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Medical coder jobs in Pennsylvania

- 434 jobs
  • EHR/EMR Principal Data Analyst

    Elsevier 4.2company rating

    Medical coder job in Philadelphia, PA

    Client Facing EHR/EMR Principal Data Analyst About the role - We are seeking a Principal Data Analyst with an EHR/EMR expertise to provide the technical and operational expertise that supports ClinicalPath's sales, implementation, and product teams. This role combines a deep understanding of EHR integrations with hands-on technical skills in SQL, reporting, and automation. You will be a key partner in customer-facing technical discussions-helping clarify integration requirements, supporting security and compliance assessments, and ensuring a seamless handoff into implementation. This position is ideal for someone who thrives at the intersection of technology, healthcare workflows, and customer engagement. About the team - ClinicalPath is a clinical decision-support system used mainly in cancer care. It gives doctors evidence-based treatment pathways so they can choose the best possible care plan for each patient. Requirements Possess extensive and current SQL skills for query writing, optimization, and troubleshooting. Have a deep familiarity with EHR/EMR systems and integration workflows, including HL7, FHIR, and ADT message formats. Experience supporting or executing technical assessments, security reviews, or RFPs. Possess the ability to easily communication with both technical and clinical stakeholders. Proven ability to manage and maintain technical documentation and customer-facing collateral. Experience in technical or customer-facing role (product operations, solutions engineering, or technical account management). Understanding of cloud infrastructure (AWS, Azure) and healthcare data security best practices. Responsibilities Customer & Sales Support Participating in customer-facing technical and sales discussions to assess EHR integration needs, data exchange requirements, and clinical workflows. Providing expert guidance on interoperability standards (HL7, FHIR, ADT, API integrations) and their application within the ClinicalPath platform. Supporting the completion of technical documentation, risk/security questionnaires, and compliance assessments (HIPAA, ISO 27001). Maintaining and refresh demo environments (Figma-based and live) to ensure technical accuracy and consistency with current product capabilities. Serving as a technical liaison during the contracting and pre-implementation phase, ensuring accurate documentation and clear communication of requirements. Technical Execution & Operations Writing, optimizing, and troubleshooting SQL queries to support reporting, analytics, and data-driven product operations. Developing and maintaining recurring reporting and extract processes, including payer, client, and internal data feeds. Maintaining up-to-date technical documentation, architecture diagrams, and internal FAQs to support consistency and knowledge sharing. Cross-Functional Collaboration & Improvement Partnering closely with product, implementation, and customer success teams to translate customer requirements into clear, actionable specifications. Identifying opportunities to streamline demo, handoff, and documentation processes for greater operational efficiency. Contributing to product and process improvements based on recurring customer feedback or integration challenges. Supporting data analysis and technical insights for leadership teams across sales, product, and operations.
    $75k-99k yearly est. 1d ago
  • Coder II - Technical

    Pinnacle Health Systems

    Medical coder job in Pittsburgh, PA

    Purpose: OUTPATIENT CODING OUTPATIENT: Coding diagnosis & procedure codes ICD10 & CPT codes and charging for injections, infusions, hydrations, and observation hours. Responsibilities: * Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. * Type of coding includes reconciling NCCI edits for clinical labs, clinic visits, emergency room visits, and observation stays. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD-10-CM, CPT and DSM IV codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed. * Adhere to internal department policies and procedures to ensure efficient work processes. Actively participate in monthly coding meetings and share ideas and suggestions for operational improvements. Maintain continuing education by attending seminars, reviewing updated CPT assistant guidelines and updated coding clinics. * Make forward progress within the training period toward meeting coding accuracy standards of 95% within the first year of employment. Meet appropriate coding productivity standards within the time frame established by management staff. * Code all diagnoses and procedures by assigning and verifying the proper ICD-10-CM and CPT codes (DSM IV if applicable). Assign the principal and secondary diagnoses and procedures by thoroughly reviewing all documentation available at the time of coding. * Utilize computer applications and resources essential to completing the coding process efficiently, such as hospital information systems (Medipac/SMS/Meditech), encoders and electronic medical record repositories. If applicable, abstract required medical and demographic information from the medical record and enter the data into the appropriate information system to ensure accuracy of the database. Correct any data to be in error after reviewing the medical record and comparing with system entries. * Refer problem accounts to appropriate coding or management personnel for resolution * Complete work assignments in a timely manner and understand the workflow of the department. Maintain daily productivity statistics and submit a weekly productivity sheet to management clearly indicating the number of hours worked, the number of coding hours, the number of average charts per hour, and number of minutes/hours spent on non-coding tasks. * Determine diagnoses that were treated, monitored and evaluated and procedures done during the episode of care and assign appropriate codes. Review appropriate documents in the patients' charts to accurately assign a diagnosis and/or procedure. Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG/APC/ASC or payment tier under the Prospective Payment system or DSM IV methodology to guarantee accurate reimbursement on UPMC patients. * Identify incomplete documentation in the medical record and formulate a physician query to obtain missing documentation and/or clarification to accurately complete the coding process. Consult with DRG Specialist when applicable during query process. High School or GED equivalent. Completed an AHIMA or AACP-certified Coding program or certificate, Bidwell Training School or equivalent program. Curriculum includes Anatomy and Physiology, Pharmacology, Pathophysiology, Medical Terminology, ICD-10-CM and CPT Coding Guidelines and Procedures. Outpatient: pharmacology is taught on the job during training; pathophysiology not required. Outpatient: Pharmacology & pathophysiology coursework required. 2 years hospital coding experience required. Licensure, Certifications, and Clearances: Eligible for RHIA, RHIT, CCS * Act 34 UPMC is an Equal Opportunity Employer/Disability/Veteran
    $41k-62k yearly est. 3d ago
  • Coder/Hosp/PRN

