Qualified Professional QP / Intensive In-Home IIH
Certified professional coder job at RHA Health Services
We are hiring for:
Qualified Professional QP / Intensive In-Home IIH
Type:
Regular
If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual, developmental disabilities, and people facing mental health, and substance use challenges, join our team at RHA Health Services!
Provides support to individuals with Mental Health (MH) or Substance Abuse Issues in residential, school, workplace and community settings for children, adolescents, and families. These interventions are strength-based and focused on promoting recovery, symptom reduction, increased coping skills, and achievement of the highest level of functioning in the community. Staff ratio takes into consideration evening and weekend hours, needs of special populations and geographical areas to be served. Persons who meet the requirements specified for Qualified Professional (QP) status have the knowledge, skills, and abilities required by the population and age to be served may deliver supports within the requirements of the staff definition specified in the service definitions. Relies on supervision and direction to provide quality services.
Calling all compassionate and caring behavioral health specialists who are looking to partner with a community based service provider offering mental health and substance abuse services where individuals live and work.
RHA Behavioral Health Services is looking for dedicated Behavioral Health Specialists (Qualified Professionals) to join our interdisciplinary healthcare team providing support to individuals in residential, school, workplace and community settings.
In this dynamic and rewarding role, there is an emphasis on creating interventions that are strength-based and focused on promoting recovery, symptom reduction, increased coping skills, and achievement of the highest level of functioning for the client in the community.
If you're looking for an opportunity to truly make a difference in the lives of the people that you serve then consider RHA Behavioral Health Services where we put people first!
Job Responsibilities
As a Behavioral Health Specialist you will be responsible for the development, implementation, monitoring and revision to the Person Centered Plan in conjunction with the interdisciplinary healthcare team.
Additional responsibilities of the Behavioral Health Specialist include:
Facilitating relationships and serving as a link between the company, parents, guardians, local agencies and the community
Minimizing the negative effects of psychiatric symptoms or substance dependence that interfere with the recipient's daily living and personal development, providing supportive counseling
Supporting the client in the development of various skill building activities, including: daily and community living skills, socialization skills, adaptation skills, and behavior and anger management
Participating in a first responder on-call system available to consumers and/or his/her natural support network on a 24/7/365 basis; coordinates “first response" resources according to consumer need and the PCP
Performing Case Management functions of linking and arranging for services and referrals
Working closely with other clinical/professional staff to maintain communication and providing feedback, standardizing procedures and expediting PCP implementation
Ensuring that all initial and reauthorizations for services occur in a timely fashion
Monitoring utilization of service to ensure that it is effective, appropriate, and within the limits set forth in both rule, PCP, and the service authorization
Candidates for the Behavioral Health Specialist role are considered “Qualified Professionals" based on the following criteria:
Education:
Bachelor Degree (Not Human Services field) & 4+ years full-time experience with population served OR
Bachelor Degree (in Human Services field) & 2+ years full-time experience with population served OR
Master's Degree or Higher & 1+ years full-time experience with population served.
License, Provisional License, Certificate, Registration, Permit issued by governing board regulating human service profession.
Definitions:
Human Service Degrees Include: Social Service, Sociology, Psychology, or other Human Service Degrees.
Populations Served Include: Mentally Ill-Child, Mentally Ill- Adult, Substance Abuse-Adult, Substance Abuse-Child
Pre-employment screening:
Complete criminal background
Name checked in the registries. (OIG exclusions database, Child Abuse Registry, and Offenders Against Individuals with Developmental Disabilities)
Drug testing
Education verification and other credentialing based on position requirements.
Proof of employment history or references (if required)
Positions that require driving Proof of driver's license, driver's insurance, and vehicle, IF required for providing transportation for individuals.
We offer the following benefits to employees:
Payactiv: early access to the money you've earned from hours you've already worked, before payday!
Employee perks and discount program: to help you save money!
Paid Time Off (full-time employees only)
Health/Insurance (full-time employees only)
401(k) retirement savings program
Wellbeing Programs: Physical, Emotional and Financial
Chronic Disease management programs for hypertension and diabetes (for qualifying employees)
Training: Free CPR, first aid, and job-specific training opportunities
*contract/contingent workers and interns do not qualify for any of the above benefits
EEO Statement RHA is an equal opportunity employer. In addition, we provide reasonable accommodation to qualified employees who have protected disabilities to the extent required by applicable laws, regulations, and ordinances. If you are an individual with a disability and need a reasonable accommodation to participate in the application process, please contact our solutions center.
About RHA:
At RHA Health Services, we help individuals with intellectual and developmental disabilities, mental health and/or substance use needs live their best lives. Our mission is to provide a safe and healthy environment while creating opportunities for personal outcomes.
For over 30 years, the people we serve and support have remained at the very center of everything we do. RHA currently provides services in North Carolina, Georgia, Pennsylvania, Tennessee, and New Jersey.
If you are ready to make a difference in the lives of people we serve and support apply to join the team today.
Auto-ApplyCertified Medical Coder
New York, NY jobs
Pride Health is hiring a Certified Medical Coder (Remote Role) to support our client's medical facility based in Bronx, NY - 10461. This is a 3 -month assignment with the possibility of a contract-to-hire opportunity and a great way to start working with a top-tier healthcare organization!
Job Title: Certified Medical Coder (Remote Role)
Facility Location: Bronx, NY - 10461.
Pay Range: $33.00/hr to $36.00/hr
Shift: Days, 8:00 AM to 4:00 PM
Duration: 03 Months (Contract) with possible extension
Work Schedule & Arrangement:
Position begins with 1-2 weeks of onsite training (flexible based on candidate experience)
Transitions to a remote work arrangement once job duties are successfully mastered
Hiring Manager is flexible regarding onsite training duration based on candidate skill level
Job Duties and Responsibilities:
Perform accurate medical coding for acute care inpatient and Emergency Department (ED) records using ICD-9-CM and CPT-4 coding systems.
Utilize 3M/HDS coding applications and encoder tools to assign diagnosis and procedure codes in compliance with established standards.
Apply coding guidelines, payer requirements, and federal billing regulations to ensure accurate reimbursement and regulatory compliance.
Review clinical documentation and research coding-related issues to resolve discrepancies and ensure complete, compliant coding.
Demonstrate working knowledge of anatomy, physiology, and disease processes to support accurate code assignment.
Maintain proficiency in computer applications, including MS Word, Excel, and coding encoders.
Participate in and provide training and guidance to coding staff, supporting competency development and quality improvement.
