SINAI HOSPITAL OUTPATIENT CODER LifeBridge HealthSINAI HOSPITAL OUTPATIENT CODERBaltimore, MDRemote$21.06–$39.12 / hourSupport: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support — improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license. Reviews medical records to determine the providers diagnoses/procedures for outpatient records (ER, Infusion, other outpatient) and assigns ICD-10CM/PCS codes or CPT codes to those diagnoses/procedures.
Coding Specialist III - Plastics/Podiatric Surgery MedStar HealthCoding Specialist III - Plastics/Podiatric SurgeryNot Specified, MD$28.76–$48.96 / hourHandles complex coding case review including but not limited to surgical coding (Orthopaedics Cardiac Neurosurgery Otolaryngology etc.) extraction, co-surgery scenarios, multi-visceral transplant cases, comorbidity evaluation. In addition to interacting with physicians on coding issues, ensures that physician encounter forms, the GE IDX billing system and processes are up to date and compliant regarding coding issues.
NewCoding Quality Review Specialist -Inpatient MedStar HealthCoding Quality Review Specialist -InpatientNot Specified, MD$31.28–$56.39 / hourResponsibility includes validating ICD-10-CM/PCS codes by examining medical record documentation the assignment of present on admission (POA) indicators and discharge disposition status. Queries the medical staff and other caregivers as necessary to obtain accurate and complete physician documentation that supports the severity of the patient illness and risk of mortality.
Medical Coder IMSMedical CoderMarylandRemoteExperience in multiple specialties including Behavioral Health, Cardiology, ER, Endocrinology, Gastroenterology, Hematology/Oncology, Infectious disease, Internal medicine, Nephrology, Neurology, OB/Gyn surgery, Ophthalmology, Orthopedic, Orthopedic surgery, Outpatient, Pulmonology, Rheumatology, Sleep medicine, Transplant surgery, or Vascular surgery (preferred). Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting.
Medical Coder Level One PersonnelMedical CoderBaltimore, MarylandMINIMUM REQUIREMENTS: Must be able to complete any additional credentialing as required by the unit/facility, Formal working knowledge equivalent to an Associate's degree (2 years college) in HIM, HIT or related field. Prepares and submits a properly completed management production report to the Supervisor and/or Manager weekly and notifies the manager of problems that impact efforts to perform the job.
Medical Coder III (Cardiology experience require) SavistaMedical Coder III (Cardiology experience require)District of ColumbiaWe partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)Washington, DC$50,460–$65,599 / yearRefer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference. Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only."
Health Care | Life Sciences, Senior Associate - Registered Nurse / Certified Coder Ankura Consulting Group LLCHealth Care | Life Sciences, Senior Associate - Registered Nurse / Certified CoderDCRegistered Nurse with active license, unrestricted license • Bachelor of Science in Nursing from an accredited college/university • Substantial clinical experience with demonstrated ability to interpret clinical documentation and medical necessity • Certified Professional Coder (CPC) with coding experience across inpatient, outpatient, and professional services • Familiar with the revenue cycle process and facility and professional claims • Demonstrates excellent communication skills, both written and oral • Experience managing small projects and teams • Familiar with accessing and identifying clinical documentation in electronic medical record systems • Proficient in Excel, Word, and PowerPoint and able to draft reports and presentations and present findings • Ability to problem solve, multi-task, and prioritize assignments • Understands the importance of privileged and confidential communication • Willingness to travel when needed • Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future. Our clients include academic medical centers, health systems, physician practice groups, post- and sub-acute providers, health plans, pharmacies, and pharmacy benefit management companies, as well as pharmaceutical and medical device manufacturers.
Profee Coder III (Radiology (IR), Vascular and Neurosurgery Coding) SavistaProfee Coder III (Radiology (IR), Vascular and Neurosurgery Coding)District of ColumbiaWe partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results.
