Medical coder jobs near me

We are seeking an experienced Inpatient Coding Denials Specialist to review and resolve inpatient coding-related denials and prevent lost reimbursement. The ideal candidate has strong inpatient coding expertise, DRG assignment experience, and the ability to write effective clinical/coding appeals. In this role, you will review medical documentation, ensure coding accuracy, validate DRG assignments, develop appeal letters, and collaborate with leadership to address denial trends and prevention strategies. Schedule: Monday-Friday, Days (Core hours 8:00 AM-4:00 PM EST; flexible after training; no weekends) Work Environment: Remote, office-based Key Responsibilities Review inpatient medical records and assign accurate diagnoses, procedures, DRGs, and discharge dispositions Analyze denials, validate DRGs, and develop clear and effective appeal letters Research payer policies and regulatory resources, including CMS and NCD/LCD guidelines Identify trends and recommend denial prevention strategies Maintain productivity, accuracy, credentialing, and compliance standards Stay current with coding guidelines and participate in ongoing education Required Qualifications CCS, RHIT, or RHIA credential required 3+ years acute care inpatient coding experience (5+ preferred) Experience with DRG assignment (denial/appeals experience preferred) Strong knowledge of ICD-10-CM, ICD-10-PCS, MS-DRGs, and inpatient coding guidelines High level of accuracy, analytical ability, and communication skills Skilled in Microsoft Office and able to work independently and meet deadlines Education High school diploma/GED required HIM/HIT degree preferred Additional Experience Prior coding audit/denials experience a plus Physical/Work Requirements Remote work; requires sustained computer use and sitting Ability to lift up to 25 lbs occasionally

Salary: $85,000+ depending on experience Skills: Auditing, Inpatient Coding, DRG Validation, Quality Review About the Company / Opportunity: Are you passionate about upholding quality standards in health information management and coding practices? Our client, an industry leader in the hospitals and health care sector, provides nationwide revenue cycle services to a vast network of hospitals and physician practices. This remote opportunity allows you to leverage your expertise in coding quality review, ensuring compliance with national guidelines and maintaining data integrity. Join a mission-driven organization focused on supporting patient outcomes and enhancing health care delivery through excellence in coding quality. Responsibilities: Lead, coordinate, and perform all functions of quality review for inpatient and outpatient coding across multiple facilities. Conduct routine, pre-bill, policy-driven, and incentive plan-driven coding quality audits to ensure compliance with established guidelines and policies. Support coding staff adherence to national coding guidelines and company policies through audits and targeted feedback. Apply expert-level knowledge of medical coding practices to identify areas for improvement and provide education to coding staff. Participate in special projects or reviews as needed to support continuous quality improvement. Maintain or exceed productivity and accuracy standards (95%+). Stay current on official data quality standards, coding guidelines, and ongoing educational requirements. Must-Have Skills: CCS, RHIA, and/or RHIT (mandatory). At least 10 years of hospital medical coding experience, with a minimum of 3 years auditing MS-DRG Inpatient medical records. Demonstrated expertise as an IP Coding Auditor with advanced MS-DRG auditing experience. Proven experience coding across all body systems (not limited to specialty areas). Strong understanding of official coding guidelines, data quality standards, and hospital coding compliance. Nice-to-Have Skills: Undergraduate degree in Health Information Management (HIM) or Health Information Technology (HIT) (Associate's or Bachelor's preferred). Experience participating in special quality review projects or process improvement initiatives. Background supporting multi-site health systems or large-scale coding review teams. Familiarity with remote work tools and distributed team collaboration. Ongoing commitment to professional development and continuous education in medical coding.

