Medical records director jobs near me

Job Title : Certified Medical Coders - Inpatient Duration : 3 Months Contract (with possible extension) Education : High School Diploma/GED, AHIMA, RHIA or RHIT and/or CCP, CCS. Shift Details : 8:00 AM-04:00 PM General Description: ·Medical coding in an acute care setting; must possess proficient computer skills (e.g., MS Word, Excel, ICD 9 CM, CPT 4, Encoder); knowledge of coding guidelines, payor guidelines, federal billing guidelines; knowledge of anatomy, physiology & disease processes; ability to research coding related issues; competence in coder training; must have CCS and knowledgeable with 3M/HDS coding application. ·Seeking certified coders with a strong inpatient coding background. ·Candidate should be able to work with minimal training. Inpatient and ED experience. Starts onsite for training, then transitions to remote work once duties are mastered. Education: High School Diploma/GED, AHIMA, RHIA or RHIT and/or CCP, CCS.

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

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

For ambitious, culturally diverse, curious minds seeking booming careers, Job Duck unlocks and nurtures your potential. We connect you with rewarding, remote job opportunities with US-based employers who recognize and appreciate your skills, allowing you to not just survive but thrive. As a lifestyle company, we ensure that everybody working here has a fantastic time, which is why we've earned the Great Place to Work Certification every year since 2022! : Join Job Duck as a Medical Records Case Manager and become an integral part of a dynamic legal team dedicated to excellence in personal injury law. In this role, you will manage critical case documentation, ensuring accuracy and timeliness while supporting attorneys in delivering exceptional client service. You'll thrive if you are detail-oriented, organized, and proactive, with a strong sense of accountability and ownership. This position offers the opportunity to make a meaningful impact every day by streamlining processes and maintaining high standards in a collaborative environment. • Salary Range: from $1,220 to $1,320 USD Responsibilities include, but are not limited to: Communicate effectively with attorneys and team members to support case progress Conduct follow-ups with providers and clients to ensure timely updates Perform data entry for case-related documentation Ensure compliance with firm standards and confidentiality requirements Accurately fill and maintain medical records in the system Maintain organized case files and documentation in FileVine Request and obtain medical records, bills, and liens from providers Requirements: Required Skills: •Minimum of 1 year of experience as a legal assistant or case manager, or in a legal support role and/or related Bachelor's degree in legal studies •Advanced/native-level English skills (both written and spoken) • Customer Service • Team Player • Ownership • Attention to Detail • Organizational Skills • Timeliness Additional Job Description: • Location: Remote support for a Florida-based law firm • Time Zone: Eastern Standard Time (EST) • Working Hours: 9:00 AM - 5:00 PM EST • Language Requirement: Spanish (mandatory) and English. • Software/Tools: • FileVine (CRM) • VOIP system (as provided by the firm) Work Shift: Languages: English, Spanish Ready to dive in? Apply now and make sure to follow all the instructions! Our application process involves multiple stages, and submitting your application is just the first step. Every candidate must successfully pass each stage to move forward in the process. Please keep an eye on your email and WhatsApp for the next steps. A recruiter will be assigned to guide you through the application process. Be sure to check your spam folder as well.

Med-Scribe, Inc. is a staffing firm dedicated to recruiting promising candidates to the perfect healthcare opportunities since 1987! Let us assist you! Join a leading health insurance organization in a 6-12 month project-based role focused on advancing healthcare quality through value-based payment initiatives. In this position, you'll play a critical role in enabling seamless data exchange between providers and an advanced analytics platform, supporting quality measures that improve patient outcomes. These are REMOTE opportunities for candidates within Buffalo, Rochester, Syracuse, and Utica areas! Job Responsibilities: Oversee the integration of claims data from a major insurance provider into an external analytics platform, supporting quality and value-based care initiatives. Track project milestones, manage deliverables, and ensure clear communication across internal teams and external provider practices. Collaborate with provider offices and technical teams to establish EMR connectivity, troubleshoot issues, and maintain smooth data exchange. Test and validate claims and EMR data, conducting reasonability checks to align with HEDIS and other quality measures. Partner with cross-functional teams to analyze performance data and generate insights that support improved care delivery. Schedule: Full-time; Monday through Friday, 40 hours/week Pay Rate: $39.50/hr with a full benefits package (medical, dental, vision, and PTO).