Outpatient Coder, Senior University of Maryland Baltimore Washington Medical CenterOutpatient Coder, SeniorBaltimore, MD$28.41–$40.35 / hourPartnering with the University of Maryland School of Medicine, University of Maryland School of Nursing, and University of Maryland, Baltimore, who educate the states future healthcare professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban, and rural communities across the state of Maryland. Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.
SR. OUTPATIENT CODER University of Maryland Baltimore Washington Medical CenterSR. OUTPATIENT CODERBaltimore, MD$28.41–$40.35 / hourPartnering with the University of Maryland School of Medicine, University of Maryland School of Nursing, and University of Maryland, Baltimore, who educate the states future healthcare professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban, and rural communities across the state of Maryland. Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.
Health Care | Life Sciences, Senior Associate - Registered Nurse / Certified Coder Ankura Consulting GroupHealth Care | Life Sciences, Senior Associate - Registered Nurse / Certified CoderWashington DC, District of ColumbiaRemoteOur clients include academic medical centers, health systems, physician practice groups, post- and sub-acute providers, health plans, pharmacies, and pharmacy benefit management companies, as well as pharmaceutical and medical device manufacturers. Our practitioners provide expert witness testimony on commercial disputes involving payers and providers, as well as in matters involving False Claims Act, Anti-kickback, Stark, and FDA disputes and investigations.
SINAI HOSPITAL OUTPATIENT CODER Sinai Hospital of BaltimoreSINAI HOSPITAL OUTPATIENT CODERBaltimore, MDRemoteSINAI HOSPITAL OUTPATIENT CODER in Baltimore, MD - LifeBridge Health Career Site SINAI HOSPITAL OUTPATIENT CODER in Baltimore, MD - LifeBridge Health Career Site Save Job Saved. Support: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support - improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license.
SR. INPATIENT CODER University of Maryland Baltimore Washington Medical CenterSR. INPATIENT CODERBaltimore, MD$30.26–$42.37 / hourPartnering with the University of Maryland School of Medicine, University of Maryland School of Nursing, and University of Maryland, Baltimore, who educate the states future healthcare professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban, and rural communities across the state of Maryland. Strong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability.
Inpatient Coder, Senior University of Maryland Baltimore Washington Medical CenterInpatient Coder, SeniorBaltimore, MD$30.26–$42.37 / hourStrong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability. Partnering with the University of Maryland School of Medicine, University of Maryland School of Nursing and University of Maryland, Baltimore who educate the state's future health care professionals, UMMS is an integrated network of care, delivering 25 percent of all hospital care in urban, suburban and rural communities across the state of Maryland.
Certified Risk Adjustment Coder (CRC), Senior Associate Ankura Consulting Group LLCCertified Risk Adjustment Coder (CRC), Senior AssociateDC$85,000–$200,000 / yearAssociates use their experience and knowledge related in coding, revenue cycle and clinical operations, along with their project management capabilities, to contribute to complex investigations, whistleblower lawsuits, internal investigations, payer/provider disputes, and acquisition due diligence, among others. We combine in-depth operational, compliance, and clinical industry knowledge with exceptional data analytics, information-gathering, and forensic skills enabling us to help our clients and their legal counsel assess and quantify the potential impact of a dispute.
Inpatient Coder Omm IT SolutionsInpatient CoderBaltimore, MarylandRemoteMinimum of 3 years ICS-10-CM/ICD-10-PCS coding and abstracting experience with a Level 1 trauma and rehab hospital or 4 years of experience with coding inpatient hospital medical records required . The Inpatient Coder is responsible for reviewing inpatient medical records and assigning accurate ICD-10-CM and ICD-10-PCS codes in accordance with official coding guidelines, regulatory requirements, and Clint policies.
NewSenior Risk Adjustment Coder & Provider Education Lead Astrana Health ManagementSenior Risk Adjustment Coder & Provider Education LeadAnnapolis, MD$70,000–$85,000 / yearThis full-time role involves conducting high-volume chart reviews to ensure coding accuracy for Medicare and ACA requirements. The position follows a hybrid work structure, requiring occasional travel to provider sites in Maryland.
