Remote Certified Coder
Lubbock, 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
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.
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.
Remote Certified Coder
San Antonio, 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
Remote Certified Coder
El Paso, 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
Remote Certified Coder
Austin, 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
Remote Certified Coder
Dallas, 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
Remote Certified Coder
Arlington, 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
Remote Certified Coder
Corpus Christi, 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
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
Medical Coder
Sacramento, CA jobs
Duration :: 13 Weeks Contract
Seeking experienced Professional Fee (Pro Fee)-focused Coding Educators to support large-scale chart review, coding accuracy validation, physician education, and documentation improvement initiatives. These roles are high-visibility and require strong communication and presentation skills to engage directly with clinicians and support client revenue cycle, audit, and education functions.
Candidates must live within the client geographic footprint and be available for occasional on-site work and local travel.
Positions are structured as 13-week temp-to-hire with conversion opportunities.
Key Responsibilities
Coding Education & Training
Deliver physician and coder education for assigned groups, with emphasis on Pro Fee (ASC, surgery, outpatient) environments.
Facilitate individual and group training sessions; must be comfortable presenting to clinicians.
Address provider and coder questions related to documentation standards, audit findings, and coding requirements.
Audits & Accuracy Monitoring
Perform focused coding audits and detailed chart reviews to validate CDI opportunities and coding accuracy.
Identify coding trends, discrepancies, and risks; partner with leadership to build targeted education plans.
Support revenue cycle initiatives tied to audit readiness, pipeline goals, and CLARO engagement.
Documentation & Compliance Support
Improve documentation integrity and reduce variation in coding practices across the organization.
Implement education initiatives to strengthen documentation quality and coding accuracy.
Collaborate with coding leads to develop education aligned with compliance expectations and organizational standards.
Required Qualifications
Certifications (must have; strong preference for Pro Fee experience):
CPC (AAPC)
CCS or CCS-P (AHIMA)
Experience:
Demonstrated success in Pro Fee coding, education, and audit environments.
Proven ability to engage directly with physicians and present complex coding concepts clearly.
Experience conducting chart reviews and coding accuracy audits.
Work Model Requirements:
Must reside within the client footprint (California).
Able to support occasional on-site needs and local travel.
Willing/eligible to convert to a permanent role after the 13-week assignment.
Preferred Qualifications
CDEO or CDIP (documentation/education alignment)
Bachelor's degree
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit ************************
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Recruiter Details:
Recruiter name: Ajeet Kumar
Recruiter's email id : *****************************
JobDiva ID :: JobDiva # 25-54020
Remote Certified Coder
Fort Worth, 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
Medical Records Technician (Inpatient Facility) - VA Federal Contract - 248653
Houston, TX jobs
Remote Medical Coder (Inpatient Facility) - VA Federal Contract
Location: 100% Remote (Work from Home) Schedule: Monday - Friday | 8:00 AM - 4:30 PM CT Employment Type: Full-Time Federal Contract
We are seeking an experienced Medical Records Technician - Coder for a high-volume inpatient facility within the VA healthcare system. This is a fully remote, investigative coding position requiring high accuracy and a deep understanding of complex inpatient documentation.
Core Responsibilities
Review inpatient medical records for accurate and complete coding.
Assign ICD-10-CM, ICD-10-PCS, DRGs, CPT, and HCPCS codes.
Perform 100% data validation of assigned encounters.
Query clinicians for documentation clarification and ensure support for coded diagnoses.
Utilize VA-specific software including CPRS, VistA, and VIRR.
Required Qualifications
Credential: Must hold one of the following: RHIT, RHIA, CCS, CCS-P, or CPC.
Experience: Minimum of three years of continuous inpatient coding experience in a large facility (tertiary care or academic medical center).
Technical Skills: Proficiency in ICD-10 CM/PCS, DRGs, and CPT/HCPCS.
Citizenship: Must be a U.S. Citizen with proficient English skills.
Why Apply?
100% Remote: Work from home with VA-provided secure access.
Stability: Predictable M-F daytime schedule with no weekends or holidays.
Mission: Support the health records and diagnostic integrity for U.S. Veterans.
Interested in joining a mission-driven team? Apply today!
Billing and Coding Specialist
Rochester, NY jobs
Scion Staffing has been engaged to conduct a search for a Billing and Coding Specialist for an established clinic in Rochester, NY. This position is 100% onsite at the clinic's Rochester office.
This Billing & Coding Specialist position supports daily billing operations for a high-volume clinic, handling claims, insurance follow-up, and coding for routine and interventional procedures. The role is ideal for someone with strong billing, denial management, and revenue cycle experience seeking long-term stability. This is a direct hire opportunity.