Ready to redefine what's possible in molecular diagnostics? Join a team of brilliant, passionate innovators who wake up every day determined to transform healthcare. At BillionToOne, we've built something extraordinary-a culture where transparency fuels trust, collaboration drives breakthroughs, and every voice matters in our mission to make life-changing diagnostics accessible to all. We don't just aim for incremental improvements; we strive to build products that are 10x better than anything that exists today. Our people are our greatest asset: talented scientists, engineers, sales professionals, and visionaries united by an unwavering commitment to changing the standard of care in prenatal and cancer diagnostics. This is where cutting-edge science meets human compassion-every innovation you contribute helps remove fear of unknown from some of life's most critical medical moments. If you're driven by purpose, energized by innovation, and ready to help build the future of precision medicine, this is where you belong. BillionToOne is seeking a EMR Integrations Manager to lead the operational delivery and continuous improvement of our EMR connectivity across both business units. This role ensures reliable, compliant, and high-performing EMR integrations that enhance provider workflows and patient access to care. This hands-on position requires an understanding of HL7 integrations, interoperability, and vendor connectivity, combined with excellent project management and stakeholder coordination and communication skills. The ideal candidate enjoys balancing technical problem-solving with process improvement and cross-functional leadership. Responsibilities: Integration Operations Manage day-to-day EMR integration operations, ensuring accurate and timely order and result transmissions across partner systems. Oversee HL7 integrations, including setup, validation, testing, and ongoing monitoring of connections through Redox and other vendors. Lead manual EMR order associations and triage-investigating and resolving missing or misrouted orders and results. Improve and maintain automation processes (bots) for EMR order matching and reduce manual touchpoints. Coordinate manual testing workloads for EMR integrations, ensuring end-to-end data validation and compliance. Work with Software engineering to ensure the scalability of our EMR integrations. Project & Stakeholder Management Serve as the project manager for EMR integrations across all business units, coordinating between Sales, Engineering, Product, and external partners. Manage the intake and approval process for new EMR integration requests, ensuring alignment with business priorities and feasibility. Represent EMR Operations on hospital and clinic integration calls, providing technical and workflow expertise. Collaborate with Engineering and Product teams to resolve issues, drive continuous improvement, and manage release readiness. Troubleshooting & Triage Lead triage of EMR order management issues, including missing results, order mismatches, or compendium misconfigurations. Coordinate with Engineering, Account Executives, and vendors (e.g., Redox, LK) to investigate and implement corrective actions. Manage the EMR Slack triage channel, responding to internal team questions, order transmission failures, and troubleshooting requests. Cross-Functional Collaboration Partner with Sales to manage client onboarding workflows, including IT questionnaires, legal contract coordination, and BAA execution. Act as the central point of communication between IT, Engineering, Sales, Legal, and Clinical Operations for all EMR-related processes. Maintain and improve internal documentation and playbooks for EMR operations and troubleshooting. Qualifications: Bachelor's degree in Health Informatics, Information Systems, or related field preferred. 5+ years of experience in lab systems, EMR integration, interoperability, or healthcare IT operations. 5+ years of experience with clinical systems, LIMS, and Salesforce. Hands-on experience with HL7, FHIR, and integration platforms (Redox, Mirth, or similar). Proven ability to manage integration projects end-to-end, including planning, testing, and production support. Excellent problem-solving, organizational, and communication skills. Benefits And Perks: Working alongside brilliant, kind, passionate and dedicated colleagues, in an empowering environment, toward a global vision, striving for a future in which transformative molecular diagnostics can help millions of patients Open, transparent culture that includes weekly Town Hall meetings The ability to indirectly or directly change the lives of hundreds of thousands patients Multiple medical benefit options; employee premiums paid 100% of select plans, dependents covered up to 80% Extremely generous Family Bonding Leave for new parents (16 weeks, paid at 100%) Supplemental fertility benefits coverage Retirement savings program including a 4% Company match Increase paid time off with increased tenure Latest and greatest hardware (laptop, lab equipment, facilities) At BillionToOne, we are proud to offer a combination of a (1) base pay range (actual amount offered is based on experience and salary/equity options split that the candidate chooses), (2) generous equity options offering, (3) corporate bonus program, on top of (4) industry leading company benefits (free healthcare options, 401k match, very generous fully paid parental leave, etc.). For this position, we offer a total compensation package of up to $255,857 per year, including a base pay range of $147,841 - $168,961 per year. BillionToOne is an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. For more information about how we protect your information, we encourage you to review our Privacy Policy. About BillionToOne BillionToOne is a next-generation molecular diagnostics company on a mission to make powerful, accurate diagnostic tests accessible to everyone. Our revolutionary QCT molecular counting technology enhances disease detection resolution by over a thousandfold using cell-free DNA-a breakthrough that's already transformed the lives of over half a million patients worldwide. Our Impact: We've pioneered game-changing diagnostic solutions that are redefining industry standards. Unity Complete™ stands as the only non-invasive prenatal screen capable of assessing fetal risk for both common recessive conditions and aneuploidies from a single maternal blood sample. In oncology, our Northstar liquid biopsy test uniquely combines treatment selection with real-time monitoring, giving oncologists unprecedented precision in cancer care. Our Growth: From $0 to $125 million in Annual Recurring Revenue in just four years. We've raised close to $400 million in funding, including a $130 million Series D round in June 2024, achieving a valuation of over $1 billion. This backing comes from world-class investors including Hummingbird, Adams Street Partners, Neuberger Berman, Baillie Gifford, and Premji Invest. Our Recognition: Forbes recently named us one of America's Best Startup Employers for 2025, and we were awarded Great Place to Work certification in 2024-with an incredible 100% of our people reporting they are willing to give extra to get the job done. These honors recognize not just our innovation but the exceptional culture we've cultivated-one that remains authentically collaborative and transparent even as we've scaled. Our Future: Headquartered in Menlo Park with facilities in Union City, California, we're continuing to push the boundaries of what's possible in molecular diagnostics. Recent clinical outcomes data for Unity Fetal Risk Screen and new advances in cancer diagnostics prove we're just getting started. At BillionToOne, you'll join a diverse team of passionate innovators who believe that the best science happens when brilliant minds collaborate openly, think boldly, and never lose sight of the patients whose lives depend on our work. Ready to help us change the world, one diagnosis at a time? Learn more at ********************