NewRemote Revenue Integrity Coder & Billing Specialist GuidehouseRemote Revenue Integrity Coder & Billing SpecialistWashington, DCRemote$49,000–$81,000 / yearCompetitive compensation ranges from $49,000 to $81,000 annually, alongside a rich benefits package that includes health insurance and retirement plans.#J-18808-Ljbffr. A leading consulting firm is seeking a Revenue Integrity Coding and Billing Specialist to join their remote team.
NewHybrid Risk Adjustment Coder - HCC Expert CareFirst BlueCross BlueShieldHybrid Risk Adjustment Coder - HCC ExpertBaltimore, MD$51,984–$95,304 / yearCareFirst is looking for a Risk Adjustment Coding Specialist to support the CMS-HCC Medicare Advantage Risk Adjustment and HHS-Risk Adjustment Data Validation audit. This position requires an Associate's Degree in a related field and CCS certification upon hire.
HIM-INPATIENT CODER Sinai Hospital of BaltimoreHIM-INPATIENT CODERBaltimore, MDSupport: A culture of collaboration with resources like unit-based practice councils and advanced clinical education support - improving both workflow efficiency and patient outcomes and allowing you to work at the top of your license. Who We Are: LifeBridge Health is a dynamic, purpose-driven health system redefining care delivery across the mid-Atlantic and beyond, anchored by our mission to "improve the health of people in the communities we serve."
NewPT Instructor Pool - Medical Coding Specialist Program Madison Area Technical College DistrictPT Instructor Pool - Medical Coding Specialist ProgramDCMadison College offers degrees, diplomas, apprenticeships and certificates in Architecture & Engineering; Arts, Design & Humanities; Business; Construction, Manufacturing & Maintenance; Culinary, Hospitality & Fitness; Education & Social Services; Health Sciences; Information Technology; Law, Protective & Human Services; Science, Math & Natural Resources; and Transportation. This includes developing a relevant and progressive curriculum, designing and implementing effective learning strategies and environments, delivering instruction of high quality, assessing student learning, advising students, and participating in college service activities at the department, division and college levels.
Senior Medical Coding Specialist (Remote) Blue Cross and Blue Shield AssociationSenior Medical Coding Specialist (Remote)DCRemote$67,464–$133,991 / yearThis role utilizes coding expertise, combined with medical policy, credentialing, and contracting rules knowledge, to build effective guidelines and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity. Consults with various teams, including the Practice Transformation Consultants, Medical Policy Analysts and Provider Networks colleagues to interpret coding and documentation language and respond to inquiries from providers.
Certified Medical Billing /Coding Specialist Moore OBGYNCertified Medical Billing /Coding SpecialistForestville, MDThe ideal candidate will have strong OB/GYN coding knowledge, payer compliance expertise, and the ability to manage accounts receivable efficiently. Moore OB/GYN is seeking an experienced and detail-oriented Certified Medical Billing & Coding Specialist to join our growing team.
Payment and Medical Policy Coordinator (Remote) Blue Cross and Blue Shield AssociationPayment and Medical Policy Coordinator (Remote)DCRemote$51,264–$101,816 / yearThis role ensures business readiness across impacted functions, including claims, configuration, provider communications and operations, and provides support during testing, implementation, and post-implementation validation. QUALIFICATIONS: Education Level: Bachelor''s Degree in Health Administration, Business, Finance or related discipline OR in lieu of a Bachelor''s degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
Medical Coding Specialist-New Jersey Avenue, Washington, D.C Unity Health Care IncMedical Coding Specialist-New Jersey Avenue, Washington, D.CDCAdvanced knowledge of medical codes involving selections of most accurate and description code using the extensive knowledge of official coding conventions and rules established by the American Medical Association (AMA), and the Center for Medicare and Medicaid Services (CMS) for assignment of diagnostic and procedural codes. Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.
