/Foot Coordination - Frequently Working Conditions * Extreme cold - Rarely * Extreme heat - Rarely * Humidity - Rarely * Wet - Rarely * Noise - Occasionally * Hazards - Rarely * Temperature Change - Rarely * Atmospheric Conditions - Rarely * Vibration - Rarely Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. Thank you for your interest in Albany Medical Center! Albany Medical is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

Abstracts clinical information from a variety of medical records, charts and documents and assigns appropriate ICD-10 and/or CPT-4 codes to patient records according to established procedures. Works with coding databases and confirms CPT codes. Inputs and maintains data on procedures required for state or other reporting. May require an associate degree. Requires a certification from AAPC Certified Professional Coder (CPC) or AHIMA RHIT or CCS. Works with the coding manager and team on this site. Has attained full proficiency in multiple specialties of discipline. Typically requires 4+ years of related OBS/OPS coding experience, and may include additional credentials. Performs coding on multiple specialties with proficiency. Business Support

Job DescriptionDescription: Full Time, Remote Exempt / Salary Organization High Country Community Health (HCCH) is a federally funded Community and Migrant Health Center with medical locations in Watauga, Avery, Burke, and Surry Counties. The mission of HCCH is to provide comprehensive and culturally sensitive primary health care services that may include dental, mental and substance abuse services to the medically under-served population of Watauga, Avery, Burke, and Surry Counties and the surrounding rural communities. Supervisory Relationship: Reports to: Deputy CFO Job Summary and Responsibilities Provides thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and patient complexity of care. Utilizes knowledge of official coding guidelines, HCC standards, Risk Adjustment Factor (RAF) scoring, and physician query briefs. Will participate in Provider education on the importance of diagnosis specificity and documentation guidelines. The Risk Adjustment Coder works to maintain a thorough knowledge of our current automated eClinicalsWork (eCW) enterprise billing system, through which the coding and documentation review are functionalized to provide support to HCCH providers and staffs as necessary. Provides subject matter expertise to others including staff in the Billing department as necessary. This position requires professional maturity, responsibility, integrity, and subject matter expertise to complete the work timely; communicate setbacks to deliverables. and to collaborate with others to meet production and quality standards. Responsibilities include: -Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines -Validate and ensure the completeness, accuracy, and integrity of coded data. -Concurrently, prospectively, and retrospectively review medical records to identify unclear, ambiguous, or inconsistent documentation ensuring full capture of severity, accuracy, and quality. -Query providers when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes. -Utilizes approved resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS and ensures documentation in the medical record follows official coding guidelines, internal guidelines, and AHIMA physician query brief standards. -Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines. -Comply with HIPAA laws and regulations. -Maintain coding quality and productivity standards set forth by HCCH. -Maintain competency in evolving areas of coding, guidelines, and risk adjustment reimbursement reporting requirements. -Assist in internal and external coding audits to ensure the quality and compliance of coding practices. -Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements, including education and support for improvement in HCC coding, and RAF scoring. -Assist with educational in-services for physicians, other providers, and clinic staff relating to coding and documentation compliance as well as new policies and procedures relating to clinical documentation compliance related to billing. -Maintains complete confidentiality of patient information. -Assists with developing, implementing, and reviewing policies, procedures, and forms related to areas of responsibility. -Other duties as assigned by your Supervisor. Requirements: Requirements/Skills/Experience -High-speed internet access -Strong clinical knowledge related to chronic illness diagnosis, treatment, and management. -Knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements is highly preferred. -Personal discipline to work remotely without direct supervision -Dental coding skills a plus -Knowledge of HIPAA, recognizing a commitment to privacy, security, and confidentiality of all medical chart documentation. Qualifications: -Bachelor's degree in allied health or any related field required. -Minimum 2 years of progressive Professional Risk Adjustment Coding experience required. -Active Certified Risk Adjustment Coder certification (CRC and/or CPC) required -Candidates hired with active CPC, but without Certified Risk Adjustment Coder certification (CRC) must obtain CRC certification within 9 months of hire. Travel Requirements None. Salary Commensurate with experience, education and certifications

Site: Mass General Brigham Incorporated Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. This position is on the surgical coding team. This role will work on Ambulatory work queues and E&M leveling. Job Summary Summary: Responsible for ensuring proper coding compliance, documentation accuracy, and adherence to coding guidelines and regulations. Does this position require Patient Care? No Essential Functions: Assign appropriate diagnosis codes (ICD-10) and procedure codes (CPT/HCPCS) to patient encounters based on medical documentation, physician notes, and other relevant information. * Ensure compliance with coding guidelines, including those outlined by the American Medical Association (AMA), Centers for Medicare and Medicaid Services (CMS), and other regulatory bodies. * Analyze medical records, including physician notes, laboratory results, radiology reports, and operative reports, to extract pertinent information for coding purposes. * Maintain a high level of accuracy and quality in coding assignments to ensure proper reimbursement and minimize claim denials. * Utilize coding software, encoders, and electronic health record systems to facilitate the coding process. * Support coding compliance efforts by participating in coding audits, internal or external coding reviews, and documentation improvement initiatives. * Maintain accurate records of coding activities, including tracking productivity, coding accuracy rates, and any coding-related issues or challenges. Qualifications Education High School Diploma or Equivalent required or Associate's Degree Medical Billing and Coding preferred Can this role accept experience in lieu of a degree? No Licenses and Credentials Certified Professional Coder - American Academy of Professional Coders (AAPC) preferred Experience Medical Coding Experience 3-5 years required Knowledge, Skills and Abilities * In-depth knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and their application in hospital billing. * Familiar with coding guidelines and regulations, including those set by the AMA, CMS, and other relevant organizations. * Strong analytical skills and attention to detail to accurately interpret medical documentation and assign appropriate codes. * Excellent understanding of anatomy, physiology, medical terminology, and disease processes to support accurate coding. * Excellent communication skills, both written and verbal, to interact effectively with healthcare providers and billing staff. * Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment. Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) Pay Range $21.78 - $31.08/Hourly Grade 4 At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package. EEO Statement: 0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at **************. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership "looks like" by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

