Medical coder jobs in West Virginia

St. Mary's Medical Center is seeking a full time Clinic Coder for our Central Business Office.Under the supervision of the Director of Health Information Management or authorized designee, is responsible for reviewing clinical documentation and diagnostic reports to extract data and apply appropriate ICD, CPT codes, modifiers, discharge dispositions, and other coding schemes to medical records for billing, internal and external reporting, research and regulatory compliance activities.

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. The Senior Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. **Activities include:** + Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent with medical record documentation. + Handles complex coding reviews and will resolve complex issues with sensitivity. Including but not limited to claim reviews for legal, compliance or rework projects. + Provide detailed written summary of medical record review findings. + Must be able to articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc. + Review and discuss cases with Medical Directors to validate decisions. + Independently research and accurately apply state or CMS guidelines related to the audit. + Assist with investigative research related to coding questions, state and federal policies. + Identify potential billing errors, abuse, and fraud. + Identify opportunities for savings related to potential cases which may warrant a prepayment review. + Maintain appropriate records, files, documentation, etc. + Uses department resources regularly and follows workflows with no assistance or intervention to perform daily work to meet metrics. + Mentor New Coders, providing training, coding, and record review guidance. + Collaboration with investigators, data analytics and plan leadership on SIU schemes. + Act as management back-up and supports the team when the manager is out of the office. + Maintains up-to-date coding knowledge, including new changes to coding compliance and reimbursement. **Required Qualifications** + AAPC Coding certification - Certified Professional Coder (CPC) + 3+ years of experience in medical coding or documentation auditing. + Strong knowledge of standard industry coding guides and guidelines including CPT, HCPCS, ICD-10. + CMS 1500 and UB04 data elements + Experience with researching coding and policies. + Experience with Microsoft products; including Excel and Word + Prior experience auditing others' work and providing feedback. + Experience mentoring others. + Must be able to travel to provide testimony if needed. **Preferred Qualifications** + 3+ years or more previous experience with Behavioral Health coding/auditing of records + Licensed Clinical Social Worker (LCSW) + Licensed Independent Social Worker (LISW) + Licensed Master Social Worker (LMSW) + Licensed Professional Counselor (LPC) + Excellent communication skills + Excellent analytical skills + Strong attention to detail and ability to review and interpret data. **Education** + AAPC Certified Professional Coder Certification (CPC) + GED or High School diploma **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $46,988.00 - $112,200.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/06/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