NewSpecial Investigation Unit (SIU) Manager CVS Health CorpSpecial Investigation Unit (SIU) ManagerMD$54,300–$159,120 / yearThe Certified Professional Coder (CPC) Manager will oversee a team of medical coders within the Special Investigations Unit (SIU) to ensure compliance with coding practices through comprehensive record reviews for medical, behavioral, transportation, and other healthcare providers. Ensure staff provide detailed written summaries of medical record review findings and ensure the team articulates findings effectively to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, and state regulators.
Coding Compliance Audit & Education Specialist Privia Health Group, IncCoding Compliance Audit & Education SpecialistDC$70,000–$80,000 / yearThe Privia Platform is led by top industry talent and exceptional physician leadership, and consists of scalable operations and end-to-end, cloud-based technology that reduces unnecessary healthcare costs, achieves better outcomes, and improves the health of patients and the well-being of providers. Technical Requirements (for remote workers only, not applicable for onsite/in office work): In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed.
Provider Coding Auditor & Educator (Remote) Anne Arundel DermatologyProvider Coding Auditor & Educator (Remote)Owings Mills, MarylandRemote$75,000–$85,000 / yearFull timeRegularly meets with physicians and ACPs to provide continuous education on billable services, medical record documentation, the correct use of CPT and ICD-10 codes, missed billing opportunities and erroneously reported services to minimize errors and loss of revenue. Maintains a thorough understanding of anatomy and physiology, medical terminology, disease processes and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT coding guidelines to diagnoses and procedures in offices.
Coding Specialist III - Plastics/Podiatric Surgery MedStar Health Research InstituteCoding Specialist III - Plastics/Podiatric SurgeryMD$28.76–$48.96 / hourHandles complex coding case review including but not limited to surgical coding (Orthopaedics Cardiac Neurosurgery Otolaryngology etc.) extraction, co-surgery scenarios, multi-visceral transplant cases, comorbidity evaluation. In addition to interacting with physicians on coding issues, ensures that physician encounter forms, the GE IDX billing system and processes are up to date and compliant regarding coding issues.
NewAudit Senior - General Davis and AssociatesAudit Senior - GeneralColumbia, MDConsulting Practice PositionsOutpatient Medical Record CoderPosition Number: CON20105Candidate must possess and maintain one of the following certifications issued by American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC).Certified Coding Specialist (CCS)Certified Coding Specialist – Physician-based (CCS-P)Certified Professional Coder (CPC)Certified Professional Coder – Hospital (CPC-H)Certified Professional Coder – Payer (CPC-P)Registered Health Information Administrator (RHIA)Possess a minimum of 1 year of outpatient coding experience within the preceding 3 years. Medical Record Coding SpecialistPosition Number: CON20109Candidate must possess and maintain one of the following certifications issued by AHIMA or AAPC.Certified Coding Specialist (CCS)Certified Coding Specialist – Physician-based (CCS-P)Certified Professional Coder – Hospital (CPC-H)Certified Professional Coder – Payer (CPC-P)Registered Health Information Administrator (RHIA)Possess a minimum of 2 years of outpatient coding experience within the preceding 3 years.
Senior Software Development Engineer Inovalon Holdings IncSenior Software Development EngineerBowie, MD$85,000–$150,000 / yearThe actual base pay offered may vary depending on multiple factors including, but not limited to, job-related knowledge/skills, experience, business needs, geographical location, and internal equity. This role will contribute to the modernization of a high-impact, revenue-critical payer application that integrates with AI models to streamline clinical workflows and improve diagnostic accuracy for medical coders and staff.
Coding Compliance Auditor Priority One Staffing ServicesCoding Compliance AuditorBaltimore, MDAudits complex cases utilizing the ICD-10-cm & ICD-10-PCS nomenclature to ensure accurate APR-DRG/SOI/ROM & POA Assignments. Accurately audits hospital Inpatient, Ambulatory Surgery, Observation & any outpatient visit for appropriate reimbursement.