Collaborate with clinical and administrative teams to clarify documentation and improve coding accuracy.
Ensure coding accuracy, timeliness, and compliance with internal policies and external regulatory standards.
Education Requirements:
High School Diploma or GED (required)
Completion of an accredited Health Information Management program preferred
AHIMA credentials such as RHIA or RHIT preferred
Skills & Experience Requirements:
Minimum three (3) years of medical coding experience
Strong knowledge of ICD-10 coding guidelines
Demonstrated experience with EPIC and 3M coding systems
Proven proficiency in inpatient and outpatient coding, with a strong emphasis on Outpatient and Emergency Department (ED) coding
Ability to work independently with minimal training
Strong attention to detail and ability to apply coding guidelines accurately
Certification Requirements:
CCS (Certified Coding Specialist) or CPC (Certified Professional Coder) certification (required)
Additional certifications such as CCP preferred
Pride Global offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, , legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
Remote Certified Coder
Houston, TX jobs
Job Title: Urology Coder
Hours: Monday - Friday, 8:00 AM - 5:00 PM CST
Contract Type: Contract
Pay: $20-29/hr
Seeking an experienced Urology Coder to accurately assign ICD-10, CPT, and HCPCS codes for urology charts. The ideal candidate will have strong coding knowledge, particularly in surgical cases and outpatient procedures, with experience in a fast-paced healthcare setting.
Key Responsibilities
Assign appropriate ICD-10, CPT, and HCPCS codes to ensure proper reimbursement and data collection.
Review and code Urology charts, including surgical cases for:
Ambulatory Surgery Centers (ASC)
Injection/Infusion procedures
Outpatient hospital charges
Code from physician's outpatient notes accurately.
Apply modifiers correctly based on procedural and coding guidelines.
Maintain coding accuracy specific to urology procedures.
Qualifications
Certification: CPC required
Minimum of 1-3 years of general coding experience
Experience coding urology charts preferred
Familiarity with Athena is a plus
CPC-A candidates welcome
Strong knowledge of CPT, ICD-10, and HCPCS coding rules and guidelines
Training & Productivity Expectations
Initial training period: 4 weeks
Productivity: ~7 encounters per hour
Certified Medical Coder
New York, NY jobs
Title: Certified Medical Coder
Shift: 8:00 AM - 4:00 PM
Work Arrangement: Onsite Training (1-2 weeks) → Remote
Pay: $35/hr to $37/hr
Contract: 3-month assignment with possible extension
Start Date: 12/01/2025 - 03/07/2026
Position Summary:
We are seeking an experienced and detail-oriented Certified Medical Coder to join our team. This role begins onsite for initial training before transitioning to remote work. The ideal candidate will have strong inpatient coding experience in an acute care setting and be proficient with ICD-10, CPT coding, EPIC, and 3M Encoder tools.
Key Responsibilities:
Perform accurate and compliant inpatient coding using ICD-10, ICD-9-CM, CPT-4, and Encoder systems
Review medical records and ensure proper documentation supports code selection
Research and resolve coding-related questions and discrepancies
Maintain coding accuracy and productivity standards
Apply current coding guidelines, payer requirements, and regulatory rules
Collaborate with clinical staff as needed to clarify documentation
Support outpatient and ED coding tasks as needed (preferred, not required)
Requirements:
CCS Certification (required)
EPIC and 3M Encoder experience (required)
Minimum 3-4+ years of inpatient coding experience, preferably in an acute care setting
Strong knowledge of ICD-10, ICD-9-CM, CPT-4, and Encoder systems
Experience with outpatient and ED coding (preferred)
Proficient computer skills, including MS Word, Excel, and coding applications
Skills & Role Expectations:
Strong understanding of coding guidelines, payer rules, and federal billing regulations
Solid knowledge of anatomy, physiology, and disease processes
Ability to work independently and efficiently after training
Ability to research issues and resolve coding questions
Experience mentoring or training coders is a plus
Seeking candidates with strong inpatient coding backgrounds
If Interested, you can reach me on my number ************** or email me at *******************************
Pride Health offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.
Medical Coder
Orlando, FL jobs
Looking for experienced Medical Coders to ramp up and support upcoming system migration from Cerner to Epic slated to go live March 2026. Will help with day-to-day as their teams lift up and move into training, to provide some relief in those processes. Must have Epic medical coding experience and experience with system migrations. Preferred to also have medical coding experience with Cerner. Need certification in CPC, CPCA, RHIT, or CSS-P, and experience with both inpatient and outpatient environments.
These coders will not need visibility into finances, nor do they have access to an encoder.
Openings by specialty/clinic:
- 2 Behavioral Health
- 2 Hospital Med
- 1 Fetal Health
- 3 Primary Care Clinic
- 1 Adolescent Medicine
- 1 ENT
- 1 Ophthalmology
*all mix of inpatient and outpatient
Job Type & Location
This is a Contract position based out of Orlando, FL.
Pay and Benefits
The pay range for this position is $35.00 - $45.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Dec 29, 2025.
h4>About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems and TEKsystems Global Services
We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Certified Medical Coder
Bishop, CA jobs
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Duration: 3+Months(possibility for extension)
Shifts: Will be a full-time remote coder who will come onsite as soon as possible, for a 7-10 day training period and then go home to code for us remotely. Will come onsite every 5-6 weeks to work with the HIM team, providers and staff.
Minimum Years of Experience: 2 years
Job Start Date:9/25/2017
Minimum Guaranteed Hours:36
Job Description:
· Current AHIMA or AAPC Certification Required (CPC, CCS-P)
· Outpatient Coding Experience Required with Experience in ED and Observation Coding Responsible for assignment of accurate, ICD-10, CPT codes and modifiers from medical record documentation. Identifies and abstracts information from medical records (paper or electronic) .
· Works within GE Centricity and McKesson Paragon/One Content, including 3M Follows established query process to clarify documentation to support coding assignments. Maintains productivity and accuracy requirements as outlined .
· Can this Coder work remotely? not at first coder must train onsite, once training is complete Coder must work onsite every 4-6 weeks.
Additional Information
All your inform
Shift Hours: Start Time:10:00 AM - End Time:06:00 PM
Behavioral Health Coder
Kansas City, MO jobs
Looking for experienced Medical Coders to ramp up and support upcoming system migration from Cerner to Epic. Must have Epic medical coding experience and experience with system migrations. Preferred to also have medical coding experience with Cerner.
Should have experience with profee inpatient and outpatient coding.