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

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

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

Remote - Clinic/Outpatient Coder I Clinic Coding Full Time Status Day Shift Pay: $20.35 - $29.51 / hour Candidates residing in the following states will be considered for remote employment: Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. This position is responsible for assigning ICD-10-CM and/or CPT codes for following types of services: Outpatient: Referrals, Recurring or Therapy services, Non-interventional radiology. Clinic: Primary Care clinic coding, and/or a single specialty. This position works under the guidance and supervision of the HIM Outpatient APC and Clinic Coding Manager and is employed by Mosaic Health System. Codes procedures and diagnoses using the ICD-10-CM, CPT classification systems, in accordance with Official Coding Guidelines, CMS guidelines, and Mosaic compliance standards. Assumes responsibility for professional development by participating in workshops, conferences and/or in-services and maintains appropriate records of participation. Communicates with providers, querying providers to ensure the highest level of specificity is provided in documentation. Caregiver may work in conjunction with Patient Financial Services to verify and modify charges and coding to ensure accuracy of supporting documentation, payer rules and correct coding. Ensures data accuracy of State HIDI data by responding to edits received. Performs other duties as assigned. High school diploma required. Medical Terminology and Anatomy and Physiology required. Must have coding education. CCS - Certified Coding Specialist; RHIA - Registered Health Information Administrator; RHIT - Registered Health Information Technician; CPC and/or CCSP - Certified Professional Coder; or COC - Certified Outpatient Coding required within 180 days of hire. 1 year of experience in a Health Information Services department performing a job that requires detail, familiarity with patient medical record preferred.

Department/Unit: Health Information Services Work Shift: Day (United States of America) Salary Range: $55,895.80 - $83,843.71 The Hospital Coder applies skills and knowledge of currently mandated coding and classification systems, and official resources to select the appropriate diagnostic and procedural codes (including applicable modifiers), and other codes representing healthcare services (including substances, equipment, supplies, or other items used in the provision of healthcare services). This position is responsible for selecting and sequencing the codes such that the organization receives the optimal reimbursement to which the facility is legally entitled, remembering that it is unethical and illegal to increase reimbursement by means that contradict requirements. Essential Duties and Responsibilities * Use a computerized encoding system to facilitate accurate coding. Sequence diagnoses and procedures by following the ICD-10-CM/PCS, CPT4, Uniform Hospital Discharge Data Set (UHDDS), Medicare, Medicaid and other fiscal intermediary guidelines. * Support the reporting of healthcare data elements (e.g. diagnoses and procedure codes, hospital acquired conditions, patient safety indicators) required for external reporting purposes (e.g. reimbursement, value based purchasing initiatives and other administrative uses, population health, quality and patient safety measurement, and research) completely and accurately, in accordance with regulatory and documentation standards and requirements, as well as all applicable official coding conventions, rules, and guidelines. * Query the provider (physician or other qualified healthcare practitioner), whether verbal or written, for clarification and/or additional documentation when there is conflicting, incomplete, or ambiguous information in the health record regarding a significant reportable condition or procedure or other reportable data element dependent on health record documentation (e.g. present on admission indicators). Advance coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. * Demonstrate behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. * Advances coding knowledge and practice through continuing education, including but not limited to meeting continuing education requirements. * Utilizes official coding rules and guidelines apply the most accurate coding to represent that patient services on the hospital claim. * Comply with comprehensive internal coding policies and procedures that are consistent with requirements. * Attends coding meetings and roundtable sessions. * Participates in daily huddles and LEAN problem-solving activities. * Focused with no distractions while working and participating in meetings. * Ensures camera on while attending Teams calls. * Assists with organizing the shared drive for the medical coding department. * Other duties as assigned by manager. Qualifications * High School Diploma/G.E.D. - required * Prior experience in hospital medical coding - preferred * Prior experience with 3M 360 and EPIC system - preferred * Applicants must receive a score of 80% or above on assessment. Will consider new coders with a higher assessment score. (High proficiency) * Excellent computer skills, navigating multiple systems at once, troubleshooting. (High proficiency) * Must be able to work independently as position is fully remote. Maintain a remote coding work area that protects confidential health information. (High proficiency) * Excellent written and verbal communication skills. (High proficiency) * Knowledge of ICD-10-CM, and ICD-10-PCS or CPT-4 Coding classification system, depending on the position being hired for. (High proficiency) * Detail-oriented and efficient while maintaining productivity. * Coding certification / credential through AHIMA or AAPC and be in good standing. - required Equivalent combination of relevant education and experience may be substituted as appropriate. Physical Demands * Standing - Occasionally * Walking - Occasionally * Sitting - Constantly * Lifting - Rarely * Carrying - Rarely * Pushing - Rarely * Pulling - Rarely * Climbing - Rarely * Balancing - Rarely * Stooping - Rarely * Kneeling - Rarely * Crouching - Rarely * Crawling - Rarely * Reaching - Rarely * Handling - Occasionally * Grasping - Occasionally * Feeling - Rarely * Talking - Frequently * Hearing - Frequently * Repetitive Motions - Frequently * Eye/Hand/Foot Coordination - Frequently Working Conditions * Extreme cold - Rarely * Extreme heat - Rarely * Humidity - Rarely * Wet - Rarely * Noise - Occasionally * Hazards - Rarely * Temperature Change - Rarely * Atmospheric Conditions - Rarely * Vibration - Rarely Thank you for your interest in Albany Medical Center! Albany Medical Center is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. Thank you for your interest in Albany Medical Center! Albany Medical is an equal opportunity employer. This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that: Access to information is based on a "need to know" and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

