Anderson Hills Pediatrics' Expectations of all Employees:
Adhere to all Anderson Hills Pediatrics' Policies and Procedures
Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times
Maintain a positive and respectful attitude with all work-related contacts
Consistently reports to work prepared to perform the duties of the position
Meets productivity standards and performs duties as workload necessitates
Primary Function : Assists the Billing Manager with the claims submission and revenue cycle of the practice.
Major Duties and Responsibilities :
• Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information
• Update patient demographic information including insurance coverage; make changes/corrections as needed; verify patient insurance benefits when applicable
• Process required referrals to specialists and/or facilities
• Audit charges from EMR for accuracy in CPT /ICD-10 / HCPCS coding
• Pursue any outstanding claims and/or appeal any denied or underpaid claims
• Respond to requests for medical records from insurance companies
• Post patient and/or insurance remittances
• File insurance claims daily
• Perform daily close of the day
• Investigate, analyze, and follow up for collection of overdue accounts
• Initiate and respond to telephone inquiries from patients, insurance companies, others
• Process BCMH applications as needed
• Participate in quality improvement initiatives as needed
• Complete necessary training on topics including, but not limited to, care coordination, patient self-management, population management, and health literacy
• Attend monthly staff meetings and scheduled department meetings
• Other miscellaneous duties as assigned by the Billing Manager
Principle Working Relationships
Works with patients/families, insurance companies and Finance Manager
Works with physicians, other managers, and staff as needed
Qualifications:
Education: High school diploma
1-3 years of medical billing office experience preferred
Coding certification required
Experience in pediatrics preferred
Essential Skills and Abilities:
Demonstrate excellent listening skills and problem-solving skills
Ability to interpret, adapt and apply guidelines and protocols
Ability to willingly invest in change processes to improve efficiencies, compliance, and overall AHP performance
Exceptional interpersonal skills, including the ability to establish and maintain effective relationships with physicians, other employees, and patients
Excellent critical thinking skills; exhibit sound judgment in decision making
Excellent communication (both oral and written)
Demonstrate strong customer service skills, including the ability to use appropriate judgment, independent thinking, and creativity when resolving customer issues
Initiative and ability to work independently, lead/work in teams, and deal persuasively and effectively with all levels throughout the organization.
Ability to manage multiple projects in varying stages of development; excellent problem-solving skills and attention to detail.
Must be able to receive constructive criticism and react quickly to change.
Ability to balance and shift multiple priorities.
Working Conditions:
Works in clinical areas as well as throughout the facility
Sits, stands, bends, lifts and moves intermittently during work hours
Relocation not available
$38k-55k yearly est. Auto-Apply 60d+ ago
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Specialist Clinical Coding II
Seh Saint Elizabeth Medical Center
Medical coder job in Cincinnati, OH
Engage with us for your next career opportunity. Right Here.
Job Type:
Regular
Scheduled Hours:
40
💙 Why You'll Love Working with St. Elizabeth Healthcare
At St. Elizabeth Healthcare, every role supports our mission to provide comprehensive and compassionate care to the communities we serve. For more than 160 years, St. Elizabeth Healthcare has been a trusted provider of quality care across Kentucky, Indiana, and Ohio. We're guided by our mission to improve the health of the communities we serve and by our values of excellence, integrity, compassion, and teamwork. Our associates are the heart of everything we do.
🌟 Benefits That Support You
We invest in you - personally and professionally.
Enjoy:
- Competitive pay and comprehensive health coverage within the first 30 days.
- Generous paid time off and flexible work schedules
- Retirement savings with employer match
- Tuition reimbursement and professional development opportunities
- Wellness, mental health, and recognition programs
- Career advancement through mentorship and internal mobility
Job Summary:
This position processes medical records by coding, abstracting data, and producing information for third party billing and to provide a complete statistical database.
Demonstrate respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background.
Job Description:
Reviews inpatient or observation, same day surgery, and interventional procedure records or emergency department or complex ancillary records. Identifies and codes principal and secondary diagnoses and principal and secondary procedures in appropriate sequence so that the accurate DRG/APC will be assigned according to Official Coding Guidelines to provide information for billing purposes. Meets department coding standards for quality and productivity of 96%. (New staff are expected to meet these standards upon completion of the training period).
Assigns all codes based on documentation. Participates in corporate compliance program. Upholds the highest ethical standards.
Abstracts demographic and medical information into computer system following departmental guidelines to provide an accurate data base for statistical reference.
Communicates with Corporate Coding Manager, Coding Team Leader, CDI Specialists, Patient Accounts staff and fellow coders in a professional manner as needed regarding held accounts, coding changes, coding questions, physician queries, rebills, etc.
Completes various reports such as productivity reports, statistical reports and log sheets in order to maintain an accurate source of reference material and other documentation. Performs daily or weekly follow-up of all dates assigned and submits updates accordingly.
Attends educational programs and applies knowledge to enhance job performance. Uses resources available for accurate coding (i.e., Coding Clinic and CPT Assistant).
Performs other duties as assigned.
Education, Credentials, Licenses:
Associate or Bachelor's degree (or equivalent hospital based coding experience)
CCS, CIC or COC, credentials
Physician coding credentials of CCS-P and CPC are not preferred but recognized for coding other than inpatient.
An apprentice credential is not sufficient
Specialized Knowledge:
Medical Terminology, Anatomy and Physiology
ICD/CPT experience Prospective Payment Systems, Outpatient Medical Necessity.
Use of personal computer
Kind and Length of Experience:
Two to Four years hospital coding experience
FLSA Status:
Non-Exempt
Right Career. Right Here. If you're looking for the right careers in healthcare, the right place to be is at St. Elizabeth. Join us, and you'll take pride in the level of care we offer our community.