Specialties Needed :
Behavioral Health
Hospital Medicine
Fetal Health
Primary Care Clinic
Adolescent Medicine
ENT
Ophthalmology
Must have a CPC, CCS, or RHIT certification
Job Type & Location
This is a Contract position based out of Kansas City, MO.
Pay and Benefits
The pay range for this position is $35.00 - $45.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Dec 29, 2025.
h4>About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems and TEKsystems Global Services
We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Medical Coder
Dallas, TX jobs
Looking for experienced Medical Coders to ramp up and support upcoming system migration from Cerner to Epic slated to go live March 2026. Will help with day-to-day as their teams lift up and move into training, to provide some relief in those processes. Must have Epic medical coding experience and experience with system migrations. Preferred to also have medical coding experience with Cerner. Need certification in CPC, CPCA, RHIT, or CSS-P, and experience with both inpatient and outpatient environments.
These coders will not need visibility into finances, nor do they have access to an encoder.
Openings by specialty/clinic:
- 2 Behavioral Health
- 2 Hospital Med
- 1 Fetal Health
- 3 Primary Care Clinic
- 1 Adolescent Medicine
- 1 ENT
- 1 Ophthalmology
*all mix of inpatient and outpatient
Job Type & Location
This is a Contract position based out of Dallas, TX.
Pay and Benefits
The pay range for this position is $35.00 - $45.00/hr.
Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or Sick Leave)
Workplace Type
This is a fully remote position.
Application Deadline
This position is anticipated to close on Dec 29, 2025.
h4>About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
About TEKsystems and TEKsystems Global Services
We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.
The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
Remote Certified Coders
Memphis, TN jobs
Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in:
1. CMS HCC Risk Adjustment
2. HEDIS
3. Medical Record Reviews (Accreditation)
4. And more
Job Description
These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines).
Responsibilities:
• Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group assignments as applicable.
• Assign Altegra Health Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.
• Remain current on medical coding guidelines and reimbursement reporting requirements.
• Check chart assignments every day and report accurately all hours worked on a weekly basis.
• Report work-related concerns to assigned Coder Advocate and if not adequately addressed to Sr. Manager of Clinical Operations.
• 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.
• Participate in testing and training as required by the Company.
Qualifications:
• Active nursing license (RN or LPN) and/or certified coder certification through AHIMA or AAPC required
• At least one years' experience as a medical coder/abstractor.
• Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred);
• Ability to code using an ICD-9-CM code book (without using an encoder);
• Strong clinical skills related to chronic illness diagnosis, treatment and management;
• Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts);
• Personal discipline to work remotely without direct supervision;
• Exemplary attention to detail and completeness-all medical coders must maintain minimum QA passing requirements based on HCC scoring model(HCCx < or equal to 5 and HCCm < or equal to 5);
• Computer proficiency (including MS Windows, MS Office, and the Internet);
• Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better;
• Strong organization skills; interpersonal and customer service skills; written and oral communication skills; and analytical skills;
• Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation.
Qualifications
1 year of certified coding experience
Additional Information
All your information will be kept confidential according to EEO guidelines.
Coding Denials Resolution Specialist / Coding Team Lead
Farmington, MI jobs
Job DescriptionDescription:
Responsible for reviewing all post-billed denials (including coding-related denials) for coding accuracy and appealing them based on coding expertise and judgment within Hospital and/or Medical Group partner revenue operations. Serves as part of the coding denials resolution team responsible for identifying and determining root causes of denials. Responsible for using coding knowledge and standard procedures to track appeals through all levels and ensure timely filing as required by payers. Also promotes departmental awareness of coding best practices.
Duties and Responsibilities
Knows, understands, incorporates, and demonstrates the Healthrise Core Values.
Provides detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, ICD-10-PCS codes, and CPT-4 procedural codes for UB-04 outpatient or inpatient claims.
Responsible for understanding and resolving Professional Billing HCFA1500 claims or other coding-related issues, and processing charge corrections based on medical record reviews, contracts, and regulations as directed by the supervisor.
Interprets data, draws conclusions, and reviews findings with all levels for further review.
Takes initiative to continuously learn all aspects of the role to support progressive responsibility.
Maintains a working knowledge of applicable federal, state, and local laws and regulations.
Additional Duties and Responsibilities - Coding Team Lead
Serves as first-line support for coders, answering questions, troubleshooting issues, and escalating complex cases to the manager.
Reviews team members' work for accuracy and compliance, providing coaching and real-time feedback.
Tracks productivity and quality metrics at the individual and team level and communicates performance trends to leadership.
Supports onboarding and training of new coders, ensuring consistency in process knowledge and documentation.
Responsible for monitoring and maintaining assigned leader workqueues.
Requirements:
High school diploma or Associate degree in Accounting, Business Administration, or related field, and a minimum of four years of experience in a hospital, clinic environment, health insurance company, managed care organization, or healthcare financial service setting; or an equivalent combination of education and experience. Experience in a complex, multi-site environment preferred.
Comprehensive knowledge of professional/physician diagnostic and procedural coding, typically obtained through a coding certificate program, and at least one year of professional and hospital outpatient coding experience, or a minimum of two years of hospital inpatient coding experience including DRG assignment.
Must hold one of the following credentials: RHIA, RHIT, CCS, CPC. CPMA will also be considered.
Experience with NCCI edits, NCDs, LCDs, and outpatient coding guidelines for official coding and reporting.
Detailed understanding of compliant healthcare billing and collections principles.
Expertise in medical terminology, disease processes, patient health record content, and the medical record coding process.
Comfortable operating in a collaborative, shared leadership environment.
Previous experience working with Global Partner vendors preferred.
Physical Demands and Work Environment
Remote work environment requiring a dedicated space that ensures confidentiality and privacy.
Frequent communication via Microsoft Teams, email, and phone with colleagues across locations.
Manual dexterity required to operate a keyboard; hearing required for phone and Teams communication.
Ability to concentrate, meet deadlines, work on multiple projects, and adapt to interruptions.
Must be able to set and manage work priorities independently, adjust to changing demands, and work under potentially stressful conditions with individuals possessing diverse personalities and work styles, including Global Partner vendors.
Urgent Requirement - Certified Professional Coder
Ewing, NJ jobs
Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.
We've stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.
Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients' success.
Job Description:
Title: Certified Professional Coder
Location: Ewing, NJ
Duration: Full Time
Job Summary:
This position is accountable for the review, interpretation and codification of Medical Policies and Legislative Mandates utilizing CPT-4, HCPC and ICD-9/ICD-10 coding parameters.