Summary Description: Under general direction, this position will be responsible for improving charge capture accuracy through workflow assessments coding reviews process improvement collaboration and reporting. The Cardiology Coding Specialist works collaboratively with leadership to assist in development project management and implementation of process enhancements or corporation initiatives to enhance charge capture accuracy. In addition, this role monitors and analyzes coding performance at the section and business unit levels. The primary role of this position is to support education, documentation principals, clean claims, and denial prevention. Essential Duties and Responsibilities: Review charts and capture all reportable services. Coordinate with other coding staff to ensure all reportable services are captured and assigned to appropriate physician or ARNP. Assign all appropriate ICD codes, CPT codes, and modifiers per ICD, CPT, and Medicare or commercial carrier published guidelines. Enter charges, review WQs to address edits/denials. Review work queues in EMR and resolve coding issues for professional services for both hospital and clinic places of service. Reconcile charges monthly to ensure capture of all reportable services. Work with business office to resolve hospital billing questions/coding denials or concerns. Assist employees and physicians in providing coding guidance. Ability to communicate effectively both orally and in writing. Pull audit reports and back up documentation for internal audits. Comply with all legal requirements regarding coding procedures and practices Conduct audits and coding reviews to ensure all documentation is precise and accurate Assign and/or review the sequence of all CPT and ICD 10 codes for services rendered Collaborate with AR teams to ensure all claims are completed and processed in a timely manner Support the team with applying expertise and knowledge as it relates to claim denials Aid in submitting appeals with various payers about coding errors and disputes Submit statistical data for analysis and research by other departments Ability to identify PSI triggers or have working knowledge of PSI triggers which includes identifying and assigning co-morbidities and complications. Ability to assign the appropriate DRG, discharge disposition code and principal DX codes Serves as the liaison between revenue cycle operations and clients as it relates to charge capture documentation and reconciliation Possesses a clear understanding of the physician revenue cycle Oversees understands and communicates coding and charging processes for each client account based on their existing EHR system as it relates to office and hospital-based services which includes charge captures charge linkages to the CDM and charging processes. Analyzes and communicates denial trends to Clients and operational leaders. CPC or CCS coding credentials required. Cardiology experience preferred. EMR, eCW, Centricity, Epic, Encoder Pro or 3M experience highly desired. Microsoft Office Skills: Excel - Must have the ability to create and manage simple spreadsheets. Word - Must be able to compose business correspondence. License: CPC, CCC or CCS (Required)

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities. Summary: This position performs facility coding and abstracting functions of Inpatient. Responsibilities And Duties: 1. 60% Assigns appropriate admit, & principal and secondary diagnoses and/or procedure codes by reading documentation present in medical record and applying knowledge of correct coding guidelines as appropriate for hospital service and/or patient type while maintaining 95% quality and meeting and maintaining the minimum Coder productivity requirements. Assign Present on Admission PO a indicators to all inpatient account diagnoses as required by official coding guidelines. Accurately Assign DRG/MSDRG/APR-DRG at the minimum standards of 95% Review Diagnosis and CC/MCC for maximum SOI/ROM Clinical understand of laboratory and radiology values Knowledge of quality outcomes indicators Work with CDS to improve physician documentation and case mix index Assign Principal Diagnosis accurately at least 95% or better Monitor and appropriately assign HAC codes when appropriate Responsible for recognizing when it is necessary to obtain further clarification from physician when documentation is inadequate, ambiguous, or unclear for coding purposes. Assists educators and supervisors with reviewing accounts denied by RAC and other governmental payers for appropriate documentation to support original coding. 2. 20% In the event of insufficient, missing or conflicting documentation, assigns transaction codes in HBOC system and follows department policy for follow up and physician query. 3. 10% : Abstracts all data elements necessary to complete UB0 4 and meet hospital-reporting requirements. 4. 5% : Verifies demographics, corrects account number, charges and service and identify missing or incorrect forms in each record. 5. 5% : Identifies problem cases on the DNFB and forwards to appropriate staff for follow up. The major duties, responsibilities and listed above are not intended to be all-inclusive of the duties, responsibilities and to be performed by employees in this job. Employee is expected to all perform other duties as requested by supervisor. Minimum Qualifications: Bachelor's Degree (Required) AHIMA - American Health Information Management Association - American Health Information Management Association, CCS - Certified Coding Specialist - American Health Information Management Association Additional Job Description: Work Shift: Day Scheduled Weekly Hours : 40 Department Hospital Coding Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment Remote Work Disclaimer: Positions marked as remote are only eligible for work from Ohio.