As a Healthcare Revenue Cycle / HIM Manager, your responsibilities will include: 1. Supporting a remote team for daily operations of the healthcare revenue cycle / healthcare coding department. 2. Identifying and implementing strategies to accelerate the revenue cycle by reducing accounts receivable days, improving cash flow, and enhancing profitability. 3. Managing account reconciliation, pre-collection, and post-collection activities to ensure accuracy and timeliness. 4. Identifying and resolving issues that affect revenue cycle performance using analytical and problem-solving skills. 5. Collaborating with cross-functional teams, including billing, coding, and clinical operations, to ensure the effectiveness of the revenue cycle process. 6. Training and mentoring staff on revenue cycle processes and best practices. 7. Staying abreast with the latest trends and regulations in the healthcare industry to ensure compliance and operational efficiency. 8. Developing and implementing policies and procedures to enhance operational efficiency and improve revenue cycle performance. 9. Providing regular reports and updates to senior management about the status and performance of the revenue cycle. 10. This individual will manage routine client meetings to obtain updates on initiatives and address any issues. Qualifications: The ideal candidate for the Healthcare Revenue Cycle / HIM Manager will have the following qualifications: 1. A minimum of 7 years of experience in healthcare revenue cycle management, including account reconciliation, pre-collection, and post-collection. 3. Strong knowledge of healthcare financial management and medical billing processes. 4. Exceptional analytical and problem-solving skills with a strong attention to detail. 5. Proficient in using healthcare billing software and revenue cycle management tools, with a strong background in Oracle Health (Cerner) software. 6. Strong leadership skills with the ability to manage and motivate a team. 7. Excellent communication and interpersonal skills with the ability to interact effectively with all levels of the organization. 8. Strong knowledge of federal, state, and payer-specific regulations and policies. 9. Ability to work in a fast-paced environment and manage multiple priorities. **Responsibilities** Analyzes business needs to help ensure Oracle's solution meets the customer's objectives by combining industry best practices and product knowledge. Effectively applies Oracle's methodologies and policies while adhering to contractual obligations, thereby minimizing Oracle's risk and exposure. Exercises judgment and business acumen in selecting methods and techniques for effective project delivery on small to medium engagements. Provides direction and mentoring to project team. Effectively influences decisions at the management level of customer organizations. Ensures deliverables are acceptable and works closely with the customer to understand and manage project expectations. Supports business development efforts by pursuing new opportunities and extensions. Collaborates with the consulting sales team by providing domain credibility. Manages the scope of medium sized projects including the recovery of remedial projects. Disclaimer: **Certain US customer or client-facing roles may be required to comply with applicable requirements, such as immunization and occupational health mandates.** **Range and benefit information provided in this posting are specific to the stated locations only** US: Hiring Range in USD from: $87,000 to $178,100 per annum. May be eligible for bonus and equity. Oracle maintains broad salary ranges for its roles in order to account for variations in knowledge, skills, experience, market conditions and locations, as well as reflect Oracle's differing products, industries and lines of business. Candidates are typically placed into the range based on the preceding factors as well as internal peer equity. Oracle US offers a comprehensive benefits package which includes the following: 1. Medical, dental, and vision insurance, including expert medical opinion 2. Short term disability and long term disability 3. Life insurance and AD&D 4. Supplemental life insurance (Employee/Spouse/Child) 5. Health care and dependent care Flexible Spending Accounts 6. Pre-tax commuter and parking benefits 7. 401(k) Savings and Investment Plan with company match 8. Paid time off: Flexible Vacation is provided to all eligible employees assigned to a salaried (non-overtime eligible) position. Accrued Vacation is provided to all other employees eligible for vacation benefits. For employees working at least 35 hours per week, the vacation accrual rate is 13 days annually for the first three years of employment and 18 days annually for subsequent years of employment. Vacation accrual is prorated for employees working between 20 and 34 hours per week. Employees working fewer than 20 hours per week are not eligible for vacation. 9. 11 paid holidays 10. Paid sick leave: 72 hours of paid sick leave upon date of hire. Refreshes each calendar year. Unused balance will carry over each year up to a maximum cap of 112 hours. 11. Paid parental leave 12. Adoption assistance 13. Employee Stock Purchase Plan 14. Financial planning and group legal 15. Voluntary benefits including auto, homeowner and pet insurance The role will generally accept applications for at least three calendar days from the posting date or as long as the job remains posted. Career Level - IC4 **About Us** As a world leader in cloud solutions, Oracle uses tomorrow's technology to tackle today's challenges. We've partnered with industry-leaders in almost every sector-and continue to thrive after 40+ years of change by operating with integrity. We know that true innovation starts when everyone is empowered to contribute. That's why we're committed to growing an inclusive workforce that promotes opportunities for all. Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs. We're committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing accommodation-request_************* or by calling *************** in the United States. Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans' status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law.

Evaluate patients records, work to resolve inaccurate charges, and assign appropriate diagnoses & procedure codes using the coding systems according to HIPPA regulations. Abstract pertinent data from patients' clinical records. Review records for reimbursement purposes and to ensure quality control. Responsibilities * Read and interpret ambulatory surgery or observation or outpatient or inpatient medical record entries to identify all diagnoses and surgical procedures. * Assign appropriate ICD-9-CM/ICD-10 and CPT-4 codes in compliance with recognized coding principles and department policies. * Determine appropriate diagnostic and procedural sequencing in compliance with UHDDS guidelines. * Effectively utilize the APCpro features of 3M with the 3M encoder and grouper software to identify appropriate assign modifiers, make appropriate changes to charges, notify departments to make changes, identify missing documentation, and prepare the account as a clean claim for billing to the third party payer. * For inpatient accounts, effectively utilize the APR-DRG and MS-DRG features of 3M with the 3M encoder and grouper software to appropriately assign Present on Admission indicator, Risk of Mortality score, Severity of Illness score, identify missing documentation and work with Clinical Documentation Specialists to resolve documentation deficiencies. Utilize the 3M encoder and grouper for DRG assignment for inpatient records and the APC Grouper for APC assignments for outpatient records. * Responsible for the accurate and timely entry of all abstracted and coded date into the computer system. * Comply with HCFA's Medicare code edits. * Ensure quality and accuracy of records for appropriate reimbursement. * Verify and correct any data discrepancies by initiating communication with physicians and other hospital personnel. * Guide physicians in recording and sequencing final diagnoses. * Provide one-to-one physician consultation regarding diagnostic sequencing, specificity and grouper concepts. * Assist with physician education regarding the requirements of the Prospective Payment System. * Assist with improving record documentation practices to support DRG assignments. * Promote and enhance positive customer service and a positive work environment. Knowledge, Skills & Abilities Patient Group Knowledge (Only applies to positions with direct patient contact) The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients. Competency Statement Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist. Common Duties and Responsibilities (Essential duties common to all positions) 1. Maintain and document all applicable required education. 2. Demonstrate positive customer service and co-worker relations. 3. Comply with the company's attendance policy. 4. Participate in the continuous, quality improvement activities of the department and institution. 5. Perform work in a cost effective manner. 6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations. 7. Perform work in alignment with the overall mission and strategic plan of the organization. 8. Follow organizational and departmental policies and procedures, as applicable. 9. Perform related duties as assigned. Education * High School Diploma or GED (Required) Experience: 1 yr related coding Credentials * No Certification, Competency or License Required Work Schedule: Days Status: Full Time Regular 1.0 Location: Document Center Building Location of Job: US:WV:Charleston Talent Acquisition Specialist: Tamara B. Young ******************************