Responsibilities:
• Reviews and interprets current Medical Policies for systematization.
• Translates written policy interpretation into CPT, HCPC, ICD-9/ICD-10 codes for input into systems.
• Translates Legislative Mandates into CPT, HCPC, ICD-9/ICD-10 codes for input into systems.
• Maintains a database for all policies and mandates that is updated each time new/revised/deleted CPT/HCPC/ICD-9/ICD-10 are released.
• Monitor compliance with policies and procedures relevant to clinical data reviewed.
• Perform updates to the criteria file to include adds/deletes/revisions of CPT-4 and HCPC codes. Review all codes for accuracy; review database to criteria file before implementation of policy.
• Handle internal and external areas requests to investigate current state and historical of changes made to a particular CPT-4/HCPC/Diagnosis code such as effective dates, messages used, parameter limitations.
• Review and analyze BRD/TRD/Summary to ensure accuracy of implementation of policies.
• Review of scripts concerning Edits in criteria file. Review logic concerning implementation of policies.
• Assist benefit file on criteria loading to best accommodate implementation of benefits.
• Ensure files (provider/criteria) are loaded correctly in order to receive proper Edits 405/406.
• Perform other related tasks as assigned.
Knowledge:
• Requires proficiency in the CPT-4, HCPC, ICD-9/ICD-10 coding.
• Requires knowledge of anatomy, physiology and medical terminology of medical procedures, abbreviations and terms.
• Requires knowledge of the health care delivery system.
Skills and Abilities:
• Requires the ability to utilize a personal computer and applicable software ( e.g. proficiency in Word, Excel, Access).
• Must have effective verbal and written communication skills and demonstrate the ability to work well within a team.
• Demonstrated ability to deliver highly clinical information to technical individuals.
• Must demonstrate professional and ethical business practices, adherence to company standards and a commitment to personal and professional development.
• Proven ability to exercise sound judgment and strong problem solving skills.
• Proven ability to ask probing questions and obtain thorough and relevant information.
• Must have the ability to organize/prioritize/analyze complex tasks.
• Use of CMS website for CCI rules and regulations.
• Use of other approved websites for research.
Qualifications
Education/Experience:
• Bachelor's Degree preferred.
• Requires experience with McKesson ClaimsXten
• Requires a clinical medical background (Clinical editing).
• Requires a minimum of 3 years clinical experience.
• Requires 3 - 5 years of Medical Coding experience.
• Requires a minimum of 2 years' experience in Health Insurance/Claims Processing and/or Utilization Review.
• Prefer knowledge/experience with computer processing systems.
• Requires current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist from the American Health Information Management (AHIMA).
Additional Information
Thanks,
Nishit
732-429-1639
Remote Certified Coder
Dallas, TX jobs
Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in:
1. CMS HCC Risk Adjustment
2. HEDIS
3. Medical Record Reviews (Accreditation)
4. And more
Job Description
These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines).
Responsibilities:
• Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group assignments as applicable.
• Assign Altegra Health Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.
• Remain current on medical coding guidelines and reimbursement reporting requirements.
• Check chart assignments every day and report accurately all hours worked on a weekly basis.
• Report work-related concerns to assigned Coder Advocate and if not adequately addressed to Sr. Manager of Clinical Operations.
• 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.
• Participate in testing and training as required by the Company.
Qualifications:
• Active nursing license (RN or LPN) and/or certified coder certification through AHIMA or AAPC required
• At least one years' experience as a medical coder/abstractor.
• Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred);
• Ability to code using an ICD-9-CM code book (without using an encoder);
• Strong clinical skills related to chronic illness diagnosis, treatment and management;
• Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts);
• Personal discipline to work remotely without direct supervision;
• Exemplary attention to detail and completeness-all medical coders must maintain minimum QA passing requirements based on HCC scoring model(HCCx < or equal to 5 and HCCm < or equal to 5);
• Computer proficiency (including MS Windows, MS Office, and the Internet);
• Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better;
• Strong organization skills; interpersonal and customer service skills; written and oral communication skills; and analytical skills;
• Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation.
Qualifications
1 year of certified coding experience
Additional Information
All your information will be kept confidential according to EEO guidelines.
Certified Professional Coder (CPC) Lead/Provider Liaison
Newark, NJ jobs
A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
This is Contract position with my direct client
Job Description
Direct Client Need- Immediate Interviews- We have a strong hold, with many consultants working onsite! Location could be : Newark, NJ OR West Trenton OR Ewing OR Wall, NJ
Duration: Contract to Hire
Job Summary:
The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational materials for Network Management professionals to communicate with providers and staff regarding client's risk adjustment programs.
Primary responsibilities include working with the Risk Adjustment Management Business Analyst to measure commercial risk adjustment performance for the development of education materials.
Ongoing responsibilities include communicating and educating Network Management Provider Educators to enable content delivery to specific providers.
This role will operate within the Risk Adjustment Management function, but work closely with the Network Management team. Responsibilities: · Operates as the intermediary between the Risk Adjustment Management team and provider-facing staff to report and deliver commercial risk adjustment insights ·
Works closely with the Risk Adjustment Management Business Analyst to monitor risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysis · Collaborates with the Network Management leadership in developing, monitoring and driving key performance metrics for Network Management Provider Educators ·
Collaborates with the Network Management leadership in developing and delivering commercial risk adjustment educational content and materials for internal and external use, including clinicians and supporting staff · Validates documentation against submitted claims diagnosis codes and prepares detailed reports · Supports Risk Adjustment Data Validation audits · Drives communication with pertinent staff and managers to ensure that interdependencies between the departments, other projects and functional work streams are accurately identified and addressed · Provides status reports to management
Qualifications
Certifications: ·
AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS)
Knowledge:
· Understands key tenets of commercial risk adjustment and the HHS-HCC risk adjustment model · Mastery of medical coding best practices
· Project management skills
· Experience displaying ability to think analytically
· Strong communications and presentation skills · Computer skills: Outlook, Excel, Word & Powerpoint;
Additional Information
Contact me at 732 429 1953
PROVIDER LIAISON - Certified Professional Coder (CPC) / Certified Coding Specialist (CCS)
Newark, NJ jobs
A Few Words About Us Integrated Resources, Inc is a premier staffing firm recognized as one of the tri-states most well-respected professional specialty firms. IRI has built its reputation on excellent service and integrity since its inception in 1996. Our mission centers on delivering only the best quality talent, the first time and every time. We provide quality resources in four specialty areas: Information Technology (IT), Clinical Research, Rehabilitation Therapy and Nursing.