Job Overview: This position abstracts provider documentation and assigns specific and appropriate ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes based on clinical documentation and official guidelines/regulations provided by government and insurance carriers. Job Requirements: High School Degree or GED CPC-A, CPC, CCS-P, CCA ICD-10-CM and CPT Coding Guidelines Medical terminology Anatomy Physiology Experience Related Fields Job Responsibilities: Assists with coding/billing questions from both internal and external customers. Which will include follow up on denials, research, review of charts for potential coding issues. Follow up with provider on any documentation that is insufficient or unclear and escalate where necessary. Communicate with other clinical staff regarding documentation trends. Maintains a close working relationship with all departments and internal customers including leadership and consolidates effotrts to ensure appropriate and standardized coding procedures are followed. Ensures understanding and compliance with coding protocols, rules and regulations from government agencies, insurance companies, and other resources. Maintains knowledge of current coding revisions and effectively communicates changes with provider. Maintains accurate and current CPT and ICD-10-CM resources within the billing and clinical systems. Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable. Ensure that all codes are current, active, and billiable according to CCI. Validate and/or abstract codes specific to diagnoses and procedures, using ICD and CPT codes. Receive and review patient charts and documents to ensure codes are accurate and sequenced correctly and in accordance with government and insurance were applicable. Ensure that all codes are current, active, and billiable according to CCI. Other job-related information: Qualifications: Successful completion of a certification program from an accredited organization. Strong knowledge of anatomy, physiology, and medical terminology. Excellent typing and 10-key speed accuracy. Commitment to a high level of customer service. Superior mathmatical skills. Familarity with ICD-10 codes and procedures. Solid oral and written communication skills. Working knowledge of medical jargon and anatomy preferred. Able to work independently. Working Conditions: Climbing - Rarely Concentrating - Consistently Continuous Learning - Consistently Hearing: Conversation - Consistently Hearing: Other Sounds - Frequently Interpersonal Communication - Consistently Kneeling - Rarely Lifting
Lifting 50+ Lbs - Rarely Lifting 11-50 Lbs - Rarely Pulling - Rarely Pushing - Rarely Reaching - Rarely Reading - Consistently Sitting - Consistently Standing - Frequently Stooping - Rarely Talking - Frequently Thinking/Reasoning - Consistently Use of Hands - Occasionally Color Vision - Rarely Visual Acuity: Far - Frequently Visual Acuity: Near - Frequently Walking - Occasionally TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… * Welcome everyone by making eye contact, greeting with a smile, and saying "hello" * Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist * Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… * Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met * Offer patients and guests priority when waiting (lines, elevators) * Work on improving quality, safety, and service Respect: ALWAYS… * Respect cultural and spiritual differences and honor individual preferences. * Respect everyone's opinion and contribution, regardless of title/role. * Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… * Value the time of others by striving to be on time, prepared and actively participating. * Pick up trash, ensuring the physical environment is clean and safe. * Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… * Acknowledge wins and frequently thank team members and others for contributions. * Show courtesy and compassion with customers, team members and the community
$51k-62k yearly est. 44d ago
Medical Coding Appeals Analyst
Elevance Health
Medical coder job in Mason, OH
Sign On Bonus: $1,000 **Location:** This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. **Alternate locations may be considered if candidates reside within a commuting distance from an office.**
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
This position is not eligible for employment based sponsorship.
**Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.**
PRIMARY DUTIES:
+ Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code.
+ Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy.
+ Translates medical policies into reimbursement rules.
+ Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits.
+ Coordinates research and responds to system inquiries and appeals.
+ Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy.
+ Perform pre-adjudication claims reviews to ensure proper coding was used.
+ Prepares correspondence to providers regarding coding and fee schedule updates.
+ Trains customer service staff on system issues.
+ Works with providers contracting staff when new/modified reimbursement contracts are needed.
**Minimum Requirements:**
Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required.
**Preferred Skills, Capabilities and Experience:**
+ CEMC, RHIT, CCS, CCS-P certifications preferred.
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$71k-99k yearly est. 3d ago
Digital Health Systems Co-op Student
Uc Health 4.6
Medical coder job in Cincinnati, OH
UC Health is hiring a Full Time Digital Health Systems Co-Op Student Co-Op students participate in an organized co-op program sponsored by a university. The Co-op student will provide a variety of support tasks while participating in a mentoring and learning environment. The student may work in different functional areas within IS&T.
About UC Health
UC Health is an integrated academic health system serving Greater Cincinnati and Northern Kentucky. In partnership with the University of Cincinnati, UC Health combines clinical expertise and compassion with research and teaching-a combination that provides patients with options for even the most complex situations. Members of UC Health include: UC Medical Center, West Chester Hospital, University of Cincinnati Physicians and UC Health Ambulatory Services (with more than 900 board-certified clinicians and surgeons), Lindner Center of HOPE and several specialized institutes including: UC Gardner Neuroscience Institute and the University of Cincinnati Cancer Center. Many UC Health locations have received national recognition for outstanding quality and patient satisfaction. Learn more at uchealth.com.