We are seeking a professional coder to join our team in Grantsville, WV. The ideal candidate will have an AAPC/AHIMA certification and be responsible for accurately assigning diagnostic and procedural codes to patient records. The professional coder will work closely with healthcare providers to ensure proper documentation and coding practices are followed. Strong attention to detail and knowledge of medical terminology are essential for this role. Duties (not an all inclusive list) Performs all types of coding Coding and charge entry of new services Maintains and reports productivity and accuracy of all levels of coding. Assists in hospital wide training and development for providers Run necessary reports Research denials Monitors unbilled reports. Abstracts pertinent information from patient records. Assigns appropriate ICD-10-CM diagnostic and CPT/HCPCS procedural codes as well as modifiers for optimum reimbursement, following official coding guidelines and procedures Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. Contact ancillary departments when additional information is needed to code the record Completes charging process and assignment of ICD-10-CM, HCPCS, & CPT codes as needed Investigate and resolve complicated medical necessity issues Keeps abreast of coding guidelines and reimbursement reporting requirements. The ability to learn, apply and teach ICD-10-CM and PCS coding concepts.

Job Summary: The Medical Coding Auditor protects company assets by completing coding documentation and quality & program audits to ensure support of services billed, complying with all federal and state regulations and internal controls, and recommending improvements in internal control structure. Primary Responsibilities (illustrative): Follows established protocols, selects and reviews a percentage of records to assess coding documentation, billing and/or reimbursement practices for compliance with all regulations for federal and state agencies, third-party payers, and organization policy. Communicates audit progress and findings by preparing reports and providing information to the Compliance Officer, CMO, Medical Coding Lead, Compliance Specialist and Chief Quality Officer as needed. In conjunction with appropriate personnel, investigates, evaluates, and identifies opportunities for improvement, recognizes their relative significance in the overall system, and provides guidance to departments regarding internal controls. Develops and maintains professional skills and knowledge through attendance at relevant conferences, seminars and other educational programs, participation in professional organizations, and review of current literature. Conducts billing and coding training, including provider training, as they relate to billing, coding, and documentation compliance. Assists with the development and review of policy and procedures and provides necessary staff support and resources to develop and maintain policies to ensure compliance with designated federal and state laws, regulations, and policies. Assists the Compliance Officer in developing and implementing education and training materials related to documentation and coding, as well as regulatory compliance. Supports the Compliance Officer in the review of, and response to, documentation and coding reviews and quality and program audits, compiling information for submission to the QA/QI committee and Board of Directors. Participates in monitoring reviews and audits conducted by various regulatory agencies. Analyzes provider documentation to assure the appropriate Evaluation and Management (E&M) levels are assigned using the correct CPT code. Fields coding questions from clinical and ancillary staff. Other duties as assigned. Job Requirements: Knowledge of healthcare compliance regulations. Ability to use Excel spreadsheets and other analytical software. Thorough knowledge of Valley Health EMR system. Effective communication skills - when presenting to individuals and groups and must use appropriate tact when communicating chart audits/documentation concerns with providers Ability to conduct audits. Ability to report research results. Ability to analyze information and conduct statistical analyses. Ability to act with objectivity. Must adhere to all confidentiality policies and procedures in the performance of duties. Qualifications: 1-2 years of experience in health care Professional Billing Coding certification (CPC, CCS-P) required Advanced knowledge of medical terminology, techniques and surgical procedures; anatomy and physiology; major disease processes. Excellent understanding of HIPAA regulations and issues. Working Conditions: Work is sedentary in nature; however, the ability to stand and/or walk for short periods of time; stooping, bending, reaching, lifting approximately 10 pounds is required. Work is repetitive in nature and requires concentration and constant technical attention to accuracy and detail for extended periods of time. Conveys a professional and positive image and attitude of regarding the health center and organization. Duties are complex, varied; require planning and coordinating several activities at once. Subject to frequent interruptions. Work is performed in a normal office environment, with travel to all Valley Health clinical sites.