Job Description
One of our direct client is looking for potential candidate with the below mentioned skills
Direct Client: Immediate Interview
Contract to Hire
Position: Provider Liaison
MUST HAVE:
• 5 years of experience into Project Management
• At least 2 years of experience after CPC or CCS certification
• Bachelor's degree is a must
Certifications
· AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS)
Job Summary:
• The Provider Liaison is accountable for extracting insights specific to providers and provider groups regarding commercial risk adjustment and developing educational materials for Network Management professionals to communicate with providers and staff regarding Client's risk adjustment programs. Primary responsibilities include working with the Risk Adjustment Management Business Analyst to measure commercial risk adjustment performance for the development of education materials. Ongoing responsibilities include communicating and educating Network Management Provider Educators to enable content delivery to specific providers. This role will operate within the Risk Adjustment Management function, but work closely with the Network Management team.
Responsibilities:
• Operates as the intermediary between the Risk Adjustment Management team and provider-facing staff to report and deliver commercial risk adjustment insights
• Works closely with the Risk Adjustment Management Business Analyst to monitor risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysis
• Collaborates with the Network Management leadership in developing, monitoring and driving key performance metrics for Network Management Provider Educators
• Collaborates with the Network Management leadership in developing and delivering commercial risk adjustment educational content and materials for internal and external use, including clinicians and supporting staff
• Validates documentation against submitted claims diagnosis codes and prepares detailed reports
Supports Risk Adjustment Data Validation audits
• Drives communication with pertinent staff and managers to ensure that interdependencies between the departments, other projects and functional work streams are accurately identified and addressed
Provides status reports to management
Certifications:
•
AAPC Certified Professional Coder (CPC) or AHIMA Certified Coding Specialist (CCS)
Knowledge:
• Understands key tenets of commercial risk adjustment and the HHS-HCC risk adjustment model
• Mastery of medical coding best practices
• Project management skills
• Experience displaying ability to think analytically
• Strong communications and presentation skills
• Computer skills: Outlook, Excel, Word & Powerpoint; SAS & Access preferred
Kind Regards
Sammeer Gaikwad
Operations Manager
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I
(BOARD) # 732-549-2030 - Ext - 243
Qualifications
Education Experience:
• Bachelor's degree in business, healthcare administration, or other related field
• Requires a minimum of three (3) years of healthcare experience, preferably with provider focus
• Requires CPC or CCS certification
• Requires program/project management experience
Additional Information
Kind Regards
Sammeer Gaikwad
Operations Manager
Integrated Resources, Inc.
IT Life Sciences Allied Healthcare CRO
Certified MBE |GSA - Schedule 66 I GSA - Schedule 621I
(BOARD) # 732-549-2030 - Ext - 243
Remote Certified Coder
Atlantic City, NJ jobs
Altegra Health is a total solutions partner for healthcare data auditing and analytics. Altegra provides end-to-end solutions to help improve payment integrity data, to support accreditation programs, and to meet regulatory requirements. Altegra's nationwide network of registered nurses and certified coders professionally acquire, audit, and analyze healthcare data for healthcare organizations. Altegra Health specializes in:
1. CMS HCC Risk Adjustment
2. HEDIS
3. Medical Record Reviews (Accreditation)
4. And more
Job Description
These are a remote/home based temporary positions forecast to run through the end of 2015 and Coders will be paid by the chart. Remote Certified Coders review medical records and apply appropriate ICD-9-CM diagnostic codes and Altegra Health Flagged Event. Codes must meet Altegra Health QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines).
Responsibilities:
• Abstract pertinent information from patient medical records. Assign appropriate ICD-9-CM codes, creating HCC and/or RxHCC group assignments as applicable.
• Assign Altegra Health Flagged Event codes when documentation in the record is inadequate, ambiguous, or otherwise unclear for medical coding purposes.
• Remain current on medical coding guidelines and reimbursement reporting requirements.
• Check chart assignments every day and report accurately all hours worked on a weekly basis.
• Report work-related concerns to assigned Coder Advocate and if not adequately addressed to Sr. Manager of Clinical Operations.
• 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.
• Participate in testing and training as required by the Company.
Qualifications:
• Active nursing license (RN or LPN) and/or certified coder certification through AHIMA or AAPC required
• At least one years' experience as a medical coder/abstractor.
• Extensive knowledge of ICD-9-CM outpatient diagnosis coding guidelines (with knowledge and demonstrated understanding of CMS HCC Risk Adjustment coding and data validation requirements is preferred);
• Ability to code using an ICD-9-CM code book (without using an encoder);
• Strong clinical skills related to chronic illness diagnosis, treatment and management;
• Reliability and a commitment to meeting tight deadlines (24-hour turnaround time on all assigned charts);
• Personal discipline to work remotely without direct supervision;
• Exemplary attention to detail and completeness-all medical coders must maintain minimum QA passing requirements based on HCC scoring model(HCCx < or equal to 5 and HCCm < or equal to 5);
• Computer proficiency (including MS Windows, MS Office, and the Internet);
• Must have high-speed Internet access, a home computer with a current Windows operating system, MS Internet Explorer (version 6.0.2 or better), and Adobe 6.0 or better;
• Strong organization skills; interpersonal and customer service skills; written and oral communication skills; and analytical skills;
• Knowledge of HIPAA, recognizing a commitment to privacy, security and confidentiality of all medical chart documentation.
Qualifications
1 year certified remote coding experience
Additional Information
All your information will be kept confidential according to EEO guidelines.
Professional, Certified Coding Integrity
Scranton, PA jobs
The Certified Coding Integrity Professional is responsible for all aspects of the coding and billing of all inpatient and outpatient claims, as well as all aspects of the CCM billing. The Certified Coding Integrity Professional, a key position in the Revenue Cycle, facilitates the coding as well as manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries and patients related to coding issues. The incumbent will assist in the clarification and development of process improvements and inquiries in order to maximize revenues and will have an onsite presence at the clinical locations.
Requirements
ESSENTIAL JOB DUTIES and FUNCTIONS
While living and demonstrating our Core Values, the Certified Coding Integrity Professional will:
* Perform accurate and timely multi-specialty coding for daily claims submission.
* Prepare and submit clean claims to third-party payers working closely with clinical team members regarding claims appeal, denial, and resolution.