**MUST ATTEND ORIENTATION IN PERSON IN ARCATA, CALIFORNIA SUMMARY: The primary function of this position is to review ICD, CPT and HCPCS coding for data and reimbursement. The coding function is a primary source for data and information used in health care today, and promotes quality client care, captures accurate reporting numbers and optimizes reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned. Level I Performs comprehensive review of the health record, evaluates the record for documentation, consistency, accuracy and correlation of recorded data. Ensures the final diagnosis as stated by the provider is valid, complete and accurately reflects the care and treatment rendered. Consults with provider when conflicting or ambiguous documentation is present. Requests correction of the record before assigning a code that is not supported by documentation. Assigns and sequences International Classification of Diseases (ICD), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), Current Dental Terminology (CDT), Diagnostic and Statistical Manual of Mental Disorders (DSM) codes to diagnosis and procedures from documented information. Adheres to all official coding guidelines, conventions, standards of ethical coding and rules established by the American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), American Medical Association (AMA), and Centers for Medicare & Medicaid Service (CMS). Assists with performing routine audits in accordance with the facility Compliance Plan and Quality Improvement, which may include findings from provider documentation trends, coding peer reviews, and reimbursement denials. Reviews the records for compliance with established third party reimbursement agencies and special screening criteria. Provides medical staff and other healthcare providers education on coding and classification systems, including updates or changes in coding conventions or rules, documentation guidelines, and rules and regulations governing reimbursement. Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code. Participates in committee I staff meetings as delegated by the supervisor. Performs all duties according to established safety procedures and UIHS policy. Performs other duties assigned by the Operating Revenue Manager. Level II NextGen Certified Professional Serve as the primary resource for: Training and supporting UIHS Coders. Medical providers regarding coding, workflows, addendums, and templates. Troubleshooting technical systems including NextGen Practice Management, ClaimRemedi, and reporting and claims issues. Assist in preparing financial reports as needed for fiscal audits and reconciliations. SUPERVISORY RESPONSIBILITIES: This position is a not a supervisory position. The incumbent reports to the Operating Revenue Manager. QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. EDUCATION /EXPERIENCE: Educational degrees must be from a US Department of Education accredited school Level I Must have High School Diploma or equivalent. Two years of coding experience using ICD-10-CM or equivalency. The incumbent is expected to enroll in continuing education courses to maintain certification; many of which will be provided by UIHS. Six to twelve months would be required to become proficient in most phases of the job. Level II All education listed as above and five (5) years of coding experience, or Associates Degree or equivalent and two (2) years of direct, unsupervised coding experience