    Holy Redeemer Health System 3.6company rating

    Medical coder job in Pennsylvania

    Join us in shaping the future of healthcare as an allied health professional at Redeemer Health. We offer a dynamic environment equipped with state-of-the-art facilities and a culture that prioritizes safety. With our workforce spanning southeastern Pennsylvania and New Jersey, we celebrate diversity and inclusivity. We're committed to your long-term success, providing competitive benefits, as well as resources like educational assistance and a unique onboarding program that sets you up for long-term success while introducing you to our mission and celebrated service orientation. Join us, and let's make a difference together. SUMMARY OF JOB The Senior Coding Specialist assigns diagnostic and procedural codes consistent with ICD-9-CM and CPT-4 guidelines, UHDDS sequencing guidelines, CMS coding guidelines, Medicare and Medicaid regulations and the American Hospital Association coding guidelines and in its publication, Coding Clinic and AMA's publication CPT Assistant. Responsible for meeting quality expectations for data abstraction, coding, APC assignment, DRG assignment and meets Redeemer Health's expected productivity standards for the position. Performs assigned duties in accordance with hospital specific coding policies and procedures. The Senior Coding Specialist will conduct monthly data and coding quality assessments to determine whether coding accuracy is at the 95% rate. The Senior Coding Specialist will assist the Coding Coordinator in development of educational programs for all coding staff on an ongoing basis. Assists the Coding Coordinator with the documentation improvement programs. Responsible for remaining current with latest healthcare technology and coding advice through reading available coding literature, attendance of seminars and in-services, internet research and other educational resources. Performs duties in support of the Medical Center mission to ensure the highest quality of patient care in an economically sound and efficient manner. Connecting To Mission: All individuals within the scope of their position are responsible to perform their job in light of the Mission & Values of the Health System. Regardless of the position, every job contributes to the challenge of providing healthcare. There is an ongoing responsibility for ensuring the values of Respect, Compassion, Justice, Hospitality, Holistic Approach, Stewardship, and Collaboration are present in our interactions with one another and in the service we provide. RECRUITMENT REQUIREMENTS Registered Health Information Technician, Registered Health Information Administrator preferred or equivalent experience. Certified Coding Specialist required or agreement to sit and successfully pass the examination within one year of hire date. Must have a minimum of 1 year coding experience utilizing ICD-9-CM and CPT-4 in an acute care setting. Internal progression from Coding Specialist to Sr. Coding Specialist I may occur less than 1 year coding experience when the internal candidate has demonstrated consistency in meeting the quality and quantity standards for the Sr. Coding Specialist I job position and has obtained the CCS credential. A strong background in Anatomy, Physiology, Clinical Medicine and Medical Terminology. A graduate of an accredited hospital based coding program with certification of completion or successful completion of college credited course work in Medical Terminology, Anatomy & Physiology and Pathophysiology/Disease Processes/Pharmacology required. Requires the ability to read and interpret medical terminology and apply coding skills utilizing knowledge of anatomy, physiology and disease processes. Must be detail oriented and have basic computer skills. Experience with computerized encoders and abstracting systems preferred. EQUAL OPPORTUNITY Redeemer Health is an equal opportunity employer. We prohibit discrimination in employment due to race, color, gender, religion, creed, national origin, age, sex, sexual orientation, gender identity or expression, disability veteran status or any other protected classification required by law.
    $32k-42k yearly est. Auto-Apply 31d ago
  • Certified Medical Coder | Behavioral Health

    Lenape Valley Foundation 3.9company rating

    Medical coder job in Doylestown, PA

    Join Our Team Are you ready to bring precision and purpose to your career? In this newly created role, Lenape Valley Foundation (LVF) is seeking a Certified Medical Coder who will be instrumental in ensuring accurate, compliant, and high-quality coding across our clinical operations. At LVF, our team is united by a shared commitment to mental health, wellness, and compassionate care. If you're detail oriented, driven by purpose and ready to contribute to a team that values your expertise, we would love to meet you. What We Offer Paid onboarding and orientation Potential for a hybrid schedule after 90-day introductory period Comprehensive benefits package including Medical, Dental, and Vision Insurance Credit available for Medical Opt-Out Continuing Education Benefits Generous PTO policy: 10 PTO Days 10 Paid Sick Days 4 Paid Personal Days 7 Paid Holidays 5 Paid Conference Days Basic Life Insurance & Long-Term Disability Employee Assistance Program (EAP) Wellness Plans and more! What You Bring Education & Certification High School Diploma or equivalent Completion of a Medical Coding Program Active coding certification required: Certified Professional Coder (CPC) Professional Experience Minimum of 2 years of outpatient and inpatient facility coding experience Technical & Coding Knowledge Proficient in ICD-10-CM/PCS coding guidelines and conventions Understanding of Official Coding Guidelines, MS-DRG, APR-DRG, and IPPS regulatory requirements Strong grasp of medical terminology, anatomy, pathophysiology, pharmacology, and ancillary test results Proficient with Microsoft Office applications (Outlook, Word, Excel) Familiarity with payer systems and Electronic Health Records (EHR) Analytical & Communication Skills Strong organizational, analytical, and critical thinking abilities Ability to interpret, assess, and evaluate provider documentation Excellent interpersonal, verbal, and written communication skills Demonstrated teamwork and collaboration capabilities Ability to provide coding/documentation feedback to clinicians at all levels of the organization. Work Style & Flexibility Self-motivated and able to work independently with minimal supervision Ability to meet the physical requirements of the role, with or without accommodation Your Role Assign principal and secondary diagnosis and procedure codes using ICD-10 guidelines Validate documentation and initiate physician queries when needed Analyze records for complications, comorbidities, and severity indicators Confirm and correct ADT data Support workflow improvements and participate in quality audits Contribute to process enhancements About Lenape Valley Foundation Since 1958, Lenape Valley Foundation (LVF) has been a trusted non-profit provider of essential human services in Bucks and Montgomery Counties. Our mission is to partner with individuals facing mental health, substance use, or developmental challenges as they pursue personal goals and improved quality of life. With over 30 programs and a commitment to evidence-based care, LVF continues to evolve to meet community needs. Our Commitment To Diversity and Inclusion LVF is an Equal Opportunity Employer. We are committed to fostering a workplace that respects and celebrates diversity. We welcome applicants of all backgrounds and ensure a discrimination and harassment free environment where everyone is treated with dignity.
    $35k-46k yearly est. Auto-Apply 60d+ ago
  • Medical Device QMS Auditor