Mercor is collaborating with a research-focused AI organization seeking medical experts with extensive experience using electronic medical record (EMR) systems. This opportunity involves applying your domain knowledge to support the development of AI tools that better understand clinical workflows and healthcare documentation. It's a chance to leverage your practical expertise in EMR usage to shape cutting-edge technology with real-world healthcare applications. * * * **Key Responsibilities** - Review and validate AI-generated content related to EMR workflows and medical documentation - Provide feedback on clinical accuracy and usability within EMR contexts - Develop and refine case-based scenarios that simulate real-world EMR usage - Collaborate on evaluating system outputs for clinical consistency and alignment with medical standards * * * **Ideal Qualifications** - Hands-on experience with major EMR or clinical systems (e.g., Epic, Cerner, Allscripts, Meditech). - Medical education background with an understanding of medical workflows. - Strong understanding of medical documentation standards and patient record workflows. - Detail-oriented with the ability to identify inaccuracies in complex medical content. - Are currently based in the **U.S., Canada, New Zealand, UK, or Australia.** * * * **Role Highlights** Flexible workload: 10-20 hours per week, with potential to increase to 40 hours. - Fully remote and asynchronous-work on your own schedule. * * * **Role Start Date** - This role will begin in September with applications reviewed on a rolling basis. * * * **Interview Process** - You will take a technical interview where we assess your implementation experience, approach to integrations, and documentation skills. - As part of the interview you will **share your screen** and complete a practical task (≈25 minutes) such as: map a FHIR resource to EHR data fields, write an interface mapping snippet, create a high-level go-live checklist, or diagnose a sample interface error from logs. - You may be asked to evaluate an AI-generated implementation proposal (for example, a suggested mapping or configuration) and provide corrections or improvements-this helps us understand your real-world judgement on accuracy and safety. - Applicants will be selected based on their hands-on performance, clarity of technical reasoning, and ability to produce operational documentation. * * * **Compensation and Legal Details** - $60-100/hour depending on expertise and geography - You will be legally classified as an hourly contractor for Mercor - We will pay you out at the end of each week via Stripe Connect * * * **About Mercor** Mercor connects elite creative and technical talent with leading AI research labs, headquartered in San Francisco, CA. Our distinguished investors include Benchmark, General Catalyst, Peter Thiel, Adam D'Angelo, Larry Summers, and Jack Dorsey. Apply today and redefine digital creativity alongside groundbreaking AI technologies!

Remote - Clinic/Outpatient Coder III Outpatient Coding PRN Status Variable Shift Pay: $24.74 - $37.11 / hour Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, 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. Expected to be proficient in assigning ICD-10-CM and/or CPT codes for following types of services: Outpatient: Complex Surgeries, Observations (non-obstetric), Interventional radiology, radiation oncology and/or non-complex inpatient coding encounters. Clinic coder: Either proficient in coding for all non-surgery specialty areas, primary care, or complex surgeries. This position works under the guidance and supervision of the HIM Outpatient APC and Clinic Coding Manager and is employed by Mosaic Health System. Codes procedures and diagnoses using the ICD-10-CM, CPT classification systems, in accordance with Official Coding Guidelines, CMS guidelines, and Mosaic compliance standards. Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation. Communicates with providers, querying providers to ensure the highest level of specificity is provided in documentation. May assist in training of newly hired coders. Caregiver may work in conjunction with Patient Financial Services to verify and modify charges and coding to ensure accuracy of supporting documentation, payer rules and correct coding. Working reports for clean-up, auditing services, edits, and denials. Ensures data accuracy of State HIDI data by responding to edits received. Performs other duties as assigned. Must have coding education, HS Diploma and Medical Terminology and Anatomy and Physiology Required to obtain CCS - Certified Coding Specialist or RHIA - Registered Health Information Administrator or RHIT - Registered Health Information Technician or CPC and/or CCSP - Certified Professional Coder within 180 days of employment. Must also obtain COC - Certified Outpatient Coding within 180 days of employment. Five years experience in a Health Information Services department performing a job that requires detail, and familiarity with patient medical record preferred.