System Development and Support
* Assist in the development, implementation, and evaluation of digital health solutions that address specific patient needs, community health goals, or organizational objectives
* Ensure all programs comply with healthcare regulations, security and quality standards
Project Support and Stakeholder Collaboration
* Support UCH teams with user testing, troubleshooting, & refinement of digital health tools
* Collaborate with clinicians, IT, & administrative staff to improve digital health experience
Data Collection and Reporting
* Collect, review, analyze, interpret and communicate program data to track performance metrics and outcomes
* Present regular reports for UCH DHS, and other stakeholders as assigned
* Use data to identify areas for improvement and make evidence-based decisions to optimize program delivery
Compliance and Risk Management
* Assist with ensuring programs adhere to healthcare laws, regulations, and accreditation standards
* Identify potential risks and barriers related to program implementation and delivery, taking corrective actions when needed
Training and Development
* Help create training materials and provide support to contribute to documentation of processes, workflows, and lessons learned
Other duties as assigned
* Minimum Required: High School Diploma or GED
* 0 - 6 Months equivalent experience
* The Co-Op is a current student in a University Sponsored program pursuing a degree. Typically, the co-op student has completed 1 year of college training before assuming a co-op work assignment
REQUIRED SKILLS AND KNOWLEDGE:
* Gather and assess information pertaining to its reliability, reasonability and completeness;
* Prepare summaries of that information using standard Microsoft Office tools (MS Excel, MS Word, etc.);
* Have good writing skills, such that they are able to summarize their analyses and assessments;
* Work with UC Health associates from all areas of the campus;
* Have good inter-personnel skills.
Join our team to BE UC Health. Be Extraordinary. Be Supported. Be Hope. Apply Today!
At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.
As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors. UC Health is an EEO employer.
$43k-51k yearly est. Auto-Apply 27d ago
Medical Device QMS Auditor
Bsigroup
Medical coder job in Cincinnati, OH
We exist to create positive change for people and the planet. Join us and make a difference too!
Job Title: QMS Auditor
Do you believe the world deserves excellence?
BSI (British Standards Institution) is the global business standards company that equips businesses with the necessary solutions to turn standards of best practice into habits of excellence.
Our Medical Devices (or Regulatory Services) team ensures patient safety while supporting timely market access for our clients' medical device products globally. BSI is an accredited ISO 13485 Certification Body recognized in many global markets
Essential Responsibilities:
Analyze quality systems and assess ISO 13485, CE Marking and MDSAP schemes.
Prepare assessment reports and deliver findings to clients to ensure client understanding of the assessment decision and clear direction to particular items of corrective action where appropriate
Recommend the issue, re-issue or withdrawal of certificates, and report recommendations in accordance with BSI policy, procedures and prescribed time frame.
Maintain overall account responsibility and accountability for nominated accounts to ensure an effective partnership, whilst ensuring excellent service delivery and account growth.
Lead assessment teams as required ensuring that team members are adequately briefed so that quality of service is maintained and that effective working relationships are sustained both with Clients and within the team.
Provide accurate and prompt information to support services, working closely with them to ensure that client records are up to date and complete and that all other internal information requirements are met.
Coach colleagues as appropriate especially where those members are inexperienced assessors or unfamiliar with clients' business/technology and assist in the induction and coaching of new colleagues as requested
Plan/schedule workloads to make best use of own time and maximize revenue-earning activity.
Education/Qualifications:
Associate's degree or higher in Engineering, Science or related degree required
Minimum of 4 years experience in the medical device field including at least 2 years must be hands-on medical device design, manufacturing, testing or clinical evaluation experience.
The candidate will develop familiarity with BSI systems and processes as they go through the qualification process.
Knowledge of business processes and application of quality management standards.
Good verbal and written communication skills and an eye for detail.
Be self-motivated, flexible, and have excellent time management/planning skills.
Can work under pressure.
Willing to travel on business intensively.
An enthusiastic and committed team player.
Good public speaking and business development skill will be considered advantageous.
The salary for this position can range from $98,100 to $123,860 annually; actual compensation is based on various factors, including but not limited to, the candidate's competencies, level of experience, education, location, divisional budget and internal peer compensation comparisons. BSI offers a competitive salary, group-sponsored health and dental, short-term and long-term disability, a company-matched 401k plan, company paid life insurance, 11 paid holidays and 4 weeks paid time off.
#LI-REMOTE
#LI-MS1
About Us
BSI is a business improvement and standards company and for over a century BSI has been recognized for having a positive impact on organizations and society, building trust and enhancing lives.
Today BSI partners with more than 77,500 clients in 195 countries and engages with a 15,000 strong global community of experts, industry and consumer groups, organizations and governments.
Utilizing its extensive expertise in key industry sectors - including automotive, aerospace, built environment, food and retail, and healthcare - BSI delivers on its purpose by helping its clients fulfil theirs.
Living by our core values of Client-Centricity, Agility, and Collaboration, BSI provides organizations with the confidence to grow by partnering with them to tackle society's critical issues - from climate change to building trust in digital transformation and everything in between - to accelerate progress towards a better society and a sustainable world.
BSI is an Equal Opportunity Employer dedicated to fostering a diverse and inclusive workplace.
$34k-55k yearly est. Auto-Apply 48d ago
EMR Analyst II - Epic Inpatient
Cincinnati Children's Hospital Medical Center 4.5
Medical coder job in Cincinnati, OH
Join one of the top pediatric hospitals in the nation and a recognized leader and top employer for technology professionals as an Epic Analyst (Inpatient). At Cincinnati Children's, you will play a vital role in advancing our mission to improve child health and transform care delivery through technology and innovation.
In this role, you will support and enhance our Epic systems that power patient care, registration, scheduling, and billing across the enterprise. This position is ideal for someone who thrives in a technical environment-focused on Epic build, configuration, and optimization-to ensure seamless system performance for clinicians and patients alike. You will collaborate with cross-functional teams to design, implement, and maintain innovative Epic solutions that strengthen workflows, improve data integrity, and elevate operational efficiency at one of the nation's best places to work in healthcare technology.
As part of your continued growth, you will also gain exposure to Epic Bugsy Infection Control- a forward-thinking Epic module that plays a key role in advancing patient safety, infection prevention, and care quality across the organization.
JOB RESPONSIBILITIES
Build/Configuration/Release Management
* Analyze, design, implement, and maintain moderately complex systems that greatly improves clinical care and patient management.
* Support system testing.
* Document testing outcomes.
* Work to develop technical solutions.