Schedule: Part Time Weekdays - 8am-12pm Your experience matters Raleigh General is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Health Information Management Specialist, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve. How you'll contribute A Health Information Management Specialist who excels in this role: Provides clerical support along with scanning duties in the functional areas of data compilation, quantitative analysis, and verification of medical records. Maintains filing system. Reviews documentation for accuracy and updates or clears deficiencies as appropriate. Retrieves, logs, prints medical records as requested by physician offices, patients, other hospitals and other entities as needed. What we're looking for Qualified applicants must have a High School diploma or equivalent. Experience in release of information practices is preferred. Why join us We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees. Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off. Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match. Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs). Professional Development: Ongoing learning and career advancement opportunities. More about Raleigh General Hospital People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Raleigh General Hospital is a 300 bed facility caring for nearly 13,000 patients each year with over 50,000 being treated in our emergency room. We offer a wide range of surgical services as well as specialty programs including Cardiac CTA, Digital Mammography, and Trauma Services. Raleigh General Hospital is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.

ESSENTIAL FUNCTIONS (Include but not limited to) Complete assignments, reports and transcription accurately and timely. Provide medical record support for the adult or geriatric patient, ages 18 years and over. Meet strategic, operational and programmatic goals successfully as approved by the Governing Board. Plan and prioritize assignments and ensure effective use of time. Develop or assist in development of departmental operations. Maintain software for encoding and statistics. Provide all information needed for computer system to those needing access. Provide monthly or daily reports in a timely manner to supervisor and other administrative committees. Develop and update policy and procedure manuals according to Medicare and JCAHO standards. Assist in development of departmental budget. Track and adhere to financial plans with consideration of cost. Make decisions in a timely manner using all relevant information. Demonstrate appropriate communication skills in verbal reports or in written reports and memorandums. Provide communication to physicians related to Health Information Management. Keep delinquency rate below 40% Keep Medical Record Review current. Credential all Medical and Allied Health Professionals in accordance with Medicare and JCAHO standards. Take action quickly to correct or prevent problems. Exhibit leadership with a positive attitude. Demonstrate technical knowledge of Health Information Management. Direct efforts towards personal improvement of job knowledge. Display knowledge and expertise of sound management practices. Develop programs that meet Medicare and JCAHO standards. Provide ongoing reports and follow-up to senior staff as needed. Hold committee meetings as required by policy and procedure. Maintain transcription software, troubleshoot and educate physicians on its use Act in the capacity of HIPAA Privacy Officer for the hospital by participating in monthly orientations for training staff in HIPAA privacy regulations,, investigating HIPAA complaints, and maintaining strict patient privacy Release of protected health information per hospital policy and HIPAA regulations Maintain concurrent coding of all medical records using ICD-9-CM according to CMS guidelines Comply with measures for preventing exposure to blood borne pathogens. Adhere to all components of the Hospital Compliance Plan in performing job duties and report any violations or suspected violations of the Plan to the compliance Officer. Adhere to hospital attendance policy as set out in the Employee Handbook. Demonstrate professional conduct and comply with hospital and departmental policies and procedures. Comply with established Safety and Patient Safety Program practices. Develop an understanding of responsibilities for participation in Performance Improvement activities and participate in such activities. Develop an understanding of responsibilities for recognizing abuse and follow policy for making appropriate referrals/interventions. Limit access to protected health information (PHI) to the information reasonably necessary to do the job and share such information only on a need to know basis for work purposes. (Access to verbal, written and electronic PHI for this job has been determined based on job level and job responsibility within the organization. Computerized access to PHI for this job has been determined as described above and is controlled via user ID and password.) The above statements reflect the general details considered necessary to describe the principal functions of the job as identified, and shall not be considered as a detailed description of all work requirements that may be inherent in the position. Reasonable accommodation may be provided to a qualified individual with a disability who can perform the essential functions of the job with or without reasonable accommodation. MANDATORY QUALIFICATIONS (SKILLS, EXPERIENCE, EDUCATION) Current RHIT credentials Minimum five (5) years hospital RHIT experience Minimum three (3) years supervisory experience DESIRED QUALIFICATIONS Bachelor's Degree preferred RHIA credentialed Computer literate SUPERVISORY RESPONSIBILITIES Coding Specialist HIM Asisstant

