Certified Medical Coder
Remote job
Title: Certified Medical Coder
Shift: 8:00 AM - 4:00 PM
Work Arrangement: Onsite Training (1-2 weeks) → Remote
Pay: $35/hr to $37/hr
Contract: 3-month assignment with possible extension
Start Date: 12/01/2025 - 03/07/2026
Position Summary:
We are seeking an experienced and detail-oriented Certified Medical Coder to join our team. This role begins onsite for initial training before transitioning to remote work. The ideal candidate will have strong inpatient coding experience in an acute care setting and be proficient with ICD-10, CPT coding, EPIC, and 3M Encoder tools.
Key Responsibilities:
Perform accurate and compliant inpatient coding using ICD-10, ICD-9-CM, CPT-4, and Encoder systems
Review medical records and ensure proper documentation supports code selection
Research and resolve coding-related questions and discrepancies
Maintain coding accuracy and productivity standards
Apply current coding guidelines, payer requirements, and regulatory rules
Collaborate with clinical staff as needed to clarify documentation
Support outpatient and ED coding tasks as needed (preferred, not required)
Requirements:
CCS Certification (required)
EPIC and 3M Encoder experience (required)
Minimum 3-4+ years of inpatient coding experience, preferably in an acute care setting
Strong knowledge of ICD-10, ICD-9-CM, CPT-4, and Encoder systems
Experience with outpatient and ED coding (preferred)
Proficient computer skills, including MS Word, Excel, and coding applications
Skills & Role Expectations:
Strong understanding of coding guidelines, payer rules, and federal billing regulations
Solid knowledge of anatomy, physiology, and disease processes
Ability to work independently and efficiently after training
Ability to research issues and resolve coding questions
Experience mentoring or training coders is a plus
Seeking candidates with strong inpatient coding backgrounds
If Interested, you can reach me on my number ************** or email me at *******************************
Pride Health offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
Certified Medical Coders
Remote job
Job Title : Certified Medical Coders - Inpatient
Duration : 3 Months Contract (with possible extension)
Education : High School Diploma/GED, AHIMA, RHIA or RHIT and/or CCP, CCS.
Shift Details : 8:00 AM-04:00 PM
General Description:
·Medical coding in an acute care setting; must possess proficient computer skills (e.g., MS Word, Excel, ICD 9 CM, CPT 4, Encoder); knowledge of coding guidelines, payor guidelines, federal billing guidelines; knowledge of anatomy, physiology & disease processes; ability to research coding related issues; competence in coder training; must have CCS and knowledgeable with 3M/HDS coding application.
·Seeking certified coders with a strong inpatient coding background.
·Candidate should be able to work with minimal training.
Inpatient and ED experience.
Starts onsite for training, then transitions to remote work once duties are mastered.
Education:
High School Diploma/GED, AHIMA, RHIA or RHIT and/or CCP, CCS.
Remote Certified Coder
Remote job
Job Title: Urology Coder
Hours: Monday - Friday, 8:00 AM - 5:00 PM CST
Contract Type: Contract
Pay: $20-29/hr
Seeking an experienced Urology Coder to accurately assign ICD-10, CPT, and HCPCS codes for urology charts. The ideal candidate will have strong coding knowledge, particularly in surgical cases and outpatient procedures, with experience in a fast-paced healthcare setting.
Key Responsibilities
Assign appropriate ICD-10, CPT, and HCPCS codes to ensure proper reimbursement and data collection.
Review and code Urology charts, including surgical cases for:
Ambulatory Surgery Centers (ASC)
Injection/Infusion procedures
Outpatient hospital charges
Code from physician's outpatient notes accurately.
Apply modifiers correctly based on procedural and coding guidelines.
Maintain coding accuracy specific to urology procedures.
Qualifications
Certification: CPC required
Minimum of 1-3 years of general coding experience
Experience coding urology charts preferred
Familiarity with Athena is a plus
CPC-A candidates welcome
Strong knowledge of CPT, ICD-10, and HCPCS coding rules and guidelines
Training & Productivity Expectations
Initial training period: 4 weeks
Productivity: ~7 encounters per hour
Coding Specialist II, Remote
Remote job
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 role is on the Medical Specialties team.
Seeking experience coding in:
Primary care
E&M
Endocrine
Hematology
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
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:
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.