Join OBHG: Join the forefront of women's healthcare with OB Hospitalist Group (OBHG), the nation's largest and only dedicated provider of customized obstetric hospitalist programs. Celebrating over 19 years of pioneering excellence, OBHG has transformed the landscape of maternal health. Our mission-driven company offers a unique opportunity to elevate the standard of women's healthcare, providing 24/7 real-time triage and hospital-based obstetric coverage across the United States. If you are driven to join a team that makes a real difference in the lives of women and newborns and thrive in a collaborative environment that fosters innovation and excellence, OBHG is your next career destination! Location: SC Upstate area strongly preferred (Remote). Open to exceptional remote candidates in SC, NC, GA (must be located in these states to be eligible). The Good Stuff We Offer: Hourly Compensation Range: $21.00 - $24.00 per hour + eligibily for RCM bonus A mission based company with an amazing company culture. Paid time off & holidays so you can spend time with the people you love. Medical, dental, and vision insurance for you and your loved ones. Health Savings Account (with employer contribution) or Flexible Spending Account options. Employer Paid Basic Life and AD&D Insurance. Employer Paid Short- and Long-Term Disability. Optional Short Term Disability Buy-up plan. 401(k) Savings Plan, with ROTH option. Legal Plan. Identity Theft Services. Mental health support and resources. Employee Referral program - join our team, bring your friends, and get paid. Medical Coder Position Summary: The Certified Coder is responsible for the data abstraction, evaluation and auditing of Provider assigned CPT, HCPC codes, ICD-10 CM for obstetrics. Essential Medical Coder Responsibilities: Assigns and sequences diagnoses and procedures in accordance ICD-10 CM Official Coding Guidelines, CPT Assistant, Physician at Teaching Hospital Rules and Evaluation and Management Documentation Guidelines Experience with billing, collections from insurance companies and patients, insurance follow up, charge entry Analyze and resolve charge entry coding errors Familiar with revenue cycle management processes Ability to work with eBridge, Putty and Lyra software Report and analyze errors, trends, and findings Compose reports using Microsoft Excel and Word Ability to interpret regulatory and payer rules and directives concerning coding Ability to function in a high volume environment producing quality work Solid interpersonal and telephone communication skills Ability to consistently work independently and problem solve Must be able to multi-task and prioritize job responsibilities Must be dependable, responsible and team oriented Strong attention to detail (such as interpretation of clinical data including medical terminology and disease processes) Demonstrate a commitment to service, organization values and professionalism through appropriate conduct and demeanor at all times Strong working knowledge of HIPAA as it relates to the entire revenue cycle management cycle process Perform other duties as assigned. Essential Skills/Credentials/Experience/Education Certified AAPC Coder Associate or Bachelor's Degree, OR AN EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND/OR EXPERIENCE Skill in operating a personal computer; must be proficient in Word, Excel, Power Point. Ability to compose letters, memos, and other correspondence. Effective interpersonal skills required in interactions with Ob Hospitalists and personnel. Ability to work with highly confidential materials. Must possess high ethical standards. Enhances professional growth and development through in-service meetings, education, programs, conferences, etc. Physical Demands (per ADA guidelines) Sitting for long periods of time. Occupation requires this activity more than 66% of the time (5.5+ hrs/day)

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.

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

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).

Business Unit: Rush Medical Center Hospital: Rush University Medical Center Department: Medical Records Work Type: Full Time (Total FTE 1.0) Shift: Shift 1 Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM) Rush offers exceptional rewards and benefits learn more at our Rush benefits page (***************************************************** Pay Range: $29.36 - $47.79 per hour Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush's anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case. Summary: Accurately and independently makes decisions based on specialized knowledge and standard protocol. This includes, but is not limited to coding inpatient and outpatient. Exemplifies the Rush mission, vision, and values, and acts in accordance with Rush policies and procedures. Other information: Knowledge, Skills, and Abilities: High School (GED) required RHIA, RHIT, and/or CCS Certification required Minimum 3 years experience in medical record coding required Knowledge of medical terminology and anatomy and physiology required Windows applications, Outlook, WebEx and other apps as needed to perform role Cooperates well with others Competent attention to detail and accuracy Proficient with computer use and software applications Ability to concentrate on task at hand in open distracting environment independent manner; minimizing distractions in private work-from-home space Ability to apply local, state, and federal coding guidelines with attention to detail. Responsibilities: * Assigns ICD-10-CM-PCS and/or CPT-4 diagnostic and procedure codes to patient charts with accuracy and attention to detail * Abstracts selected data items and enters in 3M encoder/Epic software with accuracy and attention to detail * Completes UHDDS data abstraction as required * Maintains a log of work performed * Completes other assigned duties as directed by management Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.