Schedule: Part Time Weekdays - 8am-12pm Your experience matters Raleigh General is part of Lifepoint Health, a diversified healthcare delivery network with facilities coast to coast. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Health Information Management Specialist, you're embracing a vital mission dedicated to making communities healthier . Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve. How you'll contribute A Health Information Management Specialist who excels in this role: * Provides clerical support along with scanning duties in the functional areas of data compilation, quantitative analysis, and verification of medical records. * Maintains filing system. Reviews documentation for accuracy and updates or clears deficiencies as appropriate. * Retrieves, logs, prints medical records as requested by physician offices, patients, other hospitals and other entities as needed. What we're looking for Qualified applicants must have a High School diploma or equivalent. * Experience in release of information practices is preferred. Why join us We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers: * Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees. * Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off. * Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match. * Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs). * Professional Development: Ongoing learning and career advancement opportunities. More about Raleigh General Hospital People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Raleigh General Hospital is a 300 bed facility caring for nearly 13,000 patients each year with over 50,000 being treated in our emergency room. We offer a wide range of surgical services as well as specialty programs including Cardiac CTA, Digital Mammography, and Trauma Services. Raleigh General Hospital is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. This is an entry level position responsible for processing all release of information (ROI), specifically medical record requests, in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service. Associates must at all times safeguard and protect the patient's right to privacy by ensuring that only authorized individuals have access to the patient's medical information and that all releases of information are in compliance with the request, authorization, company policy and HIPAA regulations. **Position Highlights** **This is a Remote Role** + Full Time: Mon-Fri 8:00am -4:30pm CST + Phone support + Ability working in a high-volume environment. + Processing medical record requests such as: Insurance requests, DDS Requests, Workers Comp Request, Subpoenas + Documenting information in multiple platforms using two computer monitors. + Proficient in Microsoft office (including Word and Excel) **Preferred Skills** + Knowledge of HIPAA and medical terminology + Familiar with different EHR and Billing Systems + Experience working with subpoenas **We offer:** + Comprehensive onsite/virtual training program followed by job shadowing with an assigned mentor + Company equipment will be provided to you (including computer, monitor, virtual phone, etc.) + Full Benefits: PTO, Health, Vision, and Dental Insurance and 401k Savings Plan and tuition Assistance **You will:** + Receive and process requests for patient health information in accordance with Company and Facility policies and procedures. + Maintain confidentiality and security with all privileged information. + Maintain working knowledge of Company and facility software. + Adhere to the Company's and Customer facilities Code of Conduct and policies. + Inform manager of work, site difficulties, and/or fluctuating volumes. + Assist with additional work duties or responsibilities as evident or required. + Consistent application of medical privacy regulations to guard against unauthorized disclosure. + Responsible for managing patient health records. + Responsible for safeguarding patient records and ensuring compliance with HIPAA standards. + Prepares new patient charts, gathering documents and information from paper sources and/or electronic health record. + Ensures medical records are assembled in standard order and are accurate and complete. + Creates digital images of paperwork to be stored in the electronic medical record. + Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately. + Answering of inbound/outbound calls. + May assist with patient walk-ins. + May assist with administrative duties such as handling faxes, opening mail, and data entry. + Must meet productivity expectations as outlined at specific site. + May schedules pick-ups. + Other duties as assigned. **What you will bring to the table:** + High School Diploma or GED. + Ability to commute between locations as needed. + Able to work overtime during peak seasons when required. + Basic computer proficiency. + Comfortable utilizing phones, fax machine, printers, and other general office equipment on a regular basis. + Professional verbal and written communication skills in the English language. + Detail and quality oriented as it relates to accurate and compliant information for medical records. + Strong data entry skills. + Must be able to work with minimum supervision responding to changing priorities and role needs. + Ability to organize and manage multiple tasks. + Able to respond to requests in a fast-paced environment. **Bonus points if:** + Experience in a healthcare environment. + Previous production/metric-based work experience. + In-person customer service experience. + Ability to build relationships with on-site clients and customers. + Comfortable bringing new ideas, process improvement suggestions, and feedback to internal stakeholders. Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $15-$18.32 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (************************************************** . Know Your Rights (*********************************************************************** , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (************************************************************** Id=**********48790029&layout Id=**********48795462) by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (******************************************************************************************************* . Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy (**************************************** .