* Perform audits of the daily billing summary reviewing the quality of the clinical documentation and coded data to validate that the documentation supports services rendered while ensuring the integrity of the coding.
* Respond timely (either orally or written) to account inquiries from patients, third-party payers, clinical providers, and/or other staff on claims submission.
* Interact with physicians, learners and other patient care providers on daily basis regarding billing and documentation policies, procedures, and regulations to ensure receipt and analysis of all charges; obtains clarification of conflicting, ambiguous, or non-specific documentation; as well as develop working relationship with operational leaders.
* Perform and monitor all steps in the billing and coding process to ensure maximum reimbursement from patients, third-party payers as well as from special billing arrangements.
* Assist in provider and learner education to ensure coding quality.
* Participate in clinical huddles/didactics and other clinical meetings as requested.
* Assist in the implementation and maintenance of the billing and coding educational materials used in clinical provider and learner training.
* Assist in the implementation and maintenance of population management learner training program addressing inpatient/outpatient chart review.
* Serve as a resource and for all billing and coding matters.
* Understand all aspects of Federally Qualified Health Center (FQHC) coverage, coding, billing and reimbursement of patient services, as well as other third-party payers.
* Understand Medicare, Medicaid and other commercial payer rules and regulations applicable to billing/coding.
* Understand the considerations of coding in Value Based payment contracts.
* Responsible for reviewing and implementing changes from payor bulletins.
* Follow coding/billing guidelines and legal requirements to ensure compliance with federal and state regulations.
* Serve as a coach and mentor for billing team & education team.
* Maintain strictest confidentiality; adhere to all HIPAA guidelines/regulations
REQUIRED QUALIFICATIONS
* Bachelor or Associate degree in any Healthcare related field or equivalent experience.
* Must be a Certified Professional Coder or 5 years equivalent minimum direct professional coding experience. Certified Professional Coder CPC, Certified Risk Adjustment Coder CRC (not required but a plus), Certified Professional Compliance Officer Certification - CPCO (not required but a plus).
* Must have strong knowledge of all guidelines for ICD-10, CPT/HCPCS codes, medical terminology, and billing processes.
* Knowledge of Medical Billing/EHR (Electronic Health Records) systems preferably Medent.
* Knowledge of EOBs (Explanation of Benefit), EFTs (Electronic Funds Transfer) and ERAs (Electronic Remittance Advice).
* Knowledge of Microsoft Office software.
* Must possess team leadership skills and have a positive disposition.
* Must be focused, self-directed, & organized, with problem-solving abilities.
* Accurate and precise attention to detail.
* Excellent verbal and written communication skills.
REQUIRED LICENSES/CERTIFICATIONS
* Certified Professional Coder-CPC (not required but a plus)
* Certified Risk Adjustment Coder-CRC (not required but a plus)
* Certified Professional Compliance Officer Certification - CPCO (not required but a plus)
* FQHC billing helpful (not required but a plus).
* General working knowledge/previous exposure of healthcare environments and auditing concepts, medical billing/operations, medical terminology and clinical documentation.
Senior Professional, Certified Coding Integrity
Scranton, PA jobs
The Senior Certified Coding Integrity Professional is responsible for all aspects of the coding and billing of all inpatient and outpatient claims, as well as all aspects of the CCM billing. The Senior Certified Coding Integrity Professional, a key position in the Revenue Cycle, facilitates the coding as well as manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries and patients related to coding issues. The incumbent will assist in the clarification and development of process improvements and inquiries in order to maximize revenues and will have an onsite presence at the clinical locations.
Requirements
ESSENTIAL JOB DUTIES and FUNCTIONS
While living and demonstrating our Core Values, the Senior Certified Coding Integrity Professional will:
Perform accurate and timely multi-specialty coding for daily claims submission.
Prepare and submit clean claims to third-party payers working closely with clinical team members regarding claims appeal, denial, and resolution.
Perform audits of the daily billing summary reviewing the quality of the clinical documentation and coded data to validate that the documentation supports services rendered while ensuring the integrity of the coding.
Respond timely (either orally or written) to account inquiries from patients, third-party payers, clinical providers, and/or other staff on claims submission.
Interact with physicians, learners and other patient care providers on daily basis regarding billing and documentation policies, procedures, and regulations to ensure receipt and analysis of all charges; obtains clarification of conflicting, ambiguous, or non-specific documentation; as well as develop working relationship with operational leaders.
Perform and monitor all steps in the billing and coding process to ensure maximum reimbursement from patients, third-party payers as well as from special billing arrangements.
Assist in provider and learner education to ensure coding quality. Must have capacity to attend meetings day/evening as needed within assigned areas.
Participate in clinical huddles/didactics and other clinical meetings as requested.
Assist in the implementation and maintenance of the billing and coding educational materials used in clinical provider and learner training.
Assist in the implementation and maintenance of population management learner training program addressing inpatient/outpatient chart review.
Serve as a resource and subject matter expert for all billing and coding matters.
Understand all aspects of Federally Qualified Health Center (FQHC) coverage, coding, billing and reimbursement of patient services, as well as other third-party payers.
Understand Medicare, Medicaid and other commercial payer rules and regulations applicable to billing/coding.
Understand the considerations of coding in Value Based payment contracts.
Responsible for reviewing and implementing changes from payor bulletins.
Follow coding/billing guidelines and legal requirements to ensure compliance with federal and state regulations.
Serve as a coach and mentor for billing team & education team.
REQUIRED QUALIFICATIONS
Bachelor or Associate degree in any Healthcare related field or equivalent experience.
Must be a Certified Professional Coder with 7-10 years minimum direct professional coding experience. Certified Professional Coder CPC, Certified Risk Adjustment Coder CRC (not required but a plus), Certified Professional Compliance Officer Certification - CPCO (not required but a plus).
Must have strong knowledge of all guidelines for ICD-10, CPT/HCPCS codes, medical terminology, and billing processes.
Knowledge of Medical Billing/EHR (Electronic Health Records) systems preferably Medent.
Knowledge of EOBs (Explanation of Benefit), EFTs (Electronic Funds Transfer) and ERAs (Electronic Remittance Advice).
Knowledge of Microsoft Office software.
Must possess team leadership skills and have a positive disposition.
Must be focused, self-directed, & organized, with problem-solving abilities.
Accurate and precise attention to detail.
Excellent verbal and written communication skills.
REQUIRED LICENSES/CERTIFICATIONS
Certified Professional Coder-CPC
Certified Risk Adjustment Coder-CRC (not required but a plus)
Certified Professional Compliance Officer Certification - CPCO (not required but a plus)
PREFERRED QUALIFICATIONS
FQHC billing helpful (not required but a plus).