    Environmental & Occupational

    Medical coder job in Pittsburgh, PA

    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.
    $98.1k-123.9k yearly Auto-Apply 12d ago
  • Medical Device QMS Auditor

    Bsigroup

    Medical coder job in Pittsburgh, PA

    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.
    $98.1k-123.9k yearly Auto-Apply 13d ago
  • Hospital Inpatient Coder

    Francisan Health

    Medical coder job in Homestead, PA

    Work From Home Work From Home Work From Home, Indiana 46544 The Coder VI Specialist- Hospital Inpatient analyzes the ICD 10 codes, suggested by computer assisted coding software, to ensure they align with official coding guidelines and the electronic medical record documentation. In collaboration with the Clinical Documentation Specialist, analyzes the circumstances of the visit to determine the most accurate diagnosis related group (DRG). This position also abstracts key data elements necessary for billing and data analysis. WHO WE ARE With 12 ministries and access points across Indiana and Illinois, Franciscan Health is one of the largest Catholic health care systems in the Midwest. Franciscan Health takes pride in hiring coworkers that provide compassionate, comprehensive care for our patients and the communities we serve. WHAT YOU CAN EXPECT * Accurately review and code patient records in the following clinical areas: hospital acute inpatient services. * Meet defined coding accuracy and production standards and demonstrate a thorough knowledge of coding guidelines, medical terminology, anatomy/physiology, reimbursement schemes, and Payor specific guidelines. * Review and analyze the content of medical records to appropriately assign ICD diagnosis procedure codes, CPT procedure codes, and modifiers to meet coding guidelines. * Notify coding leadership of trends and topics for education and feedback to physicians and departments. * Identify and enter data elements for abstracting. * Participate actively in performance improvement teams, projects, and committees. * Serve as a Superuser and assist with system testing. * Serve as a backup to coding reimbursement specialist. QUALIFICATIONS * High School Diploma/GED - Required * Associate's degree - Preferred * 2 years Coding - Required * CCS or RHIT - Required * RHIT - Preferred TRAVEL IS REQUIRED: Never or Rarely JOB RANGE: Coder VI Specialist - Hospital Inpatient $22.70-$33.77 INCENTIVE: Not Applicable EQUAL OPPORTUNITY EMPLOYER It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law. Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights. Franciscan Alliance is committed to equal employment opportunity. Franciscan provides eligible employees with comprehensive benefit offerings. Find an overview on the benefit section of our career site, jobs.franciscanhealth.org.
    $41k-62k yearly est. 45d ago
  • Outpatient SDS Coder (FT)

    E4Health 3.8company rating

    Medical coder job in Pittsburgh, PA

    Job DescriptionDescription: At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes-when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our solutions streamline clinical, financial, and health information workflows, optimize coding, quality, and clinical documentation integrity processes, and address health IT operational challenges to deliver material results for healthcare organizations across the country. Learn more about us at ************** POSITION TITLE: Outpatient Coder ROLE TYPE: Full Time EMPLOYMENT TYPE: Non-Exempt JOB SUMMARY: The Outpatient SDS Coder is responsible for accurately abstracting data into appropriate client electronic medical record systems, following the Official ICD-10-CM, CPT, and HCPCS Guidelines for Coding, AMA CPT Guidelines, and CMS directives. Performs data entry of required abstracted patient information into the client's information system. Queries physicians when appropriate and interacts with Clinical Documentation staff as per account requirements. Maintains consistent coding accuracy rate of 95% or better while also meeting productivity standards. ESSENTIAL DUTIES AND RESPONSIBILITIES: Assigns appropriate ICD-10-CM, CPT, HCPCS codes and modifiers to facility-based Ancillary, Emergency Department, Observation, and/or Outpatient Surgery Accounts as per designated workflow Abstracts and enters coded data and/or charges for hospital statistical and reporting requirements Queries physicians to clarify conflicting, imprecise, incomplete, ambiguous, and/or inconsistent clinical information when appropriate Communicates documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution Communicates with Clinical Documentation Improvement and/or Revenue Cycle teams for follow up and reconciliation of accounts Maintains required productivity and quality requirements Maintains coding credential requirements BENEFITS: We offer an excellent salary, full benefits package including 401(k) with company match, medical, dental, vision, life, short/long term disability insurance, and PTO policy. PHYSICAL DEMANDS OF THE ESSENTIAL FUNCTIONS: This role requires prolonged periods of desk working on a computer Talking, hearing, and near vision are required to perform computer-based tasks and virtual communications Sensory perception (visual, auditory, and tactile) is essential for computer and phone use WORKING CONDITIONS WHILE PERFORMING ESSENTIAL FUNCTIONS: This is a remote role; work is performed in a home office environment. e4health is an equal opportunity employer and will consider all applications without regard to race, color, religion, national origin, ancestry, marital status, veteran status, age, disability, pregnancy, genetic information, gender, sexual orientation, gender identity or any other legally protected category. Applicants for U.S. based positions with e4health must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available for this position. Requirements: REQUIRED QUALIFICATIONS: Candidate must possess an approved AHIMA or AAPC coding credential Minimum 2 years' coding experience required; Trauma Level 1 and Academic Teaching facility experience preferred Minimum 2 years SDS experience required KEY SUCCESS ATTRIBUTES:? Integrity, passion, and ethics are required Demonstrates strong collaboration skills Has strong analytic and problem-solving abilities and techniques Exhibit consistent initiative with strong drive for results and success Demonstrate commitment to a team environment? Demonstrate excellent interpersonal skills Well-developed written, verbal, and presentation communication skills including deep listening and attention to detail Ability to self-motivate and self-direct Possess strong time management and organizational skills Commitment and adherence to company Core Values CORE COMPETENCIES: High level of integrity & ethical judgement Communication Consistency and Reliability Meeting Standards
    $33k-46k yearly est. 2d ago
  • Coder II (Clinic & E/M Coding)

