Coding Specialist II Medical College of WisconsinCoding Specialist IIMilwaukee, WisconsinResolve edits for electronic charges, following established policies and procedures to ensure that all data elements (claim requirements – CPT, ICD-10 CM, modifiers, provider, billing area, etc.) are applied. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.
Prepay Coding Consultant UnitedHealth Group IncPrepay Coding ConsultantPlymouth, MA$24–$43 / yearThe fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. We have received recent reports of fraudulent LinkedIn messages and emails alleging or claiming to be sent from UnitedHealth Group, UnitedHealthcare, or Optum Executives.
NewCoding Client Success Specialist WellSky CorpCoding Client Success SpecialistRemoteWork with internal teams to support quality plans and assist with providing the appropriate tools and resources to internal coding teams and global partners. The Coding Client Success Specialist is responsible for serving as a trusted partner for clients by providing training and addressing issues related to medical coding.
Coding Quality Specialist 2: PB Outpatient - OB/GYN & Primary Care University of VirginiaCoding Quality Specialist 2: PB Outpatient - OB/GYN & Primary CareCharlottesville, VAAssigns and reviews the accuracy of the diagnostic codes (ICD-10-CM) and CPT codes for providers' Evaluation and Management Services (E/M), procedures and diagnostic testing in all settings for purposes of billing, research and providing information to government and regulatory agencies. Reviews and resolves charge sessions that fail charge review edits, claim edits and follow-up work queues, identifies areas of opportunity based on findings/resolution of errors.
Manager, Coding Compliance - Pediatrics Central Administration Washington University in St LouisManager, Coding Compliance - Pediatrics Central AdministrationSt. Louis, MO$68,100–$105,500 / yearThis leader is responsible for overseeing a team reviewing complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Skills: Accounting, Code Compliance, Coding Compliance, Compliance Management, Healthcare Auditing, Health Care Regulation, Health Insurance Portability & Accountability Act (HIPAA), ICD Coding, Medical Billing and Coding, Organizing, Supervisory Management, Trend Analysis, Trend Reporting.
Coding Quality Coach WellSky CorpCoding Quality CoachThe scope of this job involves providing service to clients and the international and US-based coding and audit teams by providing appropriate feedback and guidance on audited records and agency requested revisions. The Coding Quality Coach is responsible for performing medical coding quality audit assignments and addressing agency-specific quality concerns.
Coding Quality Assurance Specialist II Texas Children's HospitalCoding Quality Assurance Specialist IIHouston, TXIn this position, you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. Ascertains the accuracy of the physicians'' E/M and procedure coding to their documentation, completes the auditing reporting tool, and provides feedback to the education team and/or provider.
RCS CPT Coding Expert NEW Indiana University Health IncRCS CPT Coding Expert NEWIndianapolis, INThis position exists to provide accurate and timely clinical data for billing and optimal reimbursement, quality assessment, comparative databases, physician profiling, and administrative purposes. This position is responsible for, but not limited to, physician coding, outpatient facility coding, or rectifying pre-bill coding related edits and coding related denials.
Investigator, Special Investigative Unit Coding (Remote) Molina Healthcare IncInvestigator, Special Investigative Unit Coding (Remote)CARemoteWorking knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.). In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
Investigator, Special Investigative Unit Coding Molina Healthcare IncInvestigator, Special Investigative Unit CodingFLWorking knowledge of local, state and federal laws and regulations pertaining to health insurance, investigations and legal processes (commercial insurance, Medicare, Medicare Advantage, Medicare Part D, Medicaid, Tricare, Pharmacy, etc.). In some states, 5 years of experience working in a fraud, waste and abuse (FWA)/special investigations unit (SIU)/fraud investigations role may be required (dependent on state/contractual requirements).
SUPERVISOR CODING Carson Tahoe Regional HealthcareSUPERVISOR CODINGCarson City, NVWe serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations. The Outpatient Coding Supervisor provides oversight and direction for the activities of the Outpatient Coding team of the Health Information Management Department to meet the quality, utilization, and financial needs of the organization.
Coding Quality Auditor Houston Methodist HospitalCoding Quality AuditorWAHouston Methodist also includes a research institute; a comprehensive residency program; international patient services; freestanding comprehensive care clinics, emergency care and imaging centers; and outpatient facilities. The health system consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the Texas Medical Center, seven community hospitals and one long-term acute care hospital throughout the Greater Houston metropolitan area.