General working knowledge/previous exposure of healthcare environments and auditing concepts, medical billing/operations, medical terminology and clinical documentation.
Registered or Certified Medical Coder - Flexible PT Scheduling
Philadelphia, PA jobs
Job DescriptionLocation: Philadelphia, PA 19122Date Posted: 12/16/2025Category: ClinicalEducation: None
One of our clients, a well-known hospital in Philadelphia, is urgently seeking a Medical Coder! Delta-T Group has been in business for over 35 years, and connects professionals with client opportunities within the special education, social service, behavioral health, and disability sectors.
CLIENT'S AVAILABLE HOURS
*Flexible Scheduling & Create your own schedule!
*Work up to 10 hours each week!
MUST BE CERTIFIED OR REGISTERED!
*AHIMA (American Health Information Management Association)
*CCS (Certified Coding Specialist)
*RHIT (Registered Health Information Technician)
*RHIA (Registered Health Information Administrator)
ROLE RESPONSIBILITIES
*Complies with legal requirements regarding coding procedures and practices
*Assigns and sequences all codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes
*Conducts audits and coding reviews to ensure all documentation is accurate and precise
*Ensures codes are accurate and sequenced correctly in accordance with government and insurance regulations
*Follows up with the provider on any documentation that is insufficient or unclear
*Communicates with other clinical staff regarding documentation
*Searches for information in cases where the coding is complex or unusual
*Receive and review patient charts and documents for accuracy
*Reviews the previous day's batch of patient notes for evaluation and coding
*Ensures that all codes are current and active
*Collaborate with billing department to ensure all bills are satisfied in a timely manner, review any issues related to coding preventing timely payment/billing of claims
*Communicates with insurance companies, about coding errors and disputes if necessary
*Contacts physicians and other health care professionals with questions about treatments or tests given to patients with regard to coding procedures
Interested? Reply today to speak to a Recruiter!
DTG ADVANTAGES
Establish a relationship with one of the nation's largest referral agencies for behavioral-health.
Compensation processed weekly.
Increase or decrease your schedule at your discretion: choose opportunities that best fit your schedule.
Accessibility to grow professionally.
Access to a broad array of client opportunities.
DTG'S COMPANY OVERVIEW
Delta-T Group's mission is to provide cost-effective, reliable referrals, and innovative staffing solutions, for the social services, behavioral health, allied health and special education fields, for the betterment of independent behavioral health professionals seeking new opportunities and those needing care and support.
Title: Registered or Certified Medical Coder - Flexible PT SchedulingClass: Administrative Type: TEMPORARYRef. No.: 1310520-1BC: #DTG101
Company: Delta-T Group, Inc.Contract Contact: Contract Submit PA BehavOffice Email: **************************** Office Phone: ************Office Address: 950 E Haverford Road, Suite 200, Bryn Mawr, PA 19010
About Us: Each Delta-T Group office is separately incorporated. Delta-T Group is a referral service for self-employed independent contractors seeking behavioral healthcare education and social service supplemental marketplace opportunities. Delta-T cannot guarantee any number or duration of referrals or opportunities as a result of your registration. When and if opportunities become available, you may accept or decline such referrals at your sole discretion.
Easy ApplyCertified Peer Specialist-HOPE
Philadelphia, PA jobs
Full-time Description
At COMHAR, it's our mission to provide health and human services that empower individuals, families and communities to live healthier, self-determined lives. We are currently looking for an Certified Peer Specialist for our HOPE program.
The HOPE (Helping Opportunities for People's Empowerment) program is a site and community based psychiatric rehabilitation program that is part of COMHAR's CIRC (Community Integrated Recovery Center) model for adults and seniors.
Responsibilities:
Act as a role model to persons in recovery to inspire hope, share life experiences and lessons learned as a person in recovery
Engage individuals who may be at-risk and provide stage-appropriate recovery education and supports, e.g., usage of the leveling system and evidence based practice
Assist in the orientation process for persons who are new to receiving mental health and substance use disorders services
Assist in development and implementation of educational and support groups, activities deemed beneficial by the program community, e.g., warm line, calendar of events, etc.
Introduce and link individuals to community resources and peer supports outside of the facility to promote community integration, e.g., public transportation training, computer educational/G.E.D. classes, vocational services, (OVR, job training), health and wellness, banking, and financial entitlements, etc.
Actively participate in team meetings and promote a recovery perspective as a key component of all discussions
Requirements
Requirements:
HS/GED + Certified Peer Specialist (CPS) Certification, Experience working with people who have co-occurring challenges, Mental Health, and Substance Abuse
1 year experience of MH direct service
This can be paid or volunteer work experience in MH direct care. Forensic training is a plus
We are proud to be an EEO employer M/F/D/V. We maintain a drug-free workplace. COMHAR, Inc. is a not-for-profit community based health and human service organization founded in 1975. We do not discriminate in services or employment on the basis of race, color, religion, ancestry, national origin, sex, sexual orientation, gender identity, age, disability, past or present receipt of disability-related services or supports, marital status, veteran status, or any other class of persons protected by federal, state or local law.
IDD Qualified Professional, Clear Creek ICF
Certified professional coder job at RHA Health Services
We are hiring for:
IDD Qualified Professional, Clear Creek ICF
Type:
Regular
If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual, developmental disabilities, and people facing mental health, and substance use challenges, join our team at RHA Health Services!
A Qualified Professional Is a subject expert that serves as the primary individual contributor, coordinating and monitoring the array of services and supports needed to address each person's goals and desired outcomes as identified through the personal outcome interview, including health and well-being, psychological, and promotion of personal independence. The QP assists each person in identifying and communicating his or her requests and needs for services and supports. The QP supervises, integrates and coordinates person centered plans, and monitors progress towards personal, clinical, and functional outcomes. The QP initiates periodic reviews, investigations, modifications and adjustments by soliciting the person's feedback as the person wants and needs change. May supervise the work of others. Typically reports to the Administrator.
Education, Licensure, and Experience required for the position include: Qualified Professional must have a four-year degree in a human service field and two years of experience or a four-year degree in other fields with four years of experience or hold a license in a human service profession. Graduate of a college or university with a Master's degree in a Human Service field preferred.