* Utilize development lifecycle process, operating procedures, and documentation to implement and support system solutions.
* Where applicable, collaborate on the scheduling of the applicable clinical systems training and build environments to ensure currency and usability to support end user training.
* Independently develops educational technology content for applicable use.
* Recommends opportunities for and participates in process improvement to advance education and learning processes, content tracking, content review and revision.
* Drives the use of multivariate learning modalities to cover the adult learning spectrum and clinical system education need.
Leadership
* Take ownership of tasks with sense of urgency and drive them to completion.
* Take initiative and know what needs to be done.
* Communicate to supervisor regarding overall issues, roadblocks.
* Identify the appropriate resources needed to complete small/medium projects.
* Support the communication on project-related issues and developments.
* Work with cross functional teams.
* Attend and participate in design and leadership team meetings for the various clinical applications deployed throughout the hospital.
* Consult with end users to ensure that clinical system applications and accompanying training programs and materials support global and unique patient care delivery processes.
* Network with internal and external experts to identify best practices for clinical system use and training.
* Promote use of industry best practice tools for efficiency and innovative education and learning.
Professional Growth & Development
* Maintain currency in the field by participating in educational opportunities provided by vendor and other customer connections.
* Conduct and participate in instructional sessions.
* Use knowledge to improve skills.
* Develop and maintain positive relationships, both internal and external to CCHMC.
* Motivate people and encourage teamwork.
* Work well with others and fosters a positive team environment.
* Prepare oral and written presentations.
Project Management
* Support/and or lead the design, development, and implementation of new and enhanced application requests.
* Support and/or lead project plans and other project- related documentation for moderately complex projects.
* Determine the scope of moderately complex projects.
* Coordinate the appropriate resources needed.
* Prioritize, organize, and complete assigned tasks and associated documentation upon directives from supervisor or customers.
* Seek the appropriate resources needed for activities.
* Coordinate and facilitate communication between internal and external parties on assigned tasks and related issues.
* Effectively works with cross functional teams to ensure proper integration.
* Consult with and support the end user community to develop and validate requirements for system solutions.
Customer Support
* Develop collaborative professional relationships with customer group and key stakeholders.
* Demonstrates advanced troubleshooting skills.
* Ensure outstanding end-user support is provided, including ongoing monitoring of Service Level Agreements for incident management and collaboration with other areas to ensure customer-centered incident management and support.
* Independently critically thinks to work through details of a problem to reach a positive solution.
* Plan and execute the support for a user base through clinical system training and the creation and curation of advanced education and training materials.
* Adhere to and promote continual adoption of change management policies and procedures.
* Interact with all levels of staff throughout the Medical Center in a collaborative manner.
* Strong sense of personal accountability.
* Model outstanding customer service behavior, including timely and effective follow-up with customers.
* Always maintain CCHMC's service standards of being Courteous, Attentive, Respectful and Enthusiastic team members, and Safe (CARES).
JOB QUALIFICATIONS
* Education: Bachelor's Degree or equivalent combination of education and experience.
* Experience: 2+ years of work experience in a related job discipline.
PREFERRED QUALIFICATIONS
* Epic Certifications: EpicCare Inpatient Clinical Documentation, EpicCare Inpatient Procedure Orders or Epic Bugsy Infection Control - with Bugsy experience valued for its forward-thinking approach to infection prevention and surveillance.
* Strong technical aptitude with experience in Epic build, configuration, testing, and troubleshooting.
* Experience with system integrations, interface validation, and release management processes.
* Ability to analyze workflows, translate business requirements into technical solutions, and collaborate with both technical and clinical partners.
* Desire to expand Epic expertise through exposure to advanced modules and ongoing professional development opportunities.
Primary Location
Remote
Schedule
Full time
Shift
Day (United States of America)
Department
IS Epic
Employee Status
Regular
FTE
1
Weekly Hours
40
* Expected Starting Pay Range
* Annualized pay may vary based on FTE status
$81,723.20 - $104,208.00
Market Leading Benefits Including*:
* Medical coverage starting day one of employment. View employee benefits here.
* Competitive retirement plans
* Tuition reimbursement for continuing education
* Expansive employee discount programs through our many community partners
* Shift Differential, Weekend Differential, and Weekend Option Pay Programs for qualified positions
* Support through Employee Resource Groups such as African American Professionals Advisory Council, Asian Cultural and Professional Group, EQUAL - LGBTQA Resource Group, Juntos - Hispanic/Latin Resource Group, Veterans and Military Family Advocacy Network, and Young Professionals (YP) Resource Group
* Physical and mental health wellness programs
* Relocation assistance available for qualified positions
* Benefits may vary based on FTE Status and Position Type
About Us
At Cincinnati Children's, we come to work with one goal: to make children's health better. We believe in a holistic team approach, both in caring for patients and their families, and in advancing science and discovery. We strive to do better and find energy and inspiration in our shared purpose. If you want to be the best you can be, you can do it at Cincinnati Children's.
Cincinnati Children's is:
* Recognized by U.S. News & World Report as a top 10 best Children's Hospitals in the nation for more than 15 years
* Consistently among the top 3 Children's Hospitals for National Institutes of Health (NIH) Funding
* Recognized as one of America's Best Large Employers (2025), America's Best Employers for New Grads (2025)
* One of the nation's America's Most Innovative Companies as noted by Fortune
* Consistently certified as great place to work
* A Leading Disability Employer as noted by the National Organization on Disability
* Magnet designated for the fourth consecutive time by the American Nurses Credentialing Center (ANCC)
We Embrace Innovation-Together. We believe in empowering our teams with the tools that help us work smarter and care better. That's why we support the responsible use of artificial intelligence. By encouraging innovation, we're creating space for new ideas, better outcomes, and a stronger future-for all of us.