St. Mary's Medical Center is seeking a full time Clinic Coder for our Central Business Office.Under the supervision of the Director of Health Information Management or authorized designee, is responsible for reviewing clinical documentation and diagnostic reports to extract data and apply appropriate ICD, CPT codes, modifiers, discharge dispositions, and other coding schemes to medical records for billing, internal and external reporting, research and regulatory compliance activities.

Marshall Health Network's Health Information Management department is seeking a PRN Coder Analyst IV. System Specific Duties and Responsibilities: Assign accurate diagnosis and procedure codes using ICD-10-CM/PCS, CPT, and/or HCPCS for reimbursement, compliance, and reporting purposes. Utilizes coding guidelines set up by government agencies dealing with the coding of health information. Demonstrates, promotes, and monitors for high standards of quality and productivity; focuses on quality results first. Maintains a standard of productivity that consistently meets or exceeds 98% of productivity. Maintains a standard or quality that consistently meets or exceeds 95% accuracy rate. Proficient to Expert level knowledge of ICD-10-CM, ICD-10-PCS, CPT, and HCPCS code sets. Proficient to Expert level knowledge of MS-DRG and APR-DRG groupers and Medicare's inpatient prospective payment system (IPPS) and outpatient prospective payment system (OPPS). Mentors' new hires and/or participates in the cross-training of coding professionals as requested. Participates in departmental meetings. Responsible for reading meeting minutes or handouts as provided. Completes coding education sessions as required in addition to maintaining educational requirements for credential maintenance. Contributes to team efforts for the reduction of our combined DNFC. Uses resources (people, supplies, environmental) in a responsible cost-effective manner. Uses own time and that of others effectively. Demonstrates competency with all necessary computer systems and applications. Demonstrates understanding and sensitivity to compliance issues related to the corporate compliance plan. Collaborate with billing office, finance, revenue integrity, CDI, HIM supervisors/techs, case management, information technology, compliance, quality, and other departments as needed to resolve issues/opportunities that have been identified during or after the coding process. Must possess strong interpersonal communication skills and communicate honestly. Ability to analyze and interpret complex data. Adjusts and is flexible to meeting changing work needs and demands. Assumes other duties as necessary to support the efforts of the health system. Refers coding related issues or concerns to supervisor. Maintains a high degree of ethics, integrity, and confidentiality. Appreciates, celebrates, and values diversity. Follow the code of Ethics and the Standards of Ethical Coding developed by the American Health Information Management Association and/or the Code of Ethics by the American Academy of Professional Coders. Community Engagement Active Membership to American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC)