PERKS:
Competitive compensation at $30-$34/hr
Hands-on training and mentorship in interventional psychiatry billing
All equipment provided onsite
Collaborative and inclusive clinic culture
Long-term conversion opportunity with room to grow
RESPONSIBILITIES:
Process claims, manage insurance follow-up, and resolve denials
Code and submit claims for psychiatric and interventional procedures
Assist with backlog cleanup and recurring billing issue resolution
Monitor cash flow trends and escalate problem areas
Coordinate with clinicians on documentation, copays, and authorizations
Maintain accurate records in EHR and clearinghouse platforms
QUALIFICATIONS:
Experience with medical billing, coding, or RCM workflows
Knowledge of insurance portals and denial management practices
Strong attention to detail, accuracy, and problem-solving
Ability to manage high-volume billing with steady, reliable execution
Comfortable learning systems such as Jane App, ClaimMD, and clearinghouses
COMPENSATION AND BENEFITS:
This role offers $30-$34/hr, depending on experience level.
Benefits are available and may include health, dental, vision, 401(k), sick time, and additional offerings based on eligibility.
ABOUT OUR SEARCH FIRM:
Scion Staffing is a national award-winning staffing firm! Since 2006, we have had the pleasure of successfully placing thousands of talented professionals with amazing career opportunities. Through our innovative team building and recruiting solutions, we bridge the gap in executive leadership searches, direct hire recruiting, interim leadership placement, and temporary professional staffing. We are proud to be part of the Forbes lists of the Best Recruitment Firms and the Best Executive Search Firms in America. Additionally, Scion has been recognized as a ClearlyRated Best of Staffing firm as well as a top recruitment firm by The Business Times. Additional information about our firm can also be found online.
Scion Staffing, Inc. is an equal opportunity employer and service provider and does not discriminate based on race, religion, gender, gender identity, national origin, citizenship status, sexual orientation, disability, political affiliation or belief, or any other protected class. We are committed to the principles of Equal Opportunity Employment and are dedicated to making employment decisions based on merit and value, for ourselves, our client companies, and the candidates we represent. For opportunities located in a region that have enacted fair chance, arrest or conviction-based employment ordinances, Scion Staffing proactively follows the enacted guidance and considers for employment all qualified applications with arrest and conviction records. We engage in socially conscious business practices and believe that diverse, equitable, inclusive, and non-biased talent and recruitment processes are foundational to the success of Scion as well as every client organization with whom we partner.
Medical Claims/ Appeals Specialist
Denison, TX jobs
Medical Claims/ Appeals Specialist
Duration: 6 months+ temp-to-hire!!!
Pay rate: $24/hr on W2
Note:
REMOTE role with possibility
The schedule for the training period will be a set schedule: 8:00am to 4:30pm EST time.
Training will be 5-6 weeks. After training, the candidates may choose to flex start time of 6:00 AM EST to 10:00 AM EST.
Candidates can work from 50 miles (or 1 hour) from any NGS or PulsePoint locations (EXCEPT the state of CA). These are not HYBRID requirements while working temp. However, if/when they convert temp-hire, they must be willing to work onsite depending on what the HYBRID requirements for FTE associates are at the time of conversion (usually 1-3 days per week).
JOB DESCRIPTION:
This is an entry level position in the Appeals Department that reviews, analyzes and processes non-complex pre-service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (Part A & B) related to clinical and non-clinical services, quality of service, and quality of care issues to include executive and regulatory grievances.
The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments.
Requires a High school diploma or GED; up to 2 years' experience working in grievances and appeals, claims, or customer service or any combination of education and/or experience which would provide an equivalent background.
Familiarity with medical coding and medical terminology, demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, all of the company's internal business processes, and internal local technology strongly preferred.
Preferred Skills: Medical Terminology, Letter Writing, Claims Experience, Appeals Experience
Primary duties may include, but are not limited to:
Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language.
Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing and/or medical staff for review.
The grievance and appeal work is subject to applicable accreditation and regulatory standards and requirements.
As such, the analyst will strictly follow department guidelines and tools to conduct their reviews. Analyzes and renders determinations on assigned non-complex grievance and appeal issues and completion of the respective written communication documents to convey the determination.
Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information.
I'd love to talk to you if you think this position is right up your alley, and assure a prompt communication, whichever direction.
If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you.
Recruiter Name: Gurjant “Gary” Singh
Title: Lead Recruiter
Email: **********************************
Medical Claims/ Appeals Specialist
Tampa, FL jobs
Medical Claims/ Appeals Specialist
Duration: 6 months+ temp-to-hire!!!
Pay rate: $24/hr on W2
Note:
REMOTE role with possibility
The schedule for the training period will be a set schedule: 8:00am to 4:30pm EST time.
Training will be 5-6 weeks. After training, the candidates may choose to flex start time of 6:00 AM EST to 10:00 AM EST.