Program Manager - Federal Health (CMS) DOMA TechnologiesProgram Manager - Federal Health (CMS)DCRemoteThis is a high-visibility, high-accountability role that demands deep expertise in Medicare Fee-for-Service (FFS) program operations, federal contracting environments, and large-scale healthcare program management. Lead and manage a multi-disciplinary team including clinical reviewers, medical coders, customer service representatives, and IT staff; oversee hiring, training, performance management, and workforce planning.
NewData Analyst Coding Rev Cycle MedStar Health Research InstituteData Analyst Coding Rev CycleDC$71,843–$135,907 / yearMonitors and trends coding-related KPIs including: DNFB (Discharged not final billed); denial trends coding productivity and accuracy audit findings DRG shifts case Mix Index severity of illness (SOI) Risk of Mortality (ROM) query rates and outcomes coding turnaround times physician documentation trends CC/MCC capture rates and quality measure impacts. This role partners closely with Revenue Cycle Operations Coding CDI HIM Revenue Integrity Quality to identify trends monitor coding performance support auditing activities and improve documentation and coding outcomes.
NewRemote HCC Coding Specialist | Risk Adjustment Expert Highmark HealthRemote HCC Coding Specialist | Risk Adjustment ExpertWashington, DCRemote$27.02–$41.85 / hourThe role involves performing HCC coding for Medicare Advantage and ACA, ensuring compliance with CMS guidelines. A minimum of 3 years of coding experience is required, with preferred education in medical billing and coding.
CODING SPECIALIST II Mercy Medical Center IncCODING SPECIALIST IIBaltimore, MDAssociate's Degree in Health Information Management or related field from an accredited two-year college or technical school, or Bachelor's Degree from a four-year college or university in Health Information Management or in a related field or have a Certified Coding Specialist (CCS), Certified Coding Associate (CCA), Certified Coding Specialist - Physician-based (CCS-P), Certified Professional Coder - Hospital Outpatient (CPC-H) or Certified Professional Coder (CPC) designation. The Coding Specialist II identifies, reviews, interprets, codes, and abstracts clinical information from inpatient, observation, and in our surgical records for the purpose of reimbursement, research and compliance with federal and state regulations and other agencies utilizing established coding principles and protocols.
NewCoding Quality Review Specialist -Inpatient MedStar Health Research InstituteCoding Quality Review Specialist -InpatientMD$31.28–$56.39 / hourResponsibility includes validating ICD-10-CM/PCS codes by examining medical record documentation the assignment of present on admission (POA) indicators and discharge disposition status. Queries the medical staff and other caregivers as necessary to obtain accurate and complete physician documentation that supports the severity of the patient illness and risk of mortality.
NewData Analyst Coding Rev Cycle MedStar HealthData Analyst Coding Rev CycleDC$71,843–$135,907 / yearMonitors and trends coding-related KPIs including: DNFB (Discharged not final billed); denial trends coding productivity and accuracy audit findings DRG shifts case Mix Index severity of illness (SOI) Risk of Mortality (ROM) query rates and outcomes coding turnaround times physician documentation trends CC/MCC capture rates and quality measure impacts. This role partners closely with Revenue Cycle Operations Coding CDI HIM Revenue Integrity Quality to identify trends monitor coding performance support auditing activities and improve documentation and coding outcomes.
Manager, Coding Compliance - Pediatrics Central Administration Washington University in St LouisManager, Coding Compliance - Pediatrics Central AdministrationWashingtonAccounting, 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 Grade . This 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.
Coding Compliance Auditor, Outpatient University of Maryland Baltimore Washington Medical CenterCoding Compliance Auditor, OutpatientBaltimore, MD$36.61–$45.71 / hourStrong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability. Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.
Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Elevance Health IncDiagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG)MD$86,560–$155,808 / yearPreferred Skills, Capabilities and Experiences: • One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Job Description: Diagnosis Related Group Clinical Validation Auditor-RN (CDI, MS-DRG, AP-DRG and APR-DRG) Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
CODING COMPLIANCE AUDITOR, Inpatient University of Maryland Baltimore Washington Medical CenterCODING COMPLIANCE AUDITOR, InpatientBaltimore, MD$36.61–$45.71 / hourStrong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability. Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal and state regulations according to established ICD-10-CM/PCS coding and/or CPT-4 procedure coding classification systems.