The Physician Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the Physician. Reviews and analyzes medical records and coding guidelines to formulate coding arguments for appeals and/or coding guidance for potential re-bills. Maintains a working knowledge and stays abreast of ICD diagnosis codes, CPT physician service codes, coding principles, modifier usage, medical terminology, governmental regulations, protocols and third-party payer requirements pertaining to billing, coding, and documentation. The Physician Coding Denials Specialist will also handle audit-related and compliance responsibilities. Additionally, this position will actively manage, maintain and communicate denial / appeal activity to appropriate stakeholders and report suspected or emerging trends related to payer denials. This position requires anticipating and responding to a wide variety of issues/concerns and works independently to plan, schedule and organize activities that directly impact Physician reimbursement. This position will support change management by tracking and communicating trends and root cause to support future prevention with internal customers and stakeholders as well as with payers and third parties. This role is key to securing reimbursement and minimizing avoidable write-offs. Job Expectations: * Performs critical research and timely and accurate actions including preparing and submitting appropriate appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation of denials * Maintains extensive caseload of coding denials. * Formulates strategy for prioritizing cases and maintains aging within appropriate ranges with minimal direction or intervention from Leadership. * Acts as a liaison among all department managers, staff, physicians and administration with respect to coding denials issues. * Assists with the development of denial reports and other statistical reports. * Reviews insurance coding-related denials, including but not limited to: Diagnosis codes not supported, incorrect or invalid CPT codes, modifier issues, and/or general coding error denials. * Responsible for reviewing assigned diagnostic and procedural codes against patient charts using ICD-10-CM, CPT, or any other designated coding classification system in accordance with coding rules and regulations. * Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. * Contacts insurance carriers as appropriate to resolve claim issues * Maintains payer portal access and utilizes said portal to assist in reviewing commercial medical policies * Maintains working knowledge of regulatory and third-party policies and requirements to ensure compliance; remains current with applicable insurance carriers' timely filing deadlines, claims submission processes, and appeal processes and escalates timely filing requests to leadership. * Assists with short-notice timely filing deadlines for accounts with coding issues. * Provides feedback to the coding leadership team regarding coding denials. * Compiles training material and educational sessions associated with coding denial-related topics and presents such educational materials. Collaboratively works with the coding education team & coding compliance team to assist in providing education to coders, physicians and mid-level providers. * Monitors for coding trends, works collaboratively with the revenue cycle teams to prevent avoidable denials and reduce revenue loss. * Identifies, quantifies and communicates risk concerns to leadership and supports mitigation efforts as appropriate. Demonstrates the ability to analyze coded data to identify areas of risk and provide suggestions for documentation improvement. Required Qualifications * 5 years coding-related experience such as coding, abstracting, Data Quality in coding function type as required by position * 1 year experience in managing and appealing denials * 1 year expertise in reading and interpreting commercial payer medical policies * Certified Coding Specialist-Professional (CCS-P) or * Certified Professional Coder (CPC) Preferred Qualifications * Bachelor in HIM * 7+ years of coding related experience such as coding, abstracting, Data Quality in coding function type as required by position * Epic experience in either Resolute Physician Billing * Registered Health Info Admin * Registered Health Info Tech Benefit Overview Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: ***************************************************** Compensation Disclaimer The posted pay range is for a 40-hour workweek (1.0 FTE). The actual rate of pay offered within this range may depend on several factors, such as FTE, skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization values pay equity and considers the internal equity of our team when making any offer. Hiring at the maximum of the range is not typical. If your role is eligible for a sign-on bonus, the bonus program that is approved and in place at the time of offer, is what will be honored. EEO Statement EEO/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status