Auto-ApplyRemote - Clinic/Outpatient Coder III
Remote job
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.
**UW Medicine Enterprise Records and Health Information** has an outstanding opportunity for a **Coding Specialist 1 - Edits Coder** **WORK SCHEDULE** + 100% FTE + Mondays - Fridays + 100% Remote HIGHLIGHTS** The Edits Coder position reports to the Outpatient Coding Supervisor within the Enterprise Records and Health Information Management department. Under the general supervision of the Manager of Facility Coding, and the direct supervision of the Supervisor of Outpatient Coding, the Edits Coder is responsible for implementing the mission and goals of Enterprise Records and Health Information, and incorporating a "patients are first" service culture. The Edits Coder is responsible for performing daily activities related to analyzing medical records to validate the correct coding assignment of International Classification of Disease (ICD), Current Procedural Terminology (CPT) and/or Healthcare Common Procedure Coding System (HCPCS) codes in Epic work queues (WQ) and/or Hierarchical Condition Category (HCC)/Risk Adjustment Factor (RAF) and/or Care Gap review to ensure optimal reimbursement for facility and/or professional fee coding and billing for Clinic, Outpatient and related charges needing coding review in compliance with State and Federal guidelines.
**PRIMARY JOB RESPONSIBILITIES**
+ Validates codes entered at the point of care and/or by other charge sources by reviewing electronic data and making corrections based on a review of all available electronic and other appropriate documentation to support all billable procedures and services.
+ Reviews and resolves coding accounts failed validations, revenue guard, missing modifiers, incorrect modifiers, missing charges, incorrect charges, medical necessity edits, CCI edits, claim edits, and payor denials in Epic; verifies accuracy of ICD diagnosis codes and CPT/HCPCS procedure codes.
+ Investigates and researches coding issues identified by Revenue Integrity (RI) and Patient Financial Services (PFS) related to inquiries, complaints and/or denials. Makes coding corrections to resolve coding issues; supports RI by reviewing specified procedures for charge accuracy; reroutes accounts to correct coding team for coding resolution based on revenue codes.
+ Maintains Epic WQ turnaround times for coding error and edits resolution to prevent charge lags for facility and professional fee services. Identifies potentially avoidable delays to timely billing and help identify systemic issues that contribute to delays in service or inefficient uses of resources to address root cause and prevent ongoing errors.
+ Identifies the need for documentation clarity to support the integrity of the record and for reimbursement compliance; identifies charge error trends and escalate to supervisor.
+ Performs special projects or other duties assigned.
+ May perform the work of lower level classifications of the Coding Specialist series.
**REQUIRED POSITION QUALIFICATIONS**
High school diploma or equivalent
AND
Certified as a Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Coding Specialist - Physician Based (CCS-P), Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC), Certified Interventional Radiology Cardiovascular Coder (CIRCC), Radiology Certified Coder (RCC) or Radiation Oncology Certified Coder (ROCC).
AND
One year coding experience or equivalent education/experience.
Equivalent education and/or experience may substitute for minimum qualifications except when there are legal requirements, such as a license, certification, and/or registration.
**Compensation, Benefits and Position Details**
**Pay Range Minimum:**
$59,976.00 annual
**Pay Range Maximum:**
$85,848.00 annual
**Other Compensation:**
-
**Benefits:**
For information about benefits for this position, visit ******************************************************
**Shift:**
First Shift (United States of America)
**Temporary or Regular?**
This is a regular position
**FTE (Full-Time Equivalent):**
100.00%
**Union/Bargaining Unit:**
SEIU Local 925 Nonsupervisory
**About the UW**
Working at the University of Washington provides a unique opportunity to change lives - on our campuses, in our state and around the world.
UW employees bring their boundless energy, creative problem-solving skills and dedication to building stronger minds and a healthier world. In return, they enjoy outstanding benefits, opportunities for professional growth and the chance to work in an environment known for its diversity, intellectual excitement, artistic pursuits and natural beauty.
**Our Commitment**
The University of Washington is committed to fostering an inclusive, respectful and welcoming community for all. As an equal opportunity employer, the University considers applicants for employment without regard to race, color, creed, religion, national origin, citizenship, sex, pregnancy, age, marital status, sexual orientation, gender identity or expression, genetic information, disability, or veteran status consistent with UW Executive Order No. 81 (*********************************************************************************************************************** .