Responsible for conducting coding and documentation audits for assigned providers and consulting and educating providers on documentation requirements and other compliance issues related to billing. Under the direct supervision of the Billing & Coding Compliance Manager, this full-time position will work with physicians and other clinicians to ensure they comply with documentation and coding standards, regulations and requirements. This includes conducting billing and coding audits, identifying and resolving issues, and educating clinicians and staff on requirements for documenting, coding and billing medical services. Job Responsibilities and Accountabilities: Assists with monitoring of OrthoVirginia's Compliance Program as related to billing, coding, and documentation, including the OIG Compliance Program guidance for physician practices and third-party billing companies Performs audits of coding and billing data for accuracy and compliance with federal regulations Conducts physician, APP and scribe coding and documentation education classes as needed/requested Educate clinicians, as assigned, in documentation and coding to ensure documentation meets appropriate coding levels Prepares requested reports by collecting, analyzing, and summarizing relevant information obtained through education, and other educational activities. Meets with assigned providers on a regular basis to educate and review results of audits Responsible for keeping up to date with all E/M Documentation Guidelines Monitors all compliance issues identified during routine audits and recommends areas that indicate a focused audit may be necessary Assists with projects as directed Qualified Candidates must meet all of the following criteria: Exemplifies OrthoVirginia's values - excellence, compassion and unity Bachelor's Degree or equivalent with 5 to 7 years' experience working as a credentialed coder, preferably in a medical practice Licensing, certification/degree as one of the following: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist - Physician-based (CCS-P), Certified Professional Coder (CPC), Certified Evaluation and Management Coder (CEMC) required Thorough knowledge of CPT and ICD coding principles and guidelines Knowledge of Medicare and Medicaid rules for documentation of billed services Strong analytical and problem-solving skills required including experience auditing Ability to exercise initiative, problem-solving and decision-making to effectively plan, prioritize, and complete projects/tasks with little supervision in a fast paced, changing environment Specific, thorough understanding of regulatory requirements relating to documentation, claims processing, reimbursement, and coding Skilled in establishing and maintaining effective professional working relationships with physicians, advanced practice providers, administration and team members Advanced working experience in Microsoft Office including Excel (formulas, pivot tables, dashboards, etc) Exceptional written and strong verbal communication skills: face to face, email, written correspondence, telephone Other: Has access to and knowledge of extremely sensitive, private and confidential materials-ability to maintain the highest standard of confidentiality is required with zero tolerance Participates in professional developments efforts to ensure currency in health care policies and trends Maintains detailed knowledge of practice management and other computer software as it relates to job functions Some travel to regional offices will be required Typical Physical Demands: Position requires full range of body motion including handling and lifting, manual and finger dexterity and eye-hand coordination. Involves standing and walking. Employee will occasionally be asked to lift and carry items weighing up to 30 pounds. Normal visual acuity and hearing are required. Employee will work under stressful conditions, and work irregular hours. Employee may have frequent exposure to communicable diseases, toxic substances, ionizing radiation, medicinal preparations and other conditions common to a clinic environment #STATEOV