Comprehensive job description provided upon request.
Cincinnati Children's is proud to be an Equal Opportunity Employer committed to creating an environment of dignity and respect for all our employees, patients, and families. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, genetic information, national origin, sexual orientation, gender identity, disability or protected veteran status. EEO/Veteran/Disability
$81.7k-104.2k yearly 54d ago
Senior Medical Data Analyst
Global Channel Management
Medical coder job in Mason, OH
Senior Medical Data Analyst needs 5+ years experience with health plans or medical claims
Senior Medical Data Analyst requires:
Bachelors degree or equivalent work experience
At least 5+ years experience with health plans or medical claims
Experience with Claims Processing, Medical Plan Benefit Configuration (Facets platform a plus)
HYBRID - 2 to 3x a week
SQL and Database experience with basic queries.
Excellent analytical and problem-solving skills
Strong communication and interpersonal skills
Senior Medical Data Analyst duties:
Represent Product Configuration on cross-functional project teams to implement new Government/Medical-Surgical products
Serve as the lead subject matter expert for Government/Medical-Surgical product configuration for the production team
Partner with IT Configuration on Global Configuration requirements, perform data analysis, prototyping, and testing support for Government client setup requests.
Develop and document the standard operating procedures for Government/Medical-Surgical product configuration
Develop and train the team on the knowledge of Government/Medical-Surgical product configuration.
Provide additional support working Commercial client setup and maintenance requests sent to the Plan Setup team when necessary
Perform audits on client setup or maintenance request by following established team audit controls.
$39k-57k yearly est. 60d+ ago
Medical Records Specialist
Cincinnati ASC LLC
Medical coder job in Cincinnati, OH
Job Description
Key Responsibilities
Scan and upload surgical charts, operative notes, and ancillary documents into the ASC's Electronic Health Record (EHR) system.
Verify document accuracy and index files under correct patient and procedure categories.
Maintain strict confidentiality and adhere to HIPAA and ASC-specific compliance standards.
Collaborate with clinical teams to ensure records are complete after and after procedures.
Assist with record transfers for audits, insurance requests, and quality reporting.
Follow ASC protocols for document retention and secure destruction.
Cross trained to manage the front desk and receptionist responsibilities
Greet patients and visitors in a professional, courteous manner
Manage patient check-in and check-out processes, including verifying insurance and collecting co-pays
Obtain signatures on patient forms, where applicable
Answer phones, respond to inquiries, and route calls appropriately
$27k-35k yearly est. 19d ago
Health Information Clerk
Primary Health Solutions 4.1
Medical coder job in Hamilton, OH
Our Mission
We meet people where they are and partner with them on their journey towards wellness.
Our Vision
The destination for servant leaders to provide comprehensive and exceptional care.
Our Values
R - Respect
I - Innovation
S - Stewardship
E - Excellence
Health Information Clerk Summary
The Health Information Clerk will be responsible for establishing and maintaining the health information processing (electronic and hard copy) needs of the organization. This includes creating and maintaining patient records, providing assistance with records releases, conducting audits, etc. in compliance with state and federal regulations as well as HIPAA. The Health Information Clerk will understand and fully support the mission, vision, and value statements of Primary Health Solutions.
A Day in the Life
This reflects management's assignment of essential functions. Nothing in this restricts management's right to assign or reassign duties and responsibilities to this job at any time.
· Conducts routine medical record-keeping operations and healthcare information management to ensure secure, accurate and reliable patient information management that complies with all applicable organizational, local, state, federal regulations.
· Works closely with administration, vendors, and staff to support the requests from patients and outside entities for obtaining records to support patient care.
· Follows established policies and procedures to ensure effective and compliant record management, makes suggestions for process improvements.
· Assists in implementation of digital technologies and tools to gain efficiencies, facilitate record retrieval, and ensure secure storage.
· Assist in facilitation of the retrieval, collection, and requests for medical records made by staff, patients, and affiliates.
· Monitor, facilitate and track all records requests, releases, and authorizations within the Electronic Medical Record.
· Abide by, adhere to, and conform to all applicable organizational, local, state, federal regulations.
· Maintains an up to date understanding of applicable policies, processes, laws, and regulations relative to the processing of patient health information (PHI).
· Report breaches, instances of non-compliance, patient complaints, problems, or similar instances to supervisor to protect patient health information.
· Assist patients, staff and affiliates with medical records requests and questions.
· Performs all other duties and tasks as assigned.
Requirements
Core Competencies
· Customer Service: Committed to increasing customer satisfaction, sets proper customer expectations, assumes responsibility for solving customer problems, ensures commitments to customers are met.
· Communication: Understand and communicate effectively with others using a variety of contexts and formats, which include writing, speaking, reading, listening and interpersonal skills.
· Dependability: Meets commitments, works independently, accepts accountability, handles change, sets personal standards, stays focused under pressure, meets attendance/punctuality requirements.
· Quality: Is attentive to detail and accuracy, is committed to excellence, looks for improvements continuously, monitors quality levels, finds root cause of quality problems, owns/acts on quality problems.
· Productivity: Manages a fair workload, volunteers for additional work, prioritizes tasks, develops good work procedures, manages time well, and handles information flow.
Success Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Experience
· Associate degree or a similarly accredited program in health information technology preferred.
· Registered Health Information Technician (RHIT) or the Certified Electronic Health Records Specialist (CEHRS) preferred.
· At least 3 years of experience in a medical office setting.
· Strong data entry skills.
· Excellent verbal and written communication skills.
· Advanced organization skills.
· Attention to detail to ensure accuracy.
· Familiarity with medical terminology.
· Basic computer skills to scan, organize and access electronic health records.
· Able to work independently and possess strong time management skills.
· Excellent problem-solving skills.