Job DescriptionDescription: Full Time, Remote Exempt / Salary Organization High Country Community Health (HCCH) is a federally funded Community and Migrant Health Center with medical locations in Watauga, Avery, Burke, and Surry Counties. The mission of HCCH is to provide comprehensive and culturally sensitive primary health care services that may include dental, mental and substance abuse services to the medically under-served population of Watauga, Avery, Burke, and Surry Counties and the surrounding rural communities. Supervisory Relationship: Reports to: Deputy CFO Job Summary and Responsibilities Provides thorough concurrent, prospective, and retrospective review of ambulatory medical record clinical documentation to ensure accurate and complete capture of the clinical picture, severity of illness, and patient complexity of care. Utilizes knowledge of official coding guidelines, HCC standards, Risk Adjustment Factor (RAF) scoring, and physician query briefs. Will participate in Provider education on the importance of diagnosis specificity and documentation guidelines. The Risk Adjustment Coder works to maintain a thorough knowledge of our current automated eClinicalsWork (eCW) enterprise billing system, through which the coding and documentation review are functionalized to provide support to HCCH providers and staffs as necessary. Provides subject matter expertise to others including staff in the Billing department as necessary. This position requires professional maturity, responsibility, integrity, and subject matter expertise to complete the work timely; communicate setbacks to deliverables. and to collaborate with others to meet production and quality standards. Responsibilities include: -Review and accurately code medical records and encounters for diagnoses and procedures related to Risk Adjustment and HCC coding guidelines -Validate and ensure the completeness, accuracy, and integrity of coded data. -Concurrently, prospectively, and retrospectively review medical records to identify unclear, ambiguous, or inconsistent documentation ensuring full capture of severity, accuracy, and quality. -Query providers when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes. -Utilizes approved resources to determine the appropriate ICD-10-CM, CPT, and/or HCPCS and ensures documentation in the medical record follows official coding guidelines, internal guidelines, and AHIMA physician query brief standards. -Comply with the Standards of Ethical Coding as set forth by the American Health Information Management Association and adhere to official coding guidelines. -Comply with HIPAA laws and regulations. -Maintain coding quality and productivity standards set forth by HCCH. -Maintain competency in evolving areas of coding, guidelines, and risk adjustment reimbursement reporting requirements. -Assist in internal and external coding audits to ensure the quality and compliance of coding practices. -Provide ongoing feedback to physicians and other providers regarding coding guidelines and requirements, including education and support for improvement in HCC coding, and RAF scoring. -Assist with educational in-services for physicians, other providers, and clinic staff relating to coding and documentation compliance as well as new policies and procedures relating to clinical documentation compliance related to billing. -Maintains complete confidentiality of patient information. -Assists with developing, implementing, and reviewing policies, procedures, and forms related to areas of responsibility. -Other duties as assigned by your Supervisor. Requirements: Requirements/Skills/Experience -High-speed internet access -Strong clinical knowledge related to chronic illness diagnosis, treatment, and management. -Knowledge and demonstrated understanding of Risk Adjustment coding and data validation requirements is highly preferred. -Personal discipline to work remotely without direct supervision -Dental coding skills a plus -Knowledge of HIPAA, recognizing a commitment to privacy, security, and confidentiality of all medical chart documentation. Qualifications: -Bachelor's degree in allied health or any related field required. -Minimum 2 years of progressive Professional Risk Adjustment Coding experience required. -Active Certified Risk Adjustment Coder certification (CRC and/or CPC) required -Candidates hired with active CPC, but without Certified Risk Adjustment Coder certification (CRC) must obtain CRC certification within 9 months of hire. Travel Requirements None. Salary Commensurate with experience, education and certifications

Job Posting We are dedicated to providing exceptional care to every patient, every time. St. Luke's Hospital is a value-driven award-winning health system that has been nationally recognized for its unmatched service and quality of patient care. Using talents and resources responsibly, we provide high quality, safe care with compassion, professional excellence, and respect for each other and those we serve. Committed to values of human dignity, compassion, justice, excellence, and stewardship St. Luke's Hospital for over a decade has been recognized for “Outstanding Patient Experience” by HealthGrades. Position Summary: Performs data quality reviews on patient records to validate coding appropriateness, missed secondary diagnoses and procedures, and ensures compliance with all coding related regulatory mandates and reporting requirements. Monitors Medicare and other payer bulletins and manuals and reviews the current OIG Work Plans for coding risk areas. Responsible for promoting teamwork with all members of the healthcare team. Performs all duties in a manner consistent with St. Luke's mission and values. This position is 100% remote. Education, Experience, & Licensing Requirements: Education: Associate degree in Health Services Experience: 5 years of production coding experience or 5 years coding auditing experience. ICD-10-CM (including coding conventions and guidelines), CPT-4 (including coding conventions and guidelines), HCPCS, NCCI edits, and APC experience. Cerner and 3M/Solventum experience. Licensure: RHIA, RHIT, or CCS certification Benefits for a Better You: Day one benefits package Pension Plan & 401K Competitive compensation FSA & HSA options PTO programs available Education Assistance Why You Belong Here: You matter. We could not achieve our mission daily without the hands of our team. Our culture and compassion for our patients and team is a distinct reflection of our dynamic workforce. Each team member is focused on being part of something much bigger than themselves. Join our St. Luke's family to be a part of making life better for our patients, their families, and one another.