Candidates can work from 50 miles (or 1 hour) from any NGS or PulsePoint locations (EXCEPT the state of CA). These are not HYBRID requirements while working temp. However, if/when they convert temp-hire, they must be willing to work onsite depending on what the HYBRID requirements for FTE associates are at the time of conversion (usually 1-3 days per week).
JOB DESCRIPTION:
This is an entry level position in the Appeals Department that reviews, analyzes and processes non-complex pre-service and post service grievances and appeals requests from customer types (i.e. member, provider, regulatory and third party) and multiple products (Part A & B) related to clinical and non-clinical services, quality of service, and quality of care issues to include executive and regulatory grievances.
The analyst may serve as a liaison between grievances & appeals and /or medical management, legal, and/or service operations and other internal departments.
Requires a High school diploma or GED; up to 2 years' experience working in grievances and appeals, claims, or customer service or any combination of education and/or experience which would provide an equivalent background.
Familiarity with medical coding and medical terminology, demonstrated business writing proficiency, understanding of provider networks, the medical management process, claims process, all of the company's internal business processes, and internal local technology strongly preferred.
Preferred Skills: Medical Terminology, Letter Writing, Claims Experience, Appeals Experience
Primary duties may include, but are not limited to:
Reviews, analyzes and processes non-complex grievances and appeals in accordance with external accreditation and regulatory requirements, internal policies and claims events requiring adaptation of written response in clear, understandable language.
Utilizes guidelines and review tools to conduct extensive research and analyze the grievance and appeal issue(s) and pertinent claims and medical records to either approve or summarize and route to nursing and/or medical staff for review.
The grievance and appeal work is subject to applicable accreditation and regulatory standards and requirements.
As such, the analyst will strictly follow department guidelines and tools to conduct their reviews. Analyzes and renders determinations on assigned non-complex grievance and appeal issues and completion of the respective written communication documents to convey the determination.
Responsibilities exclude conducting any utilization or medical management review activities which require the interpretation of clinical information.
I'd love to talk to you if you think this position is right up your alley, and assure a prompt communication, whichever direction.
If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you.
Recruiter Name: Gurjant “Gary” Singh
Title: Lead Recruiter
Email: **********************************
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.
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.
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.
Building Code & Zoning Specialist
New York, NY jobs
Building Code & Zoning Specialist New York, NY | Hybrid | Full-Time
Build Your Career While We Build the Future
About Us At Milrose Consultants, LLC, we build more than buildings-we build trust, expertise, and lasting partnerships. As leaders in building code and zoning consulting, we help shape the skylines of tomorrow through excellence in compliance and development strategy.
Position Overview We're seeking a Building Code & Zoning Specialist to join our Code & Zoning team. In this role, you'll serve as a subject matter expert, guiding clients through complex building code and zoning requirements. You'll collaborate with design professionals, project teams, and regulatory agencies to ensure compliance and support successful project outcomes.
What You'll Do
Review design plans for compliance with NYC and regional zoning and building codes.
Conduct due diligence for proposed developments and prepare technical documentation.
Advise clients on achieving compliance and resolving code-related issues.
Represent Milrose at project and agency meetings; liaise with city, state, and town officials.
Prepare variance requests, determinations, and zoning/building code reports.
Train staff on code updates and best practices.
Support business development by identifying new opportunities and contributing to service growth.
What You'll Bring Required:
Bachelor's degree in Architecture, Engineering, Urban Planning, or related field.
10+ years of experience on complex, large-scale projects.
Strong knowledge of NYC Zoning Resolution, Building Code, and regional codes.
Excellent organizational, communication, and problem-solving skills.
Proficiency in Microsoft Word and Excel.
Preferred :
RA, PE, or NYC Department of Buildings Class 2 Filing Representative License.
Familiarity with construction methodologies and approval processes.
Work Environment & Schedule
This position is based in New York, NY, with a hybrid schedule.
Standard working hours are Monday-Friday, 8:30am - 5:00pm.
Minimal travel may be required.
Compensation & Benefits
Salary range: $115,000 - $125,000, based on knowledge, skills, and experience.
Comprehensive health, dental, and vision, insurance, and 401K plan with a match.
Paid time off: Holiday, vacation, sick time, personal and birthday.
Career development and growth opportunities.
Milrose Consultants, LLC is an Equal Opportunity Employer . We are committed to creating an inclusive environment for all employees and applicants. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other characteristic protected by law.
Milrose Consultants, LLC is committed to providing reasonable accommodation for qualified individuals with disabilities. If you need assistance or an accommodation due to a disability, please contact us at *******************.
Notice to third party agencies:
Please refrain from calling or emailing our team directly. Our in-house Talent Acquisition team manages all recruiting operations, including the selection and management of all external suppliers.
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