    Baylor Scott & White Health 4.5company rating

    Medical coder job in Harrisburg, PA

    **About Us** Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: + We serve faithfully by doing what's right with a joyful heart. + We never settle by constantly striving for better. + We are in it together by supporting one another and those we serve. + We make an impact by taking initiative and delivering exceptional experience. **Benefits** Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: + Eligibility on day 1 for all benefits + Dollar-for-dollar 401(k) match, up to 5% + Debt-free tuition assistance, offering access to many no-cost and low-cost degrees, certificates and more + Immediate access to time off benefits At Baylor Scott & White Health, your well-being is our top priority. Note: Benefits may vary based on position type and/or level **Job Summary** The Coder 2 is skilled in three or more types of outpatient, Profee, or low acuity inpatient coding. The Coder 2 may code low acuity inpatients, one-time ancillary/series, emergency department, observation, day surgery, and/or professional fee, including evaluation and management (E/M) coding or profee surgery. For professional fee coding, team members in this job code are proficient for inpatient and outpatient, for multi-specialties. Coder 2 uses the International Classification of Disease (ICD-10-CM, ICD-10-PCS), Healthcare Common Procedure Coding System (HCPCS), including Current Procedural Terminology (CPT), and other coding references. These references ensure accurate coding and grouping of classification assignments (e.g., MS-DRG, APR-DRG, APC, etc.). The Coder 2 will abstract and enter required data. The pay range for this position is $26.66 (entry-level qualifications) - $40.00 (more experienced) The specific rate will depend upon the successful candidate's specific qualifications and prior experience. **Essential Functions of the Role** + Examines and interprets documentation from medical records and completes accurate coding of diagnosis, procedures and professional fees. + Reviews diagnostic and procedure codes and charges in the applicable documentation system to generate appropriate coding and billing. + Communicates with providers for missing documentation elements and offers guidance and education when needed. + Reconciles billing issues by formulating the rationale for rejecting and correcting inaccurate charges. + Works collaboratively with revenue cycle departments to ensure coding and edits are processed timely and accurately. + Reviews and edits charges. **Key Success Factors** + Sound knowledge of applicable rules, regulations, policies, laws and guidelines that impact the coding area. + Sound knowledge of transaction code sets, HIPAA requirements and other issues impacting the coding and abstracting function. + Sound knowledge of anatomy, physiology, and medical terminology. + Demonstrated proficiency of the use of computer applications, group software and Correct Coding Initiatives (CCI) edits. + Sound knowledge of ICD-10 diagnosis and procedural coding and Current Procedural Terminology (CPT) procedural coding. + Ability to interpret health record documentation to identify procedures and services for accurate code assignment. + Flexibility and adaptability while also balancing requirements and regulatory and accreditation guidelines that are non-negotiables. **Belonging Statement** We believe that all people should feel welcomed, valued and supported, and that our workforce should be reflective of the communities we serve. **QUALIFICATIONS** + EDUCATION - H.S. Diploma/GED Equivalent + EXPERIENCE - 2 Years of Experience + Must have ONE of the following coding certifications: + Cert Coding Specialist (CCS) + Cert Coding Specialist-Physician (CCS-P) + Cert Inpatient Coder (CIC) + Cert Interv Rad CV Coder (CIRCC) - Cert Outpatient Coder (COC) + Cert Professional Coder (CPC) + Reg Health Info Administrator (RHIA) + Reg Health Information Technician (RHIT). As a health care system committed to improving the health of those we serve, we are asking our employees to model the same behaviours that we promote to our patients. As of January 1, 2012, Baylor Scott & White Health no longer hires individuals who use nicotine products. We are an equal opportunity employer committed to ensuring a diverse workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.
    $26.7 hourly 8d ago
  • Senior Professional, Certified Coding Integrity