Language Skills
Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
Reasoning Ability
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
Computer Skills
To perform this job successfully, an individual should have the ability to gain knowledge of current practice management system, electronic medical record, Microsoft Word, text paging, Internet, and Intranet.
Certificates, Licenses, Registrations
Registered Health Information Technician (RHIT) or the Certified Electronic Health Records Specialist (CEHRS) preferred.
Other Applicable Requirements
Ability to speak Spanish desirable. Skill in maintaining records and recording test results. Skill with patients in lower socio-economic sectors of the community.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is frequently required to stand; walk; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to sit and stoop, kneel, crouch, or crawl. The employee must regularly lift and /or move up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception and ability to adjust focus.
Work Environment
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this Job, the employee are occasionally exposed to fumes or airborne particles, toxic or caustic chemicals and risk of radiation. The noise level in the work environment is usually moderate.
Affirmative Action/EEO Statement
It is the policy of Primary Health Solutions to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information, or any other protected characteristic under applicable law.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
$30k-36k yearly est. 60d+ ago
Medical Records Clerk
Community Health Centers of Greater Dayton 3.5
Medical coder job in Dayton, OH
CHCGD is seeking a full-time medical records clerk to maintain patient charts ensuring timely completeness and organization of patient s charts and medical records, while ensuring strict patient confidentiality and privacy.
Principal Duties and Responsibilities:
Performs medical records duties as appropriate.
Must ensure that confidentiality of patient information is observed by following company policies and procedures.
Ensures that a health record is maintained on each patient in a confidential and secure manner.
Sends paper charts to storage. Maintains database of records stored offsite; sends and retrieves charts to and from storage in accordance with record retention guidelines.
Reviews and processes request for subpoenas received from outside providers, agencies, schools, and attorneys in compliance with applicable state laws.
This person will perform a wide range of duties, including chart retrieval and filing, processing release of information, tracking chart location, overseeing the chart copying service, scanning/filing medical documents to EHR chart, managing HIE documents in the holding tank, and other duties as assigned.
Required Knowledge, Experience or Licensure/Registration
High School Diploma or equivalent and knowledge of medical terminology, typing and filing. Experience with NextGen EHR preferred. Basic computer skills required.
Minimum of 1 year experience in medical records, preferably in an office practice setting.
Qualified candidates must have a working knowledge of HIPAA regulation, medical terminology, and be proficient in alpha and numerical filing.
Strong telephone, customer service, organizational, computer and communication skills are required.
Must be able to multitask and work in a fast paced environment.
Requires a high degree of responsibility, responsiveness.
Must be flexible to work in and move from site to site as needed.
Must be able to respond and interact with physicians, the public and patient care team members in a courteous and collaborative manner.
$27k-33k yearly est. 16d ago
Medical Records
Carespring 4.1
Medical coder job in Cincinnati, OH
Pay $14 - $22 Depending on Certification/Credentials
Come join our team as a Medical Records Coordinator at our state of the art, skilled nursing facility. This position maintains the medical records in accordance with State and Federal regulations as well as professional standards of practice and facility policies and procedures to ensure complete, timely, and accurate medical records. Every other weekend is required.
Why Our Staff Have Chosen to Work Here!
Competitive Wages with low cost, high quality medical and dental insurance
RESPONSIBILITIES:
Performs routine audits of in-house charts upon admission and at least quarterly, to ensure completeness and accuracy. Completes focus audits and PI audits on specific topics as directed by Administrator or Regional Medical Records Director.
Provides notification to the staff on deficiencies found in the record and does follow-up to ensure the in-house records are complete.
Assembles the medical records of discharged residents.
Analyzes discharged charts for completeness and follows up with staff and physicians to ensure discharged records are completed.
Processes requests for medical information as directed by the Administrator, Regional Medical Records Director and/or corporate Risk Manager (i.e., requests from residents, attorneys, for insurance reimbursement, in response to a subpoena).
Maintains Release of Information Log for all requests for medical records and copies released for payment, continuity of care, and health care operations.
Completes Accounting of Disclosures form according to HIPAA policies and files in resident's chart.
Maintains the confidentiality of medical records by ensuring confidentiality of health information.
Monitors physician visits and reports non-compliance to the DON/Administrator at least monthly.
Purges charts, maintains destruction log, and maintains information for records at off-site storage facility.
Assigns ICD-9 CM codes for resident diagnoses. Inputs diagnoses and codes in HCS system.
Coordinates physician dictation with outside transcription company.
Files any loose sheets needing to be attached to the record.
Maintains supply of forms in department and on nursing units.
Completes discharge/transfer notice when necessary for transfers to hospital or expired residents. Inputs discharge/transfer data in HCS system and ECS.
Forwards requested records to Carespring Case Manager for managed care updates.
Serves as facility contact person to oversee Record Retention and Destruction Policy working with each department as documents/records are boxed for long term storage. Sign-off on each Record Log to confirm proper completion.
Performs other duties as assigned.
QUALIFICATIONS:
Maintains or is willing to obtain Medical Records Certification
Detail oriented person and can complete tasks on a need based schedule
PointClickCare experience is preferred.
Knowledge of Microsoft Word, Excel highly encouraged.
$32k-40k yearly est. 10d ago
Pro Fee Coding Spec - Professional Svc Coding
Kettering Medical Center Network 3.5
Medical coder job in Miamisburg, OH
Job Details System Services | Miamisburg | Full-Time | First Shift Responsibilities & Requirements This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist
Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.
* Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
* Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10
* Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy]
* Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
* Corresponds with providers on pending claims to facilitate resolution
* Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
* Communicate appropriately with providers, leaders, and staff
* Researches and resolves concerns timely
Educational Requirements:
High School Diploma or equivalent
RHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certification
Prior experience in professional fee coding/billing
Knowledge and Skill:
CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits
Medical Terminology and Anatomy & Physiology
Computer and EPIC Applications
Excellent verbal and written communication skills
Abilities:
Charge Review WQ [Edits]
* Reviews, researches and responds to Charge Review WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Claim Edit WQ [Edits]
* Reviews, researches and responds to Claim Edit WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Follow Up WQ [Denials]
* Reviews, researches and responds to Follow Up WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
* Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Departmental Responsibilities
* Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
* Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
* Follow procedures pertaining to position
* Researches and resolves concerns timely
Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
$51k-62k yearly est. Auto-Apply 36d ago
Pro Fee Coding Spec - Professional Svc Coding
Kettering Health Network 4.7
Medical coder job in Miamisburg, OH
Job Details System Services | Miamisburg | Full-Time | First Shift Responsibilities & Requirements
This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance and EPIC WQ Reconciliation.
KPN Pro Fee Coding Specialist
Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines.
Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10
Reviews and researches pending and denied claims pertaining to professional fee coding, CMS NCCI edits, and/or medical necessity requirements [CMS LDC/NCD and/or payer policy]
Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
Corresponds with providers on pending claims to facilitate resolution
Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
Communicate appropriately with providers, leaders, and staff
Researches and resolves concerns timely
Educational Requirements:
High School Diploma or equivalent
RHIT, RHIA, CCS, CCS-P, CPC or eligible specialty certification
Prior experience in professional fee coding/billing
Knowledge and Skill:
CPT, HCPCS, Modifiers, ICD-10, and CMS NCCI Edits
Medical Terminology and Anatomy & Physiology
Computer and EPIC Applications
Excellent verbal and written communication skills
Abilities:
Charge Review WQ [Edits]
Reviews, researches and responds to Charge Review WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Claim Edit WQ [Edits]
Reviews, researches and responds to Claim Edit WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Follow Up WQ [Denials]
Reviews, researches and responds to Follow Up WQ edits pertaining to coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Corresponds and communicates appropriately with providers on coding, CMS NCCI edits, and/or medical necessity requirements to facilitate resolution.
Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits
Departmental Responsibilities
Responsible for participating in departmental goals, KHN mission and implemented KHN/KPN policies
Demonstrate initiative for maintaining current knowledge of CPT, ICD-10 and CMS NCCI edits
Follow procedures pertaining to position
Researches and resolves concerns timely
Overview
Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.
$43k-54k yearly est. Auto-Apply 33d ago
Student Academic Records Coordinator
Wsu
Medical coder job in Dayton, OH
Minimum Qualifications Bachelor's degree and 1 year of related work experience Knowledge of databases Strong communication skills both written and verbal Excellent interpersonal skills, both written and verbal Flexibility to accomplish tasks within a fluid working environment, and ability to navigate multiple tasks and responsibilities effectively Strong organizational skills and attention to detail Self-motivated, comfortable working both independently and within a team.
Preferred Qualifications
Three years of progressive work experience in student affairs and student records or similar field. Working knowledge of Family Educational Rights and Privacy Act ( FERPA ) Experience working in student databases
$36k-51k yearly est. 60d+ ago
MEDICAL RECORDS CLERK
Beacon Orthopaedic Partners MSO LLC
Medical coder job in Dayton, OH
Job Description
Responsibilities/Standards:
Pay range starts at $11.50/hr and goes up with experience.
General
Attend department, clinic or company meetings as required
Demonstrate sound judgment by taking appropriate actions regarding questionable findings or concerns
Consistently work in a positive and cooperative manner with fellow staff members.
Consistently demonstrate ability to respond to changing situations in a flexible manner in order to meet current needs, such as reprioritizing work as necessary.
Attend required annual in-service programs.
Demonstrate knowledge and understanding of all company policies and procedures.
Specific Duties
Run assigned reports and prepare clinic for needed physicians. This involves checking the need to update registration paperwork for each scheduled patient and printing off any needed documents.
Take/distribute documents that we have received from outside sources, such as referrals, to the staff so they are available in time for the patient's appointment.
Scan into ICS all medical papers so they are available for Path Forward to index.
Distribute lab results and prescription refills to staff that are received by fax and mail.
Sort and distribute mail daily.
Answer phones.
Assures all urgent issues are handled after the end of the business day. Escalate issues to needed manager as situation requires.
Assist with medical records requests received from medical offices.
Process outside storage requests in a timely manner.
Performs other tasks as required by management.
Education/Experience Required:
Must be high school graduate or equivalent.
Physical Requirements:
Physical requirements for the position include the ability to frequently hear and communicate orally, see up close and at a distance, read and comprehend, stand, sit, walk, reach, handle, and/or feel objects. Must be able to climb, pull, push and kneel. Maximum unassisted lift = 25 lbs. Average lift less than 10 lbs.
Work Environment:
This position requires employees to work in close quarters, tight spaces, and on their feet for extended periods of time.
$11.5 hourly 25d ago
Certified Medical Coder (on site)
Anderson Hills Pediatrics Inc.
Medical coder job in Cincinnati, OH
Anderson Hills Pediatrics' Expectations of all Employees:
Adhere to all Anderson Hills Pediatrics' Policies and Procedures
Conduct self in a manner that represents Anderson Hills Pediatrics' core values at all times
Maintain a positive and respectful attitude with all work-related contacts
Consistently reports to work prepared to perform the duties of the position
Meets productivity standards and performs duties as workload necessitates
Primary Function: Assists the Billing Manager with the claims submission and revenue cycle of the practice.