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

We exist to create positive change for people and the planet. Join us and make a difference too! Do you believe the world deserves excellence? BSI (British Standards Institution) is the global business standards company that equips businesses with the necessary solutions to turn standards of best practice into habits of excellence. Our Medical Devices (or Regulatory Services) team ensures patient safety while supporting timely market access for our clients' medical device products globally. BSI is an accredited ISO 13485 Certification Body recognized in many global markets Essential Responsibilities: Analyze quality systems and assess ISO 13485, CE Marking and MDSAP schemes. Prepare assessment reports and deliver findings to clients to ensure client understanding of the assessment decision and clear direction to particular items of corrective action where appropriate Recommend the issue, re-issue or withdrawal of certificates, and report recommendations in accordance with BSI policy, procedures and prescribed time frame. Maintain overall account responsibility and accountability for nominated accounts to ensure an effective partnership, whilst ensuring excellent service delivery and account growth. Lead assessment teams as required ensuring that team members are adequately briefed so that quality of service is maintained and that effective working relationships are sustained both with Clients and within the team. Provide accurate and prompt information to support services, working closely with them to ensure that client records are up to date and complete and that all other internal information requirements are met. Coach colleagues as appropriate especially where those members are inexperienced assessors or unfamiliar with clients' business/technology and assist in the induction and coaching of new colleagues as requested Plan/schedule workloads to make best use of own time and maximize revenue-earning activity. Education/Qualifications: Associate's degree or higher in Engineering, Science or related degree required Minimum of 4 years experience in the medical device field including at least 2 years must be hands-on medical device design, manufacturing, testing or clinical evaluation experience. The candidate will develop familiarity with BSI systems and processes as they go through the qualification process. Knowledge of business processes and application of quality management standards. Good verbal and written communication skills and an eye for detail. Be self-motivated, flexible, and have excellent time management/planning skills. Can work under pressure. Willing to travel on business intensively. An enthusiastic and committed team player. Good public speaking and business development skill will be considered advantageous. The salary for this position can range from $98,100 to $123,860 annually; actual compensation is based on various factors, including but not limited to, the candidate's competencies, level of experience, education, location, divisional budget and internal peer compensation comparisons. BSI offers a competitive salary, group-sponsored health and dental, short-term and long-term disability, a company-matched 401k plan, company paid life insurance, 11 paid holidays and 4 weeks paid time off. #LI-REMOTE #LI-MS1 About Us BSI is a business improvement and standards company and for over a century BSI has been recognized for having a positive impact on organizations and society, building trust and enhancing lives. Today BSI partners with more than 77,500 clients in 195 countries and engages with a 15,000 strong global community of experts, industry and consumer groups, organizations and governments. Utilizing its extensive expertise in key industry sectors - including automotive, aerospace, built environment, food and retail, and healthcare - BSI delivers on its purpose by helping its clients fulfil theirs. Living by our core values of Client-Centricity, Agility, and Collaboration, BSI provides organizations with the confidence to grow by partnering with them to tackle society's critical issues - from climate change to building trust in digital transformation and everything in between - to accelerate progress towards a better society and a sustainable world. BSI is an Equal Opportunity Employer dedicated to fostering a diverse and inclusive workplace.

Our hospital provides high-quality care that transforms the lives of those living with disabling injuries and illnesses. We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve. The HIM Manager is responsible for maintaining the security, confidentiality, completeness, and accuracy of medical records in accordance with policies and procedures and within the guidelines of regulatory agencies. The HIM Manager may also act as Privacy Officer for the Hospital. Oversees compliance efforts related to the Centers for Medicare & Medicaid Services (CMS) Review Choice Demonstration (RCD) and the Final Rule Audit (FRA). Serves as the primary onsite contact for all RCD/FRA compliance initiatives. This position must integrate company values into daily practice. Essential Functions: Directs, plans, schedules, and participates in day-to-day activities within HIM department, including , indexing, transcription, quantitative analysis, chart completion, the release of medical record information and abstracting of medical information. Oversee daily concurrent medical record completion, collaborating across all disciplines to ensure 100% accuracy and adherence to the Final Rule. Acts as Cerner superuser and source expert in auditing Final Rule elements. Supports providers using Cerner. Directs record assembly and reviews medical records for data elements required for chart completion. Monitors and evaluate physicians and hospital staff to ensure compliance with record keeping requirements. Oversees all ongoing activities related to the development, implementation, maintenance of, and adherence to the organization's policies and procedures covering the privacy of, and access to, patient health information in compliance with federal and state laws and the healthcare organization's information privacy practices. Monitors and evaluates physicians and hospital staff to ensure compliance with record keeping requirements. Collaborates with RCD Leadership and hospital staff on process improvement and education regarding documentation and timeliness. Provides development guidance and assists in the identification, implementation, and maintenance of organization information privacy policies and procedures in coordination with Hospital administration, Corporate Compliance Officer, and legal counsel. May perform initial and ongoing credentialing for Hospital medical staff. Safeguards the confidentiality of all medical records by ensuring the Release of Information policy is followed in accordance with HIPAA and other requirements; securing legal/risk management records; responding timely to subpoenas and/or court orders; and representing the hospital in court hearings and/or depositions as required. Provides an environment conducive to safety for patients, visitors, and staff. Assesses the risks for safety and implements appropriate precautions. Complies with appropriate and approved safety and Infection Prevention standards. Performs other duties as assigned to support overall effectiveness of the organization. Once the HIM's hospital is formally under Review Choice Demonstration, the following will be incorporated into day-to-day duties: Follow established protocols to facilitate Medicare affirmations and respond timely to non-affirmations under the Review Choice Demonstration process. Stay informed about changes in RCD/FRA processes, including regional Medicare Administrative Contractor (MAC) approaches and review outcomes. Communicate reasons for admission non-affirmations/denials with hospital leadership and RCD leadership and assist in providing necessary justifications. Assists as directed with denials through the appeal process. Includes synthesizing clinical documentation for each patient's stay into justification for services for all payors. Manage tracking systems to ensure deadlines are met and real-time data on new admissions is available for timely submissions. Minimum Job Requirements Minimum Education & Experience: Two years medical records experience required Two years of medical coding experience preferred. Degree in Health Information Management or related subject required. Prefer program accredited by CAHIIM (Commission on Accreditation for Health Informatics and Information Management). Experience in a management role preferred. Required Licenses, Certifications, and/or Documentation: RHIA or RHIT certification preferred. CCS preferred as additional credential. Must maintain acceptable driving record, current driver's license, and insurability. Required Knowledge, Skills, and Abilities: Demonstrates knowledge in information privacy laws including 45 CFR, Health Insurance Portability and Accountability Act (HIPAA), and state medical records law. Demonstrates a clear working knowledge of general hospital operations. Knowledge of accreditation standards to ensure adherence to all standards set forth by state and accrediting agencies of TJC and CMS. Demonstrates an understanding of treatment costs and financial support as they relate to quality and efficiency. Working knowledge of medical terminology, abbreviation, and spelling. Ability to maintain exceptional levels of confidentiality. Demonstrates proficiency with general computer skills including data entry, word processing, email, and records management. Demonstrates critical thinking skills. Ability to prioritize, meet deadlines, and complete complex tasks. Ability to maintain quality and safety standards. Ability to work closely and professionally with others at all levels of the organization. Effective organizational and time management skills. Physical Requirements Over the Course of a Shift: A significant amount of sitting, walking, bending, reaching, lifting, and carrying, often for prolonged periods of time. Lifting/exerting of up to 10 lbs. Sufficient manual dexterity to operate equipment and computer keyboard. Close vision and the ability to adjust focus. Ability to hear overhead pages.