    Wright 4.2company rating

    Medical coder job in Scranton, PA

    The Senior Certified Coding Integrity Professional is responsible for all aspects of the coding and billing of all inpatient and outpatient claims, as well as all aspects of the CCM billing. The Senior Certified Coding Integrity Professional, a key position in the Revenue Cycle, facilitates the coding as well as manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries and patients related to coding issues. The incumbent will assist in the clarification and development of process improvements and inquiries in order to maximize revenues and will have an onsite presence at the clinical locations. Requirements ESSENTIAL JOB DUTIES and FUNCTIONS While living and demonstrating our Core Values, the Senior Certified Coding Integrity Professional will: Perform accurate and timely multi-specialty coding for daily claims submission. Prepare and submit clean claims to third-party payers working closely with clinical team members regarding claims appeal, denial, and resolution. Perform audits of the daily billing summary reviewing the quality of the clinical documentation and coded data to validate that the documentation supports services rendered while ensuring the integrity of the coding. Respond timely (either orally or written) to account inquiries from patients, third-party payers, clinical providers, and/or other staff on claims submission. Interact with physicians, learners and other patient care providers on daily basis regarding billing and documentation policies, procedures, and regulations to ensure receipt and analysis of all charges; obtains clarification of conflicting, ambiguous, or non-specific documentation; as well as develop working relationship with operational leaders. Perform and monitor all steps in the billing and coding process to ensure maximum reimbursement from patients, third-party payers as well as from special billing arrangements. Assist in provider and learner education to ensure coding quality. Must have capacity to attend meetings day/evening as needed within assigned areas. Participate in clinical huddles/didactics and other clinical meetings as requested. Assist in the implementation and maintenance of the billing and coding educational materials used in clinical provider and learner training. Assist in the implementation and maintenance of population management learner training program addressing inpatient/outpatient chart review. Serve as a resource and subject matter expert for all billing and coding matters. Understand all aspects of Federally Qualified Health Center (FQHC) coverage, coding, billing and reimbursement of patient services, as well as other third-party payers. Understand Medicare, Medicaid and other commercial payer rules and regulations applicable to billing/coding. Understand the considerations of coding in Value Based payment contracts. Responsible for reviewing and implementing changes from payor bulletins. Follow coding/billing guidelines and legal requirements to ensure compliance with federal and state regulations. Serve as a coach and mentor for billing team & education team. REQUIRED QUALIFICATIONS Bachelor or Associate degree in any Healthcare related field or equivalent experience. Must be a Certified Professional Coder with 7-10 years minimum direct professional coding experience. Certified Professional Coder CPC, Certified Risk Adjustment Coder CRC (not required but a plus), Certified Professional Compliance Officer Certification - CPCO (not required but a plus). Must have strong knowledge of all guidelines for ICD-10, CPT/HCPCS codes, medical terminology, and billing processes. Knowledge of Medical Billing/EHR (Electronic Health Records) systems preferably Medent. Knowledge of EOBs (Explanation of Benefit), EFTs (Electronic Funds Transfer) and ERAs (Electronic Remittance Advice). Knowledge of Microsoft Office software. Must possess team leadership skills and have a positive disposition. Must be focused, self-directed, & organized, with problem-solving abilities. Accurate and precise attention to detail. Excellent verbal and written communication skills. REQUIRED LICENSES/CERTIFICATIONS Certified Professional Coder-CPC Certified Risk Adjustment Coder-CRC (not required but a plus) Certified Professional Compliance Officer Certification - CPCO (not required but a plus) PREFERRED QUALIFICATIONS FQHC billing helpful (not required but a plus). General working knowledge/previous exposure of healthcare environments and auditing concepts, medical billing/operations, medical terminology and clinical documentation.
    $54k-63k yearly est. 60d+ ago
  • Medical Coder

    Bcforward 4.7company rating

    Medical coder job in Philadelphia, PA

    BCforward began as an IT business solutions and staffing firm. Founded in 1998, BCforward has grown with our customers' needs into a full service personnel solutions organization. BCforward's headquarters are in Indianapolis, Indiana and also operates delivery centers in 20 locations in North America as well as India and Puerto Rico. We are currently the largest consulting firm and largest MBE certified firm headquartered in Indiana. Job Description Position: Medical Coder Location: PHILADELPHIA PA 19103 Duration: 3+months Rate: $14.80/Hr on W2 Contractor will sign on daily chart review application to review medical records for risk adjustment coding. The coder will identify risk adjustment codes based upon coding guidelines. The coder will be knowledgeable and familiar with computers and technology. The coder will be a certified professional coder with at least 2 years of experience. The coder will meet 3x a week with a coding manager to review metrics and progress to-date. Additional Information Namratha Gandavarapu Sr. Recruiter Direct: ************
    $14.8 hourly 1d ago
  • Coder Abstractor - Him

    Meadville Medical Center 4.8company rating

    Medical coder job in Meadville, PA

    CODER/ABSTRACTOR Assign diagnosis and procedure codes based on documentation present on records for correct reimbursement and statistical databases MINIMUM EDUCATION, KNOWLEDGE, SKILLS, AND ABILITIES REQUIRED High school graduate and equivalent secondary education skills. Must be graduate of a health Information Technology program or Certification by AHIMA or have equivalent experience coding in a hospital for three years or more. Graduate of Health Information Technology program preferred. Coding experience required as above. Experience with Meditech and Microsoft Word preferred.
    $48k-65k yearly est. 60d+ ago
  • Medical Records Specialist

    Edgar Snyder & Associates 3.8company rating

    Medical coder job in Pittsburgh, PA

    Full-time Description At our law firm, Edgar Snyder & Associates, we help victims. We have represented over 75,000 injured people, and recovered over a billion dollars on behalf of our clients. We are excited to add a new Medical Records Specialist to our Medical Records Department! This is an exciting opportunity for an experienced individual to join a successful, growing team. Working at ESA, our employees enjoy a hybrid work arrangement, a generous benefits package, professional development, a company dedicated to D&I, and a fast-paced environment where we care for our clients. If our core values of excellence, honesty & integrity, trust & fairness, client-centeredness, empathy, and professionalism connect with you, then you should apply today! Core Job Functions: 1. Acts as a liaison between the support staff from the firm and the medical records providers, managing request with strict adherence to deadlines and confidentiality. 2. Requests, tracks and organizes medical records for client cases, expediting as needed. 3. Receives, records and profiles all medical records both electronically and via hard copies. 4. Communicates the status of medical records requests, promptly identifying and documenting issues and providing updates accordingly. 5. Provides administrative support as required. 6. Assists in reviewing and reconciling billing invoices, researching submissions, and verifying delivery for invoice payment. Requirements Preferred Requirements: One (1) to three (3) years of experience in an administrative role Experience working in an administrative support role with medical records in a law firm, health care facility or third-party records company Associate degree in business management, administrative services, or related field Requirements: HS degree or GED An equivalent combination of training and relevant work experience Advanced computer skills including MS Office applications (Word, Excel, Power Point), Internet, e-mail, database management and scheduling software programs HIPAA compliance knowledge
    $36k-45k yearly est. 10d ago
  • Medical Records Specialist