Major Duties and Responsibilities:
• Adherence to current HIPAA regulations and federal/state laws for patient protected health information (PHI) and/or medical records; adherence to all AHP policies/procedures as they pertain to patient PHI and the medical record; maintain strict confidentiality of all patient information
• Update patient demographic information including insurance coverage; make changes/corrections as needed; verify patient insurance benefits when applicable
• Process required referrals to specialists and/or facilities
• Audit charges from EMR for accuracy in CPT /ICD-10 / HCPCS coding
• Pursue any outstanding claims and/or appeal any denied or underpaid claims
• Respond to requests for medical records from insurance companies
• Post patient and/or insurance remittances
• File insurance claims daily
• Perform daily close of the day
• Investigate, analyze, and follow up for collection of overdue accounts
• Initiate and respond to telephone inquiries from patients, insurance companies, others
• Process BCMH applications as needed
• Participate in quality improvement initiatives as needed
• Complete necessary training on topics including, but not limited to, care coordination, patient self-management, population management, and health literacy
• Attend monthly staff meetings and scheduled department meetings
• Other miscellaneous duties as assigned by the Billing Manager
Principle Working Relationships
Works with patients/families, insurance companies and Finance Manager
Works with physicians, other managers, and staff as needed
Qualifications:
Education: High school diploma
1-3 years of medical billing office experience preferred
Coding certification required
Experience in pediatrics preferred
Essential Skills and Abilities:
Demonstrate excellent listening skills and problem-solving skills
Ability to interpret, adapt and apply guidelines and protocols
Ability to willingly invest in change processes to improve efficiencies, compliance, and overall AHP performance
Exceptional interpersonal skills, including the ability to establish and maintain effective relationships with physicians, other employees, and patients
Excellent critical thinking skills; exhibit sound judgment in decision making
Excellent communication (both oral and written)
Demonstrate strong customer service skills, including the ability to use appropriate judgment, independent thinking, and creativity when resolving customer issues
Initiative and ability to work independently, lead/work in teams, and deal persuasively and effectively with all levels throughout the organization.
Ability to manage multiple projects in varying stages of development; excellent problem-solving skills and attention to detail.
Must be able to receive constructive criticism and react quickly to change.
Ability to balance and shift multiple priorities.
Working Conditions:
Works in clinical areas as well as throughout the facility
Sits, stands, bends, lifts and moves intermittently during work hours
Relocation not available
$38k-55k yearly est. Auto-Apply 60d+ ago
Medical Coding Appeals Analyst
Elevance Health
Medical coder job in Mason, OH
Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.
Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
This position is not eligible for employment based sponsorship.
Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria.
PRIMARY DUTIES:
* Review medical record documentation in support of Evaluation and Management, CPT, HCPCS and ICD-10 code.
* Reviews company specific, CMS specific, and competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy.
* Translates medical policies into reimbursement rules.
* Performs CPT/HCPCS code and fee schedule updates, analyzing each new code for coverage, policy, reimbursement development, and implications for system edits.
* Coordinates research and responds to system inquiries and appeals.
* Conducts research of claims systems and system edits to identify adjudication issues and to audit claims adjudication for accuracy.
* Perform pre-adjudication claims reviews to ensure proper coding was used.
* Prepares correspondence to providers regarding coding and fee schedule updates.
* Trains customer service staff on system issues.
* Works with providers contracting staff when new/modified reimbursement contracts are needed.
Minimum Requirements:
Requires a BA/BS degree and a minimum of 2 years related experience; or any combination of education and experience, which would provide an equivalent background. Certified Professional Coder (CPC) or Registered Health Information Administrator (RHIA) certification required.
Preferred Skills, Capabilities and Experience:
* CEMC, RHIT, CCS, CCS-P certifications preferred.
Job Level:
Non-Management Exempt
Workshift:
Job Family:
MED > Licensed/Certified - Other
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ******************************************** for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.
$71k-99k yearly est. 3d ago
Medical Records Clerk
Community Health Centers of Greater Dayton 3.5
Medical coder job in Dayton, OH
Job Description
CHCGD is seeking a full-time medical records clerk to maintain patient charts ensuring timely completeness and organization of patient's charts and medical records, while ensuring strict patient confidentiality and privacy.
Principal Duties and Responsibilities:
Performs medical records duties as appropriate.
Must ensure that confidentiality of patient information is observed by following company policies and procedures.
Ensures that a health record is maintained on each patient in a confidential and secure manner.
Sends paper charts to storage. Maintains database of records stored offsite; sends and retrieves charts to and from storage in accordance with record retention guidelines.
Reviews and processes request for subpoenas received from outside providers, agencies, schools, and attorneys in compliance with applicable state laws.
This person will perform a wide range of duties, including chart retrieval and filing, processing release of information, tracking chart location, overseeing the chart copying service, scanning/filing medical documents to EHR chart, managing HIE documents in the holding tank, and other duties as assigned.
Required Knowledge, Experience or Licensure/Registration
High School Diploma or equivalent and knowledge of medical terminology, typing and filing. Experience with NextGen EHR preferred. Basic computer skills required.
Minimum of 1 year experience in medical records, preferably in an office practice setting.
Qualified candidates must have a working knowledge of HIPAA regulation, medical terminology, and be proficient in alpha and numerical filing.
Strong telephone, customer service, organizational, computer and communication skills are required.
Must be able to multitask and work in a fast paced environment.
Requires a high degree of responsibility, responsiveness.
Must be flexible to work in and move from site to site as needed.
Must be able to respond and interact with physicians, the public and patient care team members in a courteous and collaborative manner.
How much does a medical coder earn in Northbrook, OH?
The average medical coder in Northbrook, OH earns between $33,000 and $65,000 annually. This compares to the national average medical coder range of $37,000 to $70,000.
Average medical coder salary in Northbrook, OH
$46,000
What are the biggest employers of Medical Coders in Northbrook, OH?
The biggest employers of Medical Coders in Northbrook, OH are: