Medical Coder Grand PeaksMedical CoderSaint Anthony, IDWe're looking for individuals who are detail-oriented, efficient, and ready to thrive in a supportive and fast-paced healthcare environment. Good understanding of ICD-10 codes, maximizing specified diagnosis codes, CPT and modifiers.
Supervisory Inpatient/Outpatient Medical Coder Loyal Source Government Services LLCSupervisory Inpatient/Outpatient Medical CoderBoise, IDLoyal Source Government Services is looking for 1 full-time Supervisory Inpatient/Outpatient Medical Records Technician (MRT) Coder to provide remote services to the VA Northeast Ohio Healthcare System located in Cleveland, OH. Supervisory MRT Coders are expected to maintain a high degree of accurate productivity and performance while working with our VA community at the VA Northeast Ohio Healthcare System in Cleveland, OH.
Medical Record Technician Coder Lead Loyal Source Government Services LLCMedical Record Technician Coder LeadBoise, IDLoyal Source Government Services is looking for 1 full-time Inpatient/Outpatient Medical Records Technician (MRT) Coder Lead to provide remote services to the VA Northeast Ohio Healthcare System located in Cleveland, OH. MRT Coder Leads are expected to maintain a high degree of accurate productivity and performance while working with our VA community at the VA Northeast Ohio Healthcare System in Cleveland, OH.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)Fort Hall, ID$50,460–$72,644 / yearRequired 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." Refer 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.
Outpatient Medical Record Technician Coder Loyal Source Government Services LLCOutpatient Medical Record Technician CoderBoise, IDLoyal Source Government Services is looking for 10 full-time Outpatient Medical Records Technician (MRT) Coders to provide remote services to the VA Northeast Ohio Healthcare System located in Cleveland, OH. MRT Coders are expected to maintain a high degree of accurate productivity and performance while working with our VA community at the VA Northeast Ohio Healthcare System in Cleveland, OH.
Surgical Medical Record Technician Coder Loyal Source Government Services LLCSurgical Medical Record Technician CoderBoise, IDAccurately perform the full scope of assigned coding, including ambulatory surgical cases, diagnostic studies and procedures, inpatient facility coding, including inpatient discharges, surgical cases, diagnostic studies and procedures, and inpatient professional services. Loyal Source Government Services is looking for 1 full-time Surgical Medical Records Technician (MRT) Coders to provide remote services to the VA Northeast Ohio Healthcare System located in Cleveland, OH.
Inpatient Medical Record Technician Coder Loyal Source Government Services LLCInpatient Medical Record Technician CoderBoise, IDAccurately perform the full scope of assigned coding, diagnostic studies and procedures, inpatient facility coding, including inpatient discharges, surgical cases, diagnostic studies and procedures, and inpatient professional services. Loyal Source Government Services is looking for 3 full-time Inpatient Facility Medical Records Technician (MRT) Coders to provide remote services to the VA Northeast Ohio Healthcare System located in Cleveland, OH.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)ID$43,888–$102,081 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do.
Coding Supervisor | HIM | HYBRID (ON-SITE/REMOTE) Gritman Medical CenterCoding Supervisor | HIM | HYBRID (ON-SITE/REMOTE)Moscow, IDRemotePreferred Qualifications: Prefer five (5) years experience in a supervisory role in healthcare with extensive knowledge of ICD-10-CM, CPT, HCPCS, and documentation guidelines; EPIC experience, including HB and PB billing. Keeps abreast of recent technology in coding software and other forms of automation and stays informed about transaction code sets, HIPAA requirements and other future issues impacting the coding function.
Program Manager-Risk Adjustment Blue Cross and Blue Shield AssociationProgram Manager-Risk AdjustmentMeridian, IDRemote$86,650–$129,974 / yearCollaborate with cross-functional teams, including, Provider Engagement, Risk Adjustment Coders, Data Analysts, vendors, Quality/HEDIS, Healthcare Operations, Compliance, Legal, Marketing, Corporate Communications, IT and Procurement to streamline processes, ensure compliant timely execution and to support data integrity. The pay range for this position takes into account a wide range of factors including, but not limited to, specific competencies, relevant education, qualifications, certifications, relevant experience, skills, seniority, performance, travel requirements, internal equity, business or organizational needs, and alignment with market data.
Charge Master Analyst Sutter HealthCharge Master AnalystBoise, ID$106,745.60–$160,118.40 / yearPosition Overview: Serves as a subject matter expert for Charge Description Master (CDM) regulatory requirements and guidelines and payer contractual obligations in order to ensure CDM line items are aligned with current billing, coding regulations, guidelines, and contractual obligations. Maintains the CDM data elements (billing description, Current Procedural Terminology/Healthcare Procedure Coding System codes, revenue codes for Inpatient/Outpatient and appropriate modifiers) in the CDM software.
NewCharge Audit Analyst Sutter HealthCharge Audit AnalystID$42.41–$63.62 / hourPosition Overview: Responsible for activities which improve the accuracy of facility outpatient clinical documentation coding and charging, including education with the clinical departments and coding staff and root cause correction to support accurate charging and coding in compliance with policies. Demonstrated ability to utilize official coding/billing resources including CPT/HCPCS references, OPPS Manual, NCCI Manual, NUBC Manual, etc. to determine applicable charges/codes as documented in the health record.
ProFee Audit Specialist- PRN DatavantProFee Audit Specialist- PRNBoise, IDRemote$35–$45 / hourAs a Profee Auditing Specialist, you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies.
Program Integrity Clinical Spc TriWest Healthcare AllianceProgram Integrity Clinical SpcBoise, IDRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Nampa, IDRequests and reviews medical records, notes, and/or detailed bills as appropriate; formulates conclusions per protocol and other business partners to determine response; assures timeliness and appropriateness of responses per state, federal and Molina guidelines. Facilitates comprehensive research and resolution of appeals, disputes, grievances, and/or complaints from Molina members, providers, and related outside agencies to ensure that internal and/or regulatory timelines are met.
Special Investigations Unit Investigator CareOregon IncSpecial Investigations Unit InvestigatorID$74,250–$90,750 / yearStrong research, investigative and problem-solving skills Strong communication skills, including written, verbal and listening skills Effective computer skills, including MS Office Suite Strong interpersonal and motivational skills Ability to think logically and creatively without undue influence from personal biases Ability to operate with a high degree of professionalism and confidentially Ability to plan, organize, manage, and monitor work projects Ability to facilitate learning opportunities in a variety of informal and formal settings Ability to make presentations to small and large groups. Ability to bend and speak clearly for at least 3 hours/day Ability to learn, focus, understand, and evaluate information and determine appropriate actions Ability to