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. **Position Summary** The Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Activities include: - Conduct a comprehensive medical record review to ensure billing is consistent with medical record. - Provide detailed written summary of medical record review findings. - Must be able to articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc. - Review and discuss cases with Medical Directors to validate decisions. - Assist with investigative research related to coding questions, state and federal policies. - Identify potential billing errors, abuse, and fraud. - Identify opportunities for savings related to potential cases which may warrant a prepayment review. - Maintain appropriate records, files, documentation, etc. - Ability to travel for meetings and potential to testify **Required Qualifications** + AAPC Coding certification - Certified Professional Coder (CPC) + 3+ years of experience in medical coding or documentation auditing. + Strong knowledge of standard industry coding guides and guidelines including CPT, HCPCS, ICD-10, CMS 1500 and UB04 data elements + Experience with researching coding, state regulations and policies. Working experience with Microsoft Excel + Must be able to travel to provide testimony if needed. **Preferred Qualifications** + 2 years or more previous experience with Behavioral Health coding/auditing of records + Licensed Clinical Social Worker (LCSW) + Licensed Independent Social Worker (LISW) + Licensed Master Social Worker (LMSW) + Prior auditing experience + Excellent analytical skills + Strong attention to detail and ability to review and interpret data + Excellent communication skills **Education** + GED or equivalent + AAPC Certified Professional Coder Certification (CPC) **Anticipated Weekly Hours** 40 **Time Type** Full time **Pay Range** The typical pay range for this role is: $43,888.00 - $102,081.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. **Great benefits for great people** We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** . + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit ***************************************** We anticipate the application window for this opening will close on: 12/06/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Evaluate inpatient records, work to resolve inaccurate charges, and assign appropriate diagnoses and procedure codes using the coding systems according to HIPPA regulations. Abstract pertinent data from inpatients' clinical records. Review records for reimbursement purposes and to ensure quality control. Responsibilities * Read and interpret ambulatory surgery or observation or outpatient or inpatient medical record entries to identify all diagnoses and surgical procedures. * Assign appropriate ICD-9-CM/ICD-10 and CPT-4 codes in compliance with recognized coding principles and department policies. * Determine appropriate diagnostic and procedural sequencing in compliance with UHDDS guidelines. * Effectively utilize the APCpro features of 3M with the 3M encoder and grouper software to identify appropriate assign modifiers, make appropriate changes to charges, notify departments to make changes, identify missing documentation, and prepare the account as a clean claim for billing to the third party payer. * For inpatient accounts, effectively utilize the APR-DRG and MS-DRG features of 3M with the 3M encoder and grouper software to appropriately assign Present on Admission indicator, Risk of Mortality score, Severity of Illness score, identify missing documentation and work with Clinical Documentation Specialists to resolve documentation deficiencies. Utilize the 3M encoder and grouper for DRG assignment for inpatient records and the APC Grouper for APC assignments for outpatient records. * Responsible for the accurate and timely entry of all abstracted and coded date into the computer system. * Comply with HCFA's Medicare code edits. * Ensure quality and accuracy of records for appropriate reimbursement. * Verify and correct any data discrepancies by initiating communication with physicians and other hospital personnel. * Guide physicians in recording and sequencing final diagnoses. * Provide one-to-one physician consultation regarding diagnostic sequencing, specificity and grouper concepts. * Assist with physician education regarding the requirements of the Prospective Payment System. * Assist with improving record documentation practices to support DRG assignments. * Promote and enhance positive customer service and a positive work environment. Knowledge, Skills & Abilities Patient Group Knowledge (Only applies to positions with direct patient contact) The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients. Competency Statement Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist. Common Duties and Responsibilities (Essential duties common to all positions) 1. Maintain and document all applicable required education. 2. Demonstrate positive customer service and co-worker relations. 3. Comply with the company's attendance policy. 4. Participate in the continuous, quality improvement activities of the department and institution. 5. Perform work in a cost effective manner. 6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations. 7. Perform work in alignment with the overall mission and strategic plan of the organization. 8. Follow organizational and departmental policies and procedures, as applicable. 9. Perform related duties as assigned. Education * High School Diploma or GED (Required) Experience: 1 year related coding experience and must pass coding knowledge test Substitution: Clinical Coding Spec, Certification (CCS) or Certified Professional Coder Certification (CPC) for 1 yr related coding experience Comment: External candidates: Must score 80% on Medical Terminology & 80% on Anatomy & Physiology. Internal Candidates: Must achieve a rating of exceeds standard at the annual appraisal to advance from a Coder I position. Credentials * No Certification, Competency or License Required Work Schedule: Days Status: Full Time Regular 1.0 Location: Document Center Building Location of Job: US:WV:Charleston Talent Acquisition Specialist: Tamara B. Young ******************************

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. **You will:** + **Schedule: Monday-Friday 8:00am-4:30pm (Bellevue, Ohio)** + Receive and process requests for patient health information in accordance with Company and Facility policies and procedures. + Maintain confidentiality and security with all privileged information. + Maintain working knowledge of Company and facility software. + Adhere to the Company's and Customer facilities Code of Conduct and policies. + Inform manager of work, site difficulties, and/or fluctuating volumes. + Assist with additional work duties or responsibilities as evident or required. + Consistent application of medical privacy regulations to guard against unauthorized disclosure. + Responsible for managing patient health records. + Responsible for safeguarding patient records and ensuring compliance with HIPAA standards. + Prepares new patient charts, gathering documents and information from paper sources and/or electronic health record. + Ensures medical records are assembled in standard order and are accurate and complete. + Creates digital images of paperwork to be stored in the electronic medical record. + Responds to requests for patient records, both within the facility and by external sources, retrieving them and transmitting them appropriately. + Answering of inbound/outbound calls. + May assist with patient walk-ins. + May assist with administrative duties such as handling faxes, opening mail, and data entry. + Must meet productivity expectations as outlined at specific site. + May schedules pick-ups. + Other duties as assigned. **What you will bring to the table:** + High School Diploma or GED. + Must be 18 years or older. + 1-year Health Information related experience. + Ability to commute between locations as needed. + Able to work overtime during peak seasons when required. + Basic computer proficiency. + Comfortable utilizing phones, fax machine, printers, and other general office equipment on a regular basis. + Professional verbal and written communication skills in the English language. **Bonus points if:** + Experience in a healthcare environment. + Previous production/metric-based work experience. + In-person customer service experience. + Ability to build relationships with on-site clients and customers. + Comfortable bringing new ideas, process improvement suggestions, and feedback to internal stakeholders. To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (************************************************** . Know Your Rights (*********************************************************************** , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, (************************************************************** Id=**********48790029&layout Id=**********48795462) by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here (******************************************************************************************************* . Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy (**************************************** .