Physical requirements to perform essential functions of the job included:
Regularly required to lift 10 lbs. Must be able to lift a minimum of 15 lbs. Must be able to pull minimum of 10 lbs. Must be able to squat, kneel, crawl, crouch, climb, and stoop. Must be able to regularly use hands to finger, handle, or feel objects, tools, or controls. Required to regularly stand and walk. Must be able to demonstrate proficiency in CPR from the floor level requiring to work on hands, knees, bending, standing and lifting. Vision requirements include close vision, distance vision, and peripheral vision. Must be able to talk and hear.
If you are a positive and personable individual looking for a satisfying and fun opportunity to make a real difference in the lives of people with intellectual and developmental disabilities, join our team at RHA Health Services!
We are seeking an organized and positive Human Services / Support Coordinator or Qualified Professional to coordinate and monitor the array of services and supports needed to address the goals and desired outcomes of the people we serve.
As a Human Services / Support Coordinator or Qualified Professional with RHA, you will supervise Group Home Managers and Direct Care Associates as you spend time at our residential, vocational and day center locations to train staff on aspects of residential management and direct care.
Job Responsibilities
As a Human Services / Support Coordinator or Qualified Professional with RHA, you will serve as the center of the interdisciplinary service team, which consists of nurses, Direct Care Associates, the Administrator and Group Home Manager, to guide the development of person-centered plans and overall programs based on the information you gain from interviewing the people we serve. You will also complete incident reports and employee performance evaluations.
Additional responsibilities of the Qualified Professional include:
Assisting each person we support to identify and communicate his or her requests and needs for services and supports through direct interviews
Supervising, integrating and coordinating person-centered plans and monitoring progress towards personal, clinical and functional outcomes
Initiating periodic reviews, investigations, modifications, and adjustments by soliciting the feedback of the people we support as their needs and goals change
Reviewing assessments completed by the people we support and other members of the interdisciplinary team to best help the people we support to meet their full potentials
Supervising and writing the person-centered plan based on assessments, interviews, and observations
Overseeing many aspects of residential activity, including home appearance, leisure materials, cleanliness, and community integration to ensure that the people we support are healthy and safe
Visiting vocational centers, residential homes and any other area RHA provides services in to assess how person-centered plans are implemented
Reporting to the Administrator and working closely with colleagues to maintain communication and provide feedback, standardize procedures, expedite person-centered plan implementation and workflow and improve employee performance
Monitoring activities to ensure that quality assurance and/or state survey improvements are being made
Helping to recruit, hire, train and dismiss Group Home Managers
Serving as the link between the people we serve and their families and legal guardians to gain approval for services provided
Job Requirements:
Our ideal Qualified Professional is an excellent communicator and cooperative team player who excels at interviewing the people we serve to learn about their interests and goals, even individuals who cannot communicate verbally. You must also be detail-oriented and have excellent written communication skills to develop and disseminate person-centered plans.
Additional requirements for Qualified Professional include:
Bachelor's degree in Social Work, Social Services, Human Services or Special Education required; Master's degree a plus
Minimum 2 years experience working with persons with intellectual and/or developmental disabilities required; 1-year experience if paired with Master's degree
Working knowledge of applicable regulations that apply to our service offerings
Valid driver's license, auto insurance, and reliable transportation
Ability to pass a drug screen and background check
Ability to lift between 20 and 50 pounds and meet the physical requirements of performing CPR
Supervisory/management experience and experience writing person-centered (individualized service) plans preferred
Benefits
As a Human Services / Support Coordinator with RHA, you can expect a competitive market-based salary and an excellent benefits package. We are committed to maintaining a strong and dedicated workforce through innovative recruitment, comprehensive screening and competitive benefits and compensation programs.
Our leadership development and training is specifically designed to develop, retain and reward qualified and professional employees. Human Services / Support Coordinator can pursue education through our tuition reimbursement program and move into quality
assurance or management roles in various areas of RHA.
The greatest benefit of a career at RHA is the difference you make in the lives of the people we serve. Our holistic person-centered approach and focus on quality assurance, respected throughout the Human Services industry, leads our employees to see the people we serve less as clients and more as friends.
The comprehensive compensation and benefits package for full-time employees includes:
Competitive compensation program including regular performance feedback and coaching
Healthcare insurance: Medical, Dental, Vision, Disability, Voluntary Benefits, Employee Assistance Program, Telemed and Pharmacy Insurance, Health Advocate service which assists employees find doctors, schedule appointments, estimate costs, answer medical/prescription questions, resolve medical claims issues and basically does the leg-work for employees
Offering free diabetic medication and supplies
401(k) retirement savings program with Wells Fargo
Paid Time Off
Company sponsored Life and AD&D Insurance
Extensive Wellness Programs including company paid scholarships for healthy weight management and nicotine cessation, several wellness challenges and rewards through the year.
Free Annual Health Screening and Wellness coaching event.
Discounted medical premiums for nicotine free employees.
Free CPR, first aid, and job-specific training opportunities
Opportunity to make a difference in the lives of the people that you serve!
Pre-employment screening:
Complete criminal background
Name checked in the registries. (OIG exclusions database, Child Abuse Registry, and Offenders Against Individuals with Developmental Disabilities)
Drug testing
Education verification and other credentialing based on position requirements.
Proof of employment history or references (if required)
Positions that require driving Proof of driver's license, driver's insurance, and vehicle, IF required for providing transportation for individuals.
We offer the following benefits to employees:
Payactiv: early access to the money you've earned from hours you've already worked, before payday!
Employee perks and discount program: to help you save money!
Paid Time Off (full-time employees only)
Health/Insurance (full-time employees only)
401(k) retirement savings program
Wellbeing Programs: Physical, Emotional and Financial
Chronic Disease management programs for hypertension and diabetes (for qualifying employees)
Training: Free CPR, first aid, and job-specific training opportunities
*contract/contingent workers and interns do not qualify for any of the above benefits
EEO Statement RHA is an equal opportunity employer. In addition, we provide reasonable accommodation to qualified employees who have protected disabilities to the extent required by applicable laws, regulations, and ordinances. If you are an individual with a disability and need a reasonable accommodation to participate in the application process, please contact our solutions center.
About RHA:
At RHA Health Services, we help individuals with intellectual and developmental disabilities, mental health and/or substance use needs live their best lives. Our mission is to provide a safe and healthy environment while creating opportunities for personal outcomes.
For over 30 years, the people we serve and support have remained at the very center of everything we do. RHA currently provides services in North Carolina, Georgia, Pennsylvania, Tennessee, and New Jersey.
If you are ready to make a difference in the lives of people we serve and support apply to join the team today.
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