We are more than a health system. We are a belief system. We believe wellness and sickness are both part of a lifelong partnership, and that everyone could use an expert guide. We work hard, care deeply and reach further to help people uncover their own power to be healthy. We inspire hope. We learn, grow, and achieve more - in our careers and in our communities. Summary: This position performs facility coding and abstracting functions of Inpatient. Responsibilities And Duties: 1. 60% Assigns appropriate admit, & principal and secondary diagnoses and/or procedure codes by reading documentation present in medical record and applying knowledge of correct coding guidelines as appropriate for hospital service and/or patient type while maintaining 95% quality and meeting and maintaining the minimum Coder productivity requirements. Assign Present on Admission PO a indicators to all inpatient account diagnoses as required by official coding guidelines. Accurately Assign DRG/MSDRG/APR-DRG at the minimum standards of 95% Review Diagnosis and CC/MCC for maximum SOI/ROM Clinical understand of laboratory and radiology values Knowledge of quality outcomes indicators Work with CDS to improve physician documentation and case mix index Assign Principal Diagnosis accurately at least 95% or better Monitor and appropriately assign HAC codes when appropriate Responsible for recognizing when it is necessary to obtain further clarification from physician when documentation is inadequate, ambiguous, or unclear for coding purposes. Assists educators and supervisors with reviewing accounts denied by RAC and other governmental payers for appropriate documentation to support original coding. 2. 20% In the event of insufficient, missing or conflicting documentation, assigns transaction codes in HBOC system and follows department policy for follow up and physician query. 3. 10% : Abstracts all data elements necessary to complete UB0 4 and meet hospital-reporting requirements. 4. 5% : Verifies demographics, corrects account number, charges and service and identify missing or incorrect forms in each record. 5. 5% : Identifies problem cases on the DNFB and forwards to appropriate staff for follow up. The major duties, responsibilities and listed above are not intended to be all-inclusive of the duties, responsibilities and to be performed by employees in this job. Employee is expected to all perform other duties as requested by supervisor. Minimum Qualifications: Bachelor's Degree (Required) AHIMA - American Health Information Management Association - American Health Information Management Association, CCS - Certified Coding Specialist - American Health Information Management Association Additional Job Description: Work Shift: Day Scheduled Weekly Hours : 40 Department Hospital Coding Join us! ... if your passion is to work in a caring environment ... if you believe that learning is a life-long process ... if you strive for excellence and want to be among the best in the healthcare industry Equal Employment Opportunity OhioHealth is an equal opportunity employer and fully supports and maintains compliance with all state, federal, and local regulations. OhioHealth does not discriminate against associates or applicants because of race, color, genetic information, religion, sex, sexual orientation, gender identity or expression, age, ancestry, national origin, veteran status, military status, pregnancy, disability, marital status, familial status, or other characteristics protected by law. Equal employment is extended to all person in all aspects of the associate-employer relationship including recruitment, hiring, training, promotion, transfer, compensation, discipline, reduction in staff, termination, assignment of benefits, and any other term or condition of employment Remote Work Disclaimer: Positions marked as remote are only eligible for work from Ohio.