Part-time Description Required: 3-5 years of experience in acute care facility (hospital) medical coding auditing or compliance The Medical Coding Auditor is responsible for reviewing medical records to ensure accurate coding and compliance with regulatory requirements. This role ensures continuous quality improvement in coding practices while maintaining compliance with healthcare laws and organizational policies. Occasional travel may be required for audits or meetings. Key Responsibilities: · Conduct reviews and audits of medical records for coding accuracy (ICD-10-CM, CPT, HCPCS) and documentation compliance. · Ensure compliance with federal, state, and payer-specific regulations, including CMS guidelines. · Identify and address coding discrepancies and recommend corrective actions. · Prepare detailed audit reports with findings and provide feedback on documentation and coding practices. · Collaborate with relevant departments to resolve audit findings and ensure ongoing compliance with policies and regulations. · Stay current with changes in coding guidelines, healthcare regulations, and payer policies. · Assist in developing and refining audit tools, policies, and procedures to support continuous improvement. · Monitor and track corrective actions post-audit and ensure follow-up to resolve identified issues. · Ensure abstracted data impacting reimbursement is accurate: discharge disposition, admission source, POA (present on admission) indicators, procedure dates of service, etc. · Adhere to facility's coding guidelines and coding policy and procedures, as needed. Requirements Education: · Associate's Degree in Health Information Management or related field. · Bachelor's Degree in Health Information Management, Nursing, or a related field is a plus. · Or equivalent combination of education and relevant experience. Certification: · Registered Health Information Administrator (RHIA) · Registered Health Information Technician (RHIT) · Certified Coding Specialist (CCS) · Certified Coding Associate (CCA) · Certified Outpatient Coder (COC) · Certified Inpatient Coder (CIC) · Certified Professional Coder (CPC) · Registered Health Information Administrator (RHIA) Experience: · 3-5 years of relevant experience in acute care facility (hospital) medical coding, auditing, or compliance roles. Skills: · Expertise in medical coding systems (ICD-10-CM, CPT, HCPCS), healthcare billing, and medical terminology. · Familiarity with CMS regulations, payer requirements, and healthcare compliance laws. · Excellent analytical skills with a strong attention to detail. · Effective communication skills for education and collaboration. · Proficiency in using healthcare software and EHR systems (e.g., Epic, Cerner). Working Conditions: · Remote work with flexibility to manage tasks independently. · Occasional travel may be required for training sessions or audits.

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, sex, sexual orientation, gender identity, national origin, genetic information or age. PacificSource values the diversity of our community, including those we hire and serve. We are committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths. The Risk Adjustment Coding Specialist is responsible for comprehensive clinical documentation and coding chart review assigned for PacificSource Medicare Advantage Plans. This individual will collaborate with the Risk Adjustment Coding Manager to ensure the chart review process is maintained in accordance with coding expectations and meets the Medicare program regulations and coding guidelines set forth by the Centers for Medicare and Medicaid Services. This individual will be responsible to lead the application of a standardized HCC chart review process as a foundation of coding guidance supporting Medicare Advantage FFS lines of business, engage and develop strong relationships with all stakeholders at PacificSource Health Plans. This individual will also identify opportunities to improve provider documentation and deliver customized provider-specific documentation improvement recommendations to the Risk Adjustment Coding Manager for escalation purposes. Essential Responsibilities: Provide support and coding expertise to all programs that support risk adjustment and data validation efforts for assigned PacificSource Health Plans, along with other ad hoc and long-term projects assigned by the Risk Adjustment Coding Manager. Assign appropriate ICD-10-CM codes, mapping to risk adjustment models as applicable. Comply with the Standards of Ethical Coding as set forth by the American Academy of Professional Coders and adhere to official coding guidelines. Comply with the Standards of Ethical Coding as set forth by the American Academy of Professional Coders and adhere to official coding guidelines. Assist in obtaining patient records from provider Electronic Health Record (EHR) systems. Assist in obtaining remote EHR access for our chart review vendors and internal PacificSource teams. Supporting Responsibilities: Reliability and a commitment to meeting tight deadlines. Personal discipline to work remotely without direct supervision. Meet department and company performance and attendance expectations. Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information. Complete other projects and duties as needed and assigned. SUCCESS PROFILE Work Experience: A minimum of 3 years of experience as a certified coder in professional setting. A minimum 2 years of risk adjustment HCC Coding experience. Ability to code using an ICD-10-CM code book. Computer proficiency (including MS Windows, MS Office, and High-speed Internet access. Education, Certificates, Licenses: Active certified coder certification (CRC, CPC, CCS - P) through AHIMA or AAPC. Certified Professional Coder certification through AHIMA or AAPC. A CRC certification is required for this role. Knowledge: Knowledge of HIPAA, recognizing a commitment to privacy, security, and confidentiality of all medical chart documentation. Strong clinical knowledge related to chronic illness diagnosis, treatment, and management. Extensive knowledge of ICD-10-CM outpatient diagnosis coding guidelines (knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements is highly preferred). Reliability and a commitment to meeting tight deadlines. Exemplary attention to detail and completeness. Strong organization, interpersonal, and customer service, written and oral communication, and analytical skills. Competencies: Adaptability Building Customer Loyalty Building Strategic Work Relationships Building Trust Continuous Improvement Contributing to Team Success Planning and Organizing Work Standards Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time. Skills: Accountability, Collaboration, Communication (written/verbal), Flexibility, Listening (active), Organizational skills/Planning and Organization, Problem Solving, Teamwork Our Values We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business: We are committed to doing the right thing. We are one team working toward a common goal. We are each responsible for customer service. We practice open communication at all levels of the company to foster individual, team and company growth. We actively participate in efforts to improve our many communities-internally and externally. We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community. We encourage creativity, innovation, and the pursuit of excellence. Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively. Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