The Coder II must accurately code and abstract diagnoses and procedures occurring during the patient's episode of care, in a timely manner, in order for the facility to receive proper reimbursement.

The Coder II must accurately code and abstract diagnoses and procedures occurring during the patient's episode of care, in a timely manner, in order for the facility to receive proper reimbursement.

The Quality Control/Indexing (QCI) Technician is responsible for assuring that all patient records & loose documents are prepped, scanned, and indexed into the Elecenteronic Medical Record (EMR) with the highest level of quality possible while ensuring each document is assigned the appropriate document name for filing in EMR. Responsibilities * Indexer Duties: Prints PIP sheets from EMR, chooses correct PIP to attach to the discharged chart. Confirm the patient encounter number is on every page, front and back. Add the patient ID information as needed to each page by placing a label on the form or stamping the information by hand. Place all document types together and in the proper order (e.g. pages 1-2-3 in order, progress notes in chronological date order. Ensure doctype barcodes are on the front of the every page containing text. For pages without barcodes, insert DIP pages before each non-bar-coded page. Place any remaining non-bar-coded pages at the front of the batch behind the PIP page before any other bar-coded forms to ensure they go to corrections. This is especially important using Scan Job 1 due to the attachment processing. Mark out all barcodes that do not represent a document type or encounter number in the system. Ensure all pages are in the same and proper orientation, both portrait and landscape pages. Ensure the front of all pages are face up. Repair torn and wrinkled pages. Correct folded and dog-eared pages. Remove all staples and paper clips. Remove NCR copies and place original in the batch. Perforate forms as required. Stamp illegible and otherwise hard to read documents with the words "Poor Original". Identify documents that are poor quality & rescan on a flatbed scanner. Tape small paper or post-its onto letter size (8+ x 11) white paper. Only keep post-it notes and other items if there is writing on them. Move all oversized documents to the back of the batch. Ensure that all scanned documents are positioned correctly. Choose appropriate scan job to scan the documents. Scan chart or documents. Ensure quality before committing the batch. Make appropriate corrections when batch is available for corrections. Quality Check (QC) the chart when the batch has been released to EMR. Compare each page in the paper chart to pages in EMR. Each page should be accounted for and under the correct patient encounter number and document type. Split, rename, and move documents as appropriate. * Behavioral Expectations: Be able to adjust work speed for peak periods and slack times. Be involved in problem solving on a day to day basis. Complete work assignments on time. Seek help to deal with problems. Use a friendly tone of voice. Verbal communication is correct at all levels. Non-verbals are in agreement with the verbal message. Pass information in a correct and timely manner. Use appropriate language; no profanity. Be open to new ideas and situations. Knowledge, Skills & Abilities Patient Group Knowledge (Only applies to positions with direct patient contact) The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients. Competency Statement Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist. Common Duties and Responsibilities (Essential duties common to all positions) 1. Maintain and document all applicable required education. 2. Demonstrate positive customer service and co-worker relations. 3. Comply with the company's attendance policy. 4. Participate in the continuous, quality improvement activities of the department and institution. 5. Perform work in a cost effective manner. 6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations. 7. Perform work in alignment with the overall mission and strategic plan of the organization. 8. Follow organizational and departmental policies and procedures, as applicable. 9. Perform related duties as assigned. Education * High School Diploma or GED (Required) Experience: 1 yr hospital or medical office Credentials * No Certification, Competency or License Required Work Schedule: Days Status: Full Time Regular 1.0 Location: Document Center Building Location of Job: US:WV:Charleston Talent Acquisition Specialist: Tamara B. Young ******************************

The incumbent will utilize the necessary electronic and manual systems to identify and capture source documentation needed for the coding and generation of provider charges/claims. In addition, the incumbent will ensure that charge data is gathered including patient demographic and insurance information and review the information for accuracy. The Biller/Coder will work with providers to ensure that the charges, and supporting documentation is available and submitted in a timely fashion. In addition, the incumbent will assist in the charge reconciliation process, reconcile daily operating sheets, batch entry summaries and other billing related tracking mechanisms. Performs all necessary follow-up work (i.e. edits, denials and rejections) related to the charge entry and/or claim generation proess(es). Provides various reports, and provides pre-certification process for scheduled procedures as necessary, including communication of any balances due to the patient.