To request disability accommodation in the application process, contact the Disability Services Office at ************ or ********** .
Applicants considered for this position will be required to disclose if they are the subject of any substantiated findings or current investigations related to sexual misconduct at their current employment and past employment. Disclosure is required under Washington state law (********************************************************* .
University of Washington is an affirmative action and equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, religion, color, national origin, sexual orientation, gender identity, sex, age, protected veteran or disabled status, or genetic information.
Coder (Local SC Remote)
Remote job
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-CPT4.
* 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.
*
* 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.
Auto-ApplyRisk Adjustment Medical Coder
Remote job
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
Medical Records Coder
Remote job
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).
HIM Coder-Outpatient
Remote job
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.
Medical Auditor (Billing & Coding)
Remote job
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
Remote Medical Coding Auditor
Remote job
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.
Risk Adjustment Coding Specialist
Remote job
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.
Auto-ApplyOutpatient SDS Coding Specialist, Fully Remote, CCS or RHIT certified, FT, 08A-4:30P
Remote job
Accurately codes Outpatient Surgery and Observation records for the classification of all diseases, injuries, procedures, and operations using the ICD10CM and CPT4 coding system for BHSF facilities. 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 $26.50 - $34.45 / hour depending on experience.
Degrees:
* High School,Cert,GED,Trn,Exper.
Licenses & Certifications:
* AHIMA Certified Coding Specialist. CCS or RHIT
* AHIMA Registered Health Information Technician.
Additional Qualifications:
* Required Coding Certificate.
* With extensive relevant experience and not CCS or RHIT certified upon hire they must obtain within 2 years, except for BRRH employees.
* Knowledge of encoder system, outpatient prospective payment system (OPPS), APCs and Ambulatory Surgical Center payment system (ASC).
* Knowledge and thorough understanding of 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 outpatient Same Day Surgery SDS coding
Inpatient Coding Specialist, Fully Remote, $5000 Bonus, CCS or RHIT certified, FT, 08A-4:30P
Remote job
Inpatient Coding Specialist, Fully Remote, $5000 Bonus, CCS or RHIT certified, FT, 08A-4:30P-154910Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers, urgent care facilities and physician practices across Miami-Dade, Monroe, Broward and Palm Beach counties. With internationally renowned centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences, Baptist Health is supported by philanthropy and driven by its faith-based mission of medical excellence. For 25 years, we've been named one of Fortune's 100 Best Companies to Work For, and in the 2024-2025 U.S. News & World Report Best Hospital Rankings, Baptist Health was the most awarded healthcare system in South Florida, earning 45 high-performing honors.What truly sets us apart is our people. At Baptist Health, we create personal connections with our colleagues that go beyond the workplace, and we form meaningful relationships with patients and their families that extend beyond delivering care. Many of us have walked in our patients' shoes ourselves and that shared experience fuels out commitment to compassion and quality. Our culture is rooted in purpose, and every team member plays a part in making a positive impact - because when it comes to caring for people, we're all in. Description 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.Qualifications 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 Job CorporatePrimary Location RemoteOrganization CorporateSchedule Full-time Job Posting Dec 5, 2025, 5:00:00 AMUnposting Date OngoingEOE, including disability/vets
Auto-ApplyMedical Coding Auditor
Remote job
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.
Auto-ApplyMedical Records Coder 1
Remote job
Inova Health is looking for a dedicated Medical Records Coder 1 to join the HB Coding Operations team. This role is Full-time working daytime hours Monday to Friday | REMOTE.
Inova is consistently ranked a national healthcare leader in safety, quality and patient experience.
We are also proud to be consistently recognized as a top employer in both the D.C. metro area and the nation.
Featured Benefits:
Committed to Team Member Health: offering medical, dental and vision coverage, and a robust team member wellness program.
Retirement: Inova matches the first 5% of eligible contributions - starting on your first day.
Tuition and Student Loan Assistance: offering up to $5,250 per year in education assistance and up to $10,000 for student loans.
Mental Health Support: offering all Inova team members, their spouses/partners, and their children 25 mental health coaching or therapy sessions, per person, per year, at no cost.