    Spiritrust Lutheran 4.0company rating

    Medical coder job in Pennsylvania

    SpiriTrust Lutheran serves five counties in southcentral Pennsylvania by providing residential living, assisted living, personal care, memory support and nursing and rehabilitation services in six life plan communities along with home care, in-home support, hospice services and palliative care. Our communities rank amongst the best, earning the award for Best Senior Living by U.S. News & World Report. Our commitment to creating a positive and fulfilling work environment is grounded in our mission, values, and culture of considerate behavior core tenets. We are excited to invite you to apply and discover the many opportunities available to join the SpiriTrust Lutheran team. Come be a part of our team and catch the spirit as you experience the rewards of working with our team! The Village at Gettysburg is now hiring a full-time Medical Records Specialist. This position is Mon-Fri from 8a-4pm. We offer competitive pay and a robust benefits package! Basic Qualifications Education/Training: A high school diploma or equivalent. Valid practical nurse license from the commonwealth of Pennsylvania, accredited records technician, or health records technician preferred. Skill(s): Speak and understand English; proficient reading, writing, grammar, and mathematics skills; proficient interpersonal relations and communication skills; proficient keyboarding skills; proficient PC skills; knowledge of various office machines; general knowledge of assigned department s operations. Experience: A minimum of one (1) year s experience in medical records required; experience in long term care preferred. General Responsibilities Responsible for performing a variety of duties relative to the medical records function; ensuring safety and care of resident environment; providing residents with dignity and respect; achieving goals as established in the department s annual operating plan; coordinating work within the department, as well as with other departments; reporting pertinent information to the immediate supervisor; responding to inquiries or requests for information. SpiriTrust Lutheran is an Equal Opportunity Employer
    $29k-35k yearly est. 60d+ ago
  • Certified Peer Specialist

    Northern Tier Counseling 3.6company rating

    Medical coder job in Towanda, PA

    Certification is preferred but not required, training will be provided. The Certified Peer Specialist position contributes in a peer support capacity to facilitate recovery, resiliency, and enhance wellness. Serves as a role model for recovery, for staff and clients/consumers. Helps clients/consumers to develop self-help skills, build support networks and fosters the use of needed services. ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Assists clients/consumers with setting and attaining personal recovery goals. 2. Work with agency staff to identify community supports and help clients/consumers understand how to utilize these resources in the recovery process. 3. Provides support resources, information and assists family members/support systems to understand possible warning signs, triggers, appropriate supportive responses, wellness measures, and the overall recovery process. 4. Models coping techniques, self-help strategies and reinforces the potential for recovery to clients/consumers. 5. Advocates on the clients/consumers behalf to the psychiatrist/psychologist/nurse/therapist by disclosing information related to consumers health/treatment. 6. Complete all required documentation for every client/consumer encounter. 7. Develop and implement individual and group interventions. 8. Attend required trainings, in-services, staff meetings and peer support coaching sessions and meetings. Participates in required supervisory meetings; access to Clinical Director on a regular basis. 9. Utilize NTC's Electronic Health Records (E.H.R.) during tenure of employment. Initial training, and on-going training, will be provided to employee by respective supervisor and/or assigned team member. 10. Employee will be proficient in their job position within six (6) months. If at any time an employee feels they need more training/education, employee is to submit a request for such through their supervisor, manager, and/or director. 11. Other duties and functions as assigned. Requirements QUALIFICATIONS / EDUCATION and/or EXPERIENCE 1. Be a self-identified individual with a mental health diagnosis and who has reached a point in their recovery pathway where they can positively support others in similar situations. 2. Be eighteen (18) years of age or older. 3. Have completed a Department approved peer services training. 4. Obtain and maintain the certification as a CPS through the Pennsylvania Certification Board. The certification process can be found on the following website **************************** 5. Current/Valid Driver's License; Traveling Required; Reliable Vehicle and valid auto insurance; must have clean driving record 6. Criminal history checks and child abuse certification in accordance with 23 Pa.C.S. §§ 6301-6386 (relating to Child Protective Services Law) and 55 Pa.?Code Chapter 3490 (relating to protective services) required. 7. Demonstrated proficiency in reading and writing Salary Description 18.00-21.51
    $33k-41k yearly est. 60d+ ago
  • Medical Records Coder

    Wayne Memorial Health System & Community Health Centers 4.4company rating

    Medical coder job in Honesdale, PA

    Full-time (This is not a remote position.) Responsible for coding and abstracting of outpatient services which include; Ancillary, Infusion Clinic charts. Keep current with ICD-10-CM, HCPCS/CPT- 4, Modifiers and coding guidelines and disposition. Minimum Requirements Ability to communicate effectively; Good organization skills, detail oriented, legible handwriting; Knowledge of medical records principles and practices, anatomy, physiology, medical terminology and classification of diagnoses and operations. Possess a heightened level of knowledge and understanding of ICD 10-CM and CPT-4 coding principles as recommended by the AHIMA coding competencies. Prior hospital coding required; CCS preferred. Knowledge of insurance regulations helpful; Data entry experience necessary; Responsible party needs to be a self-starter and good at managing time effectively.
    $57k-83k yearly est. 31d ago
  • Professional Coder - Revenue Integrity