Join our in-house Coding Team at Baptist Health South Florida, where you'll find stability, a welcoming environment, and colleagues who truly care. * Flexible scheduling to support work-life balance * Supportive and engaged leadership that fosters a welcoming culture * Commitment to employee wellness, engagement, and success * Growth and development opportunities, including CEU access and recertification reimbursement * Individual quarterly performance bonus opportunities, along with performance-based recognition for outstanding contributions * Accurately codes Inpatient records for the classification of all diseases, injuries, procedures, and operations using the ICD10CM/PCS coding system. * Ensures compliance of coding rules and regulations according to Regulatory Agencies (CMS, OIG). * Works as a team to meet departmental goals and AR goals. * Abstracts prescribed data elements from the medical records. Estimated pay range for this position is $29.41 - $38.23 / hour depending on experience. Degrees: * High School,Cert,GED,Trn,Exper. Licenses & Certifications: * AHIMA Certified Coding Specialist. * AHIMA Registered Health Information Technician. Additional Qualifications: * Required coding certificate. * If not CCS or RHIT certified upon hire they must obtain within 2 years * For Boca they are required to have either CCS, CCA, CPC, COC, RHIT or RHIA. * Knowledge and thorough understanding of encoder system, Inpatient Prospective Payment System (IPPS), DRG/MSDRGs and National and Local Coverage Determination, NCD and LCD, Policies. * Competency in Word and Excel. * Ability to communicate effectively with coworkers, management staff, and physicians. Minimum Required Experience: 3 years of IP facility coding

At ScionHealth, we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary * Codes medical records, including all diagnoses, operative and diagnostic procedures in patient medical records, using the International Classification of Diseases and enters coded information into an automated system Essential Function * Using the coding system, assigns and records an accurate code to all diagnoses, procedures, and operations as documented in the patient medical record based on official coding guidelines * Ensures that all factors necessary for assigning an accurate DRG (Diagnostic Related Group) are present, and that all diagnoses are ranked properly * Contacts hospital designee regarding questions on diagnoses, need for greater detail or different terminology to assign accurate codes to medical records * Enter final diagnostic codes for diagnoses and procedures into an automated grouper system * Complies with internal procedures established to ensure compliance with regulatory agencies for all facilities * Reports on potential coding discrepancies to HIM/Medical Records Manager and Business Office Manager to assure that only accurate and properly documented services are coded in accordance with Federal False Claims * Provides information and responds to inquiries regarding medical documentation and DRGs to hospital staff * Conducts job responsibilities in accordance with the standards set out in the Company's Code of Business Conduct, its policies and procedures, the Support Conter Compliance Agreement, applicable federal and state laws, and applicable professional standards * Promotes adherence to the Company's Code of Business Conduct and the Support Center Compliance Agreement by monitoring employee performance and identifying and responding to compliance issues * Abstracts and retrieves medical data for evaluation, planning, or research in health care and related programs Knowledge/Skills/Abilities/Expectations * Knowledge of medical terminology, International Classification of Diseases (ICD-9-CM) codes, current procedural terminology (CPT) and HCPCS level II codes as appropriate * Ability to understand and code medical records * Ability to communicate effectively both orally and in writing * Exceptional organizational and follow-through skills * Ability to maintain confidentiality of all patients and/or employee information to assure patient and/or employee rights are protected * Approximate percentage of time required to travel: 0% * Must read, write and speak fluent English * Must have good and regular attendance * Performs other related duties as assigned Qualifications Education * High School or equivalency diploma required * College degree preferred Licenses/Certification * AHIMA Certified Coding Specialist (CCS) and/or eligibility to sit for the examination or Associate of Science degree with RHIT or Bachelor of Science with RHIA preferred Experience * 3 years Long-Term Acute Care Coding experience required

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 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.