Manager, Enterprise Hospital Coding Quality & Education University of VirginiaManager, Enterprise Hospital Coding Quality & EducationCharlottesville, VAExtensive, expert-level knowledge of inpatient coding principles and conditions affecting hospital quality measures such as Hospital Acquired Conditions (HACs); Patient Safety Indicators (PSIs); Present on Admission (POA) requirements; Hierarchical Condition Categories (HCCs). The Manager oversees coding quality reviews, second-level audits, and targeted education for coding staff, and collaborates closely with Coding Operations, CDI, Quality, Compliance, and Revenue Cycle teams.
Coding Quality Specialist 3 - PB Neurosurgery University of VirginiaCoding Quality Specialist 3 - PB NeurosurgeryCharlottesville, VAAssigns and reviews the accuracy of the diagnostic codes (ICD-10-CM) and CPT codes for providers' Evaluation and Management Services (E/M), procedures and diagnostic testing in all settings for purposes of billing, research and providing information to government and regulatory agencies. Monitors, analyzes, and resolves charge review, claim edit, and coding-related denial trends and shares trends with supervisor, managers, and team members to facilitate root cause analysis and continuous process improvement.
Network Coordinator, Coding Audit & Education St. Luke's University Health NetworkNetwork Coordinator, Coding Audit & EducationAllentown, PAEDUCATION: Must maintain and be credentialed in at least ONE of the following AHIMA and/or AAPC recognized Professional Coding Certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Auditor (CPMA); Certified Professional Coder (CPC); Certified); Certified Coding Specialist (CCS); In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Reviews and validates coded medical records to assess coding accuracy, documentation integrity, compliance risk, and reimbursement impact related to ICD-10-CM/PCS, CPT/HCPCS, DRG/APC assignment, modifiers, and applicable payment methodologies.
NewSupervisor Coding - Hybrid (Museum District) Houston Methodist HospitalSupervisor Coding - Hybrid (Museum District)Houston, TXRemains current on all coding procedures and assignments and implements training and coaching plans for all levels of staff to provide continuous coding education as it relates to International Classification of Diseases 10th Revision (ICD-10), Current Procedural Terminology (CPT), and The Healthcare Common Procedure Coding System (HCPCS) coding and ensures consistency between departments and coders. Assists in the management of essential and non-essential department expenditures to achieve financial target through optimization of productivity, supply/resource efficiency, minimizing incidental overtime and overtime percentage, and other areas according to department specifications.
Behavioral Health Medical Coding & Compliance Specialist Community Reach CenterBehavioral Health Medical Coding & Compliance SpecialistWestminster, CO$65,000–$75,000 / yearCreates, communicates and implements templates, systems and processes to ensure clinical documentation at the Center is in accordance with internal policies and procedures, Centers for Medicare and Medicaid Services (CMS), State and Federal regulations, third-party payors, and American Medical Association (AMA) guidelines. Essential Functions: Designs and implements internal compliance audits, regularly monitoring accuracy and adherence to documentation requirements in collaboration with Utilization Manager to support continuous quality improvement and compliance as identified in the Quality Management Plan (QMP).
CODING DIAGNOSTICIAN Carson Tahoe Regional HealthcareCODING DIAGNOSTICIANCarson City, NVRemoteAssigns and audits compliant, complete, and accurate APC's, ICD-9-CM diagnosis codes, CPT/HCPCS procedure codes, E/M facility level codes, and modifiers for the hospital outpatient and inpatient services to include Cardiac Catheterization, Lab, and Electrophysiology, along with the technical codes. Seeks out missing information and creates complete records, including items such as disease and procedure codes, point of origin code, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations.
Home Health Quality Assuranc / Coding Specialist Green Meadows Home Health Care IncHome Health Quality Assuranc / Coding SpecialistSanta Ana, CAFull timeThe Home Health Quality Assurance (QA) / Coding Specialist is responsible for reviewing clinical documentation to ensure compliance with Medicare Conditions of Participation (CoPs), state and federal regulations, and agency policies. This position performs ICD-10 coding, OASIS review, chart audits, and quality assurance activities to support accurate reimbursement, regulatory compliance, and high-quality patient care.
Remote Medical Coding Review Consultant HEALTH INFORMATION ASSOCIATES, INC.Remote Medical Coding Review ConsultantRemoteReviews additional chart documentation to validate admission order, admission and discharge dates, point of origin, patient status, present on admission indicator, and coder queries to ensure accuracy. Uses various software applications, groupers, 3M and other coding tools to analyze and ensure appropriate codes, sequencing and edits.