    Penn State Milton S. Hershey Medical Center

    Medical coder job in Hershey, PA

    Apply now Penn State Health - Penn State Health Corporation Work Type: Full Time FTE: 1.00 Shift: Day Hours: 8 Recruiter Contact: Garrett C. Kieffer at [email protected] Responsible to review the health record, electronic reports, and other reporting tools to identify conditions treated and the services provided to each patient. Utilize the appropriate coding systems (ICD-9-CM, CPT, HCPCS) to accurately code diagnoses, services, and procedures performed by physicians and other providers performing billable services. MINIMUM QUALIFICATION(S): * High school diploma required * 1 Year relevant Revenue Cycle or enrolled in an approved coding certification class. PREFERRED QUALIFICATION(S): * One year of professional coding experience preferred. * Certified Professional Coder or similar certification preferred. WHY PENN STATE HEALTH? Penn State Health offers exceptional opportunities to learn and grow, exposure to a wide patient population, and the ability to provide individualized, innovative, and specialized care to patients in the community. Penn State Health offers an exceptional benefits package including medical, dental and vision with no waiting period as well as a Total Rewards Program that highlights a few of the many additional offerings below: * Be Well with Employee Wellness Programs, and Fitness Discounts (University Fitness Center, Peloton). * Be Balanced with Generous Paid Time Off, Personal Time, and Paid Parental Leave. * Be Secured with Retirement, Extended Illness Bank, Life Insurance, and Identity Theft Protection. * Be Rewarded with Competitive Pay, Tuition Reimbursement, and PAWS UP employee recognition program. * Be Supported by the HR Solution Center, Learning and Organizational Development and Virtual Benefits Orientation, Employee Exclusive Concierge Service for scheduling. WHY PENN STATE HEALTH CORPORATION? There are many ways to make an impact with one of the leading research, teaching, and clinical healthcare systems in the country. Through a combination of operational, corporate, clinical, and nonclinical roles, we are advancing excellence and innovation in health care together as one team. As Penn State Health continues to evolve for the future, we are committed to hiring dedicated employees who are passionate about delivering the best possible support across our entire integrated health system. Within Penn State Health's Shared Services Entity, we encourage our employees at every turn to continue their education and advancement. Numerous opportunities are available for professional development and career growth. YOU TAKE CARE OF THEM. WE'LL TAKE CARE OF YOU. State-of-the-art equipment, endless learning, and a culture of excellence - that's Penn State Health. But what makes our healthcare award-winning? That's all you. This job posting is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position. Eligibility for shift differential pay based on the terms outlined in company policy or union contract. All individuals (including current employees) selected for a position will undergo a background check appropriate for the position's responsibilities. Penn State Health is an Equal Opportunity Employer and does not discriminate on the basis of any protected class including disability or veteran status. Penn State Health's policies and objectives are in direct compliance with all federal and state constitutional provisions, laws, regulations, guidelines, and executive orders that prohibit or outlaw discrimination. Union: Non Bargained Apply now Join our Penn State Health Talent Network Get job alerts tailored to your interests and updates on new roles delivered to your inbox. Sign Up Now
    $43k-69k yearly est. 10d ago
  • PA UCC Certified Code Specialist

    Barry Isett & Associates 3.7company rating

    Medical coder job in Pennsylvania

    Barry Isett & Associates is looking for ICC/PA UCC Certified Code Specialists to perform inspections and plan reviews for commercial (and residential) properties for clients throughout eastern PA, including working within in Central/Upper Montco, Berks, Upper Bucks Counties, PA. Through performing these inspections we are beautifying our community and upholding safety standards. Benefits Career advancement and continuing education opportunities Employee engagement events and parties Work-life balance & flexible working schedules Paid vacation/holiday/sick time Employee Stock Ownership Plan (ESOP) Medical, dental, vision, life, and disability insurances Discounted and/or free Isett wear Parental leave 401k/Roth match In additional to standard company benefits, our code professionals also receive: Company supplied cell phone, or opt out credit Company vehicle Requirements Multiple ICC/PA UCC Commercial certifications and a willingness to continue training. (Commercial certifications preferred but the right candidate with all residential certifications, including residential electric inspector will be considered.) Valid driver's license and the ability to travel to client sites. Ability to establish and maintain professional working relationships with our clients and other Isett associates. Demonstrated skills in organizing resources and establishing priorities. Plan review certification/experience a plus. Candidates will be encouraged (and supported) to obtain additional certifications. Ability to work independently/remotely. About Us Barry Isett & Associates (Isett) is an employee-owned multi-discipline engineering/consulting firm headquartered in Allentown, PA, with additional offices throughout eastern and central PA. Isett associates get the opportunity to perform meaningful work that helps enrich our community each and every day. Our company is a values-based organization which has been recognized for its award-winning culture through several regional and statewide programs: Best Places to Work in PA (annually since 2019) The Morning Call's Top Workplaces (annually, since 2013) Empowering Women Award by Central Penn Business Journal and Lehigh Valley Business (2023 & 2024) Philadelphia Inquirer's Top Workplaces (2023 & 2024) Corporate Citizen of the Year (by the Lehigh Valley Business Journal) The Societas Award for Responsible Corporate Conduct (for Ethics). We are an equal opportunity employer and welcome applications from all qualified candidates. We are committed to a diverse and inclusive workplace and do not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation or gender identity), nation origin, age (40 or older), disability or genetic information (including family medical history). Please, no third party recruiters.
    $49k-60k yearly est. 60d+ ago
  • Medical Records Coordinator

    Carepathrx

    Medical coder job in Oakdale, PA

    CarepathRx transforms hospital pharmacy from a cost center into an active revenue generator through a powerful combination of technology, market-leading pharmacy services and wrap-around services. Job Details: The Medical Records Coordinator is responsible for providing comprehensive administrative support to the office. This includes answering and directing phone calls, sorting, and delivering mail, reviewing and processing patient paperwork and performing various other administrative tasks. The ideal candidate will have excellent organizational skills, strong attention to detail, and the ability to manage multiple tasks efficiently. Responsibilities Answer and direct incoming phone calls in a professional and courteous manner. Take accurate messages and ensure they are relayed promptly to the appropriate personnel. Handle inquiries and provide information to callers, as needed. Sort and distribute incoming mail to the appropriate departments and individuals. Prepare outgoing mail and ensure it is sent in a timely manner. Work with patients to obtain signatures for courier services and deliveries. Review and process Assignment of Benefits (AOBs)(patient consents) for patient signature ensuring accuracy and completeness. Coordinate with relevant departments to ensure all needed signed patient paperwork is handled correctly. Maintain all patient records and ensure they are stored securely. Provide general administrative support including data entry, filing, and document management. Prepare and edit correspondence to include medical records requests from third party entities, reports, and other documents as needed. Performs in accordance with system-wide competencies/behaviors. Performs other duties as assigned. Skills & Abilities Excellent verbal and written communication skills. Strong organizational and time management skills. Proficiency in MS Office (Word, Excel, PowerPoint, Outlook). Ability to handle sensitive and confidential information with discretion. Attention to detail and problem-solving skills. Requirements High school diploma or equivalent. Associates degree or higher in Business Administration or related field preferred. Proven experience as an administrative assistant, medical records coordinator, or in a similar role. Experience with phone systems and office equipment. Familiarity with patient paperwork, i.e. patient consents and administrative procedures is a plus. Knowledge of medical terminology preferred. CarepathRx offers a comprehensive benefit package for full-time employees that includes medical/dental/vision, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and vision coverage are effective 1st of the month following date of hire . CarepathRx provides equal employment opportunity to all qualified applicants regardless of race, color, religion, national origin, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants encouraged to confidentially self-identify when applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country.
    $29k-38k yearly est. Auto-Apply 60d+ ago
  • Professional, Certified Coding Integrity

    The Wright Center Medical Group 4.5company rating

    Medical coder job in Scranton, PA

    Full-time Description The Certified Coding Integrity Professional is responsible for all aspects of the coding and billing of all inpatient and outpatient claims, as well as all aspects of the CCM billing. The Certified Coding Integrity Professional, a key position in the Revenue Cycle, facilitates the coding as well as manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries and patients related to coding issues. The incumbent will assist in the clarification and development of process improvements and inquiries in order to maximize revenues and will have an onsite presence at the clinical locations. Requirements ESSENTIAL JOB DUTIES and FUNCTIONS While living and demonstrating our Core Values, the Certified Coding Integrity Professional will: Perform accurate and timely multi-specialty coding for daily claims submission. Prepare and submit clean claims to third-party payers working closely with clinical team members regarding claims appeal, denial, and resolution. Perform audits of the daily billing summary reviewing the quality of the clinical documentation and coded data to validate that the documentation supports services rendered while ensuring the integrity of the coding. Respond timely (either orally or written) to account inquiries from patients, third-party payers, clinical providers, and/or other staff on claims submission. Interact with physicians, learners and other patient care providers on daily basis regarding billing and documentation policies, procedures, and regulations to ensure receipt and analysis of all charges; obtains clarification of conflicting, ambiguous, or non-specific documentation; as well as develop working relationship with operational leaders. Perform and monitor all steps in the billing and coding process to ensure maximum reimbursement from patients, third-party payers as well as from special billing arrangements. Assist in provider and learner education to ensure coding quality. Participate in clinical huddles/didactics and other clinical meetings as requested. Assist in the implementation and maintenance of the billing and coding educational materials used in clinical provider and learner training. Assist in the implementation and maintenance of population management learner training program addressing inpatient/outpatient chart review. Serve as a resource and for all billing and coding matters. Understand all aspects of Federally Qualified Health Center (FQHC) coverage, coding, billing and reimbursement of patient services, as well as other third-party payers. Understand Medicare, Medicaid and other commercial payer rules and regulations applicable to billing/coding. Understand the considerations of coding in Value Based payment contracts. Responsible for reviewing and implementing changes from payor bulletins. Follow coding/billing guidelines and legal requirements to ensure compliance with federal and state regulations. Serve as a coach and mentor for billing team & education team. Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations REQUIRED QUALIFICATIONS Bachelor or Associate degree in any Healthcare related field or equivalent experience. Must be a Certified Professional Coder or 5 years equivalent minimum direct professional coding experience. Certified Professional Coder CPC, Certified Risk Adjustment Coder CRC (not required but a plus), Certified Professional Compliance Officer Certification - CPCO (not required but a plus). Must have strong knowledge of all guidelines for ICD-10, CPT/HCPCS codes, medical terminology, and billing processes. Knowledge of Medical Billing/EHR (Electronic Health Records) systems preferably Medent. Knowledge of EOBs (Explanation of Benefit), EFTs (Electronic Funds Transfer) and ERAs (Electronic Remittance Advice). Knowledge of Microsoft Office software. Must possess team leadership skills and have a positive disposition. Must be focused, self-directed, & organized, with problem-solving abilities. Accurate and precise attention to detail. Excellent verbal and written communication skills. REQUIRED LICENSES/CERTIFICATIONS Certified Professional Coder-CPC (not required but a plus) Certified Risk Adjustment Coder-CRC (not required but a plus) Certified Professional Compliance Officer Certification - CPCO (not required but a plus) FQHC billing helpful (not required but a plus). General working knowledge/previous exposure of healthcare environments and auditing concepts, medical billing/operations, medical terminology and clinical documentation.
    $36k-43k yearly est. 60d+ ago

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