Work/Life Balance: offering paid time off, paid parental leave.
Medical Records Coder 1 Job Responsibilities:
Resolves OCE and medical necessity edits.
Appends or corrects modifiers and resolves NCI, LCD, NCD, OCE and MUE edits when required.
Meets Coding quality standards established by the Coding Operations Director and the Coding Manager.
Makes recommendations to physicians on documentation required to support ICD-10 diagnosis codes.
Ensures that ICD-910-CM diagnosis productivity rate meets minimum standards according to policies and procedures.
Assigns the appropriate ICD-10-CM diagnosis codes to Outpatient records after review of the Outpatient medical record documentation
Minimum Requirements:
Education: High School diploma or GED equivalent and completion of an AHIMA-approved coding or health information technology program.
Certification: CCA, RHIA, RHIT, or CCS certification from AHIMA, or CPC-A, CPC, or COC certification from AAPC upon start.
Auto-ApplyRisk Adjustment Medical Record Coder
Remote job
The Risk Adjustment & Quality Division at BCBST is seeking a skilled Risk Adjustment Medical Record Coder to support our mission of delivering accurate and compliant coding practices.
What You'll Do: In this role, you will perform first-pass reviews of member medical records to identify and capture active conditions that map to risk values. This is a remote, day-shift position with flexibility to work up to 8 additional hours per week in accordance with BCBST policy.
Preferred Qualifications:
CRC (Certified Risk Adjustment Coder) certification is a plus. If not currently certified, you must obtain it within one year of hire.
Strong expertise in HCC (Hierarchical Condition Category) coding, with experience in MA (Medicare Advantage) and Affordable Care Act (ACA) programs highly preferred.
What Sets You Apart:
Self-motivated and proactive, thriving in a remote work environment
A true team player, ready to engage in team chats and support colleagues
A learner, eager to grow and adapt in a constantly evolving industry
Job Responsibilities
Maintain compliance with CMS risk adjustment diagnosis coding guidelines.
Perform comprehensive 1st pass reviews of medical records and physician assessment forms (HCC coding).
Assist with the intake and quality assurance of medical records as necessary.
Perform or participate in special projects as directed by management.
ICD-10 Coding assessment is required.
Job Qualifications
Education
Associates degree or equivalent work experience required. Equivalent experience is defined as 2 years of professional work experience.
Experience
1 year - Progressive medical coding and health care experience required.
Skills\Certifications
Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA).
Must acquire the Certified Risk Adjustment Coder (CRC) certificate from AAPC within one year, after completed training.
Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability.
Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint).
Proven analytical and problem-solving skills and ability to perform non-routine analytical tasks.
Must be a team player, be organized and have the ability to handle multiple projects.
Excellent oral and written communication skills.
Strong interpersonal and organizational skills.
Understanding of ICD-10 coding standards required.
Number of Openings Available
0
Worker Type:
Employee
Company:
BCBST BlueCross BlueShield of Tennessee, Inc.
Applying for this job indicates your acknowledgement and understanding of the following statements:
BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law.
Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page:
BCBST's EEO Policies/Notices
BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means.
Auto-ApplyHealth Information Management -HIM - Coder - Inpatient -REMOTE
Remote job
Health Information Management - HIM - Coder - Inpatient
The Inpatient Coder is responsible for coding discharged inpatient encounters. May work in collaboration with Clinical Documentation Improvement nurses. Utilizes Clintegrity encoder for DRG assignment. Submits coding queries as necessary for appropriate provider clarification. Maintains coding knowledge and certifications. Maintains working knowledge of Medicare rules and regulations.
Understands importance coding plays in the revenue cycle process
Meets or exceeds coding productivity and quality standards
Assists with DRG appeals as necessary
Assists Coding Manager with identifying problems or trends that need immediate attention
Adheres to all department and hospital policies and procedures
High School diploma required. Associates or bachelors degree preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Coding Associate (CCA), or Certified Professional Coder (CPC) required.
KNOWLEDGE AND SKILLS REQUIRED:
Must possess critical thinking and analytical skills. Knowledgeable in medical terminology, anatomy and physiology, ICD-10 and PCS coding guidelines, CPT, HCPCS, and basic coding principles according to whether assigned to inpatient or outpatient duties.
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.