UPMC is seeking to hire a Certified Coding Specialist I to join our Coding Department. This is a work-from-home position, working Monday through Friday during standard business hours. To qualify for this position, you must have at least five years of coding experience. As a Certified Coding Specialist I, you will have the same responsibilities as a Certified Specialty Coder, plus provide training on code selection for new and existing staff. Specifically, you will be working on denials, special projects in targeted specialties to assist in the reduction of denials. You will perform audits to determine code and charge selection accuracy as well as summarize coder accuracy for Managers. Identify topics for training and education, research topics and assist with the assembly of training materials and CDI process. Assist with audit reviews including all internal, external, and RAC associated coding audits. Supervise on-site staff. Review and approve adjustments to accounts. Responsible for Kronos approval and sign-off. Responsibilities: * Adhere to internal system-wide policies, competencies, behaviors and procedures to ensure efficient work processes. Actively participate in periodic coding meetings and shares ideas and suggestions for operational improvements. * Utilize advanced, specialized knowledge of medical codes and coding procedures to assign and sequence appropriate diagnostic/procedure billing codes, in compliance with third party payer requirements. * Supervises staff including assignments and Kronos approval and signoff. Also assist with recruitment. * Code all diagnoses and procedures by assigning and verifying the proper ICD and CPT codes. Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding. * Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process. * Investigate and resolve reimbursement issues, including denials, in a timely manner and demonstrate proficiency on billing system. * Monitor billing performances to ensure optimal reimbursement while adhering to regulations prohibiting unbundling. Prepares periodic reports for clinical staff identifying unbilled charges due to inadequate documentation. * Advise and instruct coders/providers regarding billing and documentation policies, procedures, and regulations; interacts with providers regarding conflicting, ambiguous, or non-specific medical documentation, to obtain clarification. * Progress within the training period toward meeting departmental coding accuracy standards within the first year of employment by assigning correct principal diagnosis/procedure, complications and co-morbidities, and secondary diagnoses as reviewed by the designated trainer. Coder should meet appropriate coding productivity standards within the time frame established by management staff. * Train all new Coders to observe established coding guidelines and to utilize the appropriate billing system. * Refer problem accounts to appropriate coding or management personnel for resolution. * Lead, participate in and/or assist with departmental coding audits. * Work with department management on coding interface, development, enhancements and changes, as well as implementation of those functions. * High school graduate or equivalent. * Graduate of an approved certified coding program preferred. * Proficient computer skills with MS excel knowledge preferred. * Five years surgical coding experience (includes anesthesia coding) OR advanced E/M coding experience. Licensure, Certifications, and Clearances: CPC or Certified Coding Specialist (CCS) specialty certification required * Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT) * Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran

We exist to create positive change for people and the planet. Join us and make a difference too! 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! 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.

Rome Health is looking for a per diem OP coder to join the Health Information Management team. This team member will assist with backlogs and coverage during staff PTO. •Current coding certification required •Three years of experience coding Observation and/or Ambulatory Surgery preferred •Experience with Clintegrity, Paragon, One Content helpful •Fully remote after training Extensive knowledge of medical terminology. Experience in researching and applying coding rules and guidelines required. Must have experience with data entry of codes into a database. Proficiency in Microsoft Excel, Word, and EMR (Electronic Medical Record) systems. Excellent oral and written communication skills. Must have a positive, respectful attitude. About Rome Health Rome Health is a non-profit health care system based in Rome, N.Y., providing services to patients throughout Central New York. From primary and specialty care to long-term care, Rome Health delivers quality, compassionate medical care for every stage of life. We are a comprehensive health care system that connects you to the best clinicians and the latest technologies so they are easily accessible to you and your family. Rome Health is an affiliate of St. Joseph's Health and an affiliated clinical site of New York Medical College. The best care out there. Here.