Pro Fee Audit Educator University of Maryland Baltimore Washington Medical CenterPro Fee Audit EducatorMD$31.78–$44.50 / hourPrepare reports for the Chief Compliance, Audit and Provider Officer, Vice President, Compliance Operations, Director, Revenue Cycle Billing and Coding Compliance, Manager, Coding Compliance and Training, UMMS Executive Management and the Audit and Compliance Committee of the Board of Directors. • Develop and administer training and educational materials to address documentation and coding deficiencies identified in audits; support the development and administration of system-wide compliance education (e.g., New Provider Compliance Education and Annual Compliance Education).
Pre-Certification Coordinator II - Pediatric Endocrinology Washington University in St LouisPre-Certification Coordinator II - Pediatric EndocrinologyWashingtonCommunication, Detail-Oriented, Epic EHR, Fast-Paced Environments, Health Insurance Portability & Accountability Act (HIPAA), Insurance Claim Processing Software, Insurance Precertification, Insurance Terminology, Interpersonal Communication, Medical Coding Software, Multitasking, Organizational Savvy, Prioritization Grade . Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and non-surgical procedures, outpatient testing, and medications; notifies financial counselor for pre-payment of un-coded services.
NewDRG Clinical Validation Lead Elevance Health IncDRG Clinical Validation LeadHanover, MD$89,520–$161,136 / yearPreferred Skills, Capabilities and Experiences: One or more of the following certifications are preferred: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. How you will make an impact: Conducts pre-certification, retrospective, out of network and appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
Coding Compliance Auditor, Inpatient University of Maryland Baltimore Washington Medical CenterCoding Compliance Auditor, InpatientBaltimore, MD$33.36–$46.70 / hourStrong analytical and organizational skills; filing systems; ability to prioritize workloads; meet deadlines and work effectively under pressure; excellent customer service skills; general office procedures; ability to problem solve and work with minimal supervision; familiar with basic medical terminology; computer experience; typing ability. Assist coding specialists in writing appropriate coding queries, works collaboratively with CDI, understand Potentially Preventable Complications (PPC's)/Maryland Hospital Acquired Conditions (MHAC's), Prevention Quality Indicators (PQI's) and their impact and other indicators as needed.
Senior Consultant - Clinical Documentation Specialist Deloitte Touche Tohmatsu LtdSenior Consultant - Clinical Documentation SpecialistMD$110,700–$218,300 / yearOther skills include the ability to analyze, act and design action plans upon monthly and quarterly reports related to individual providers, facilities, MS-DRGs, APR, PSIs, severity of illness and risk of mortality, capture rates, quality metrics and can effectively prioritize their work activities. Clinical Payments Optimization: Assisting clients by validating that payments for clinical healthcare services comply with regulatory, clinical based evidence and contractual requirements while also determining that payments are appropriate for the type and level of care provided.
Pre-Certification Coordinator I - Pediatrics Cardiology Washington University in St LouisPre-Certification Coordinator I - Pediatrics CardiologyWashingtonThe screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. Performs varied professional services to ensure medical/surgical and diagnostic/ancillary services are accomplished in an efficient manner and that reimbursement is maximized through required interaction with third-party payers.
Pre-Certification Coordinator I - Pediatric Allergy & Pulmonary Medicine Washington University in St LouisPre-Certification Coordinator I - Pediatric Allergy & Pulmonary MedicineWashingtonThe screenings will include criminal background check and, as applicable for the position, other background checks, drug screen, an employment and education or licensure/certification verification, physical examination, certain vaccinations and/or governmental registry checks. Contacts appropriate insurance companies for benefit verification and pre-certification of surgical and nonsurgical procedures; notifies financial counselor for pre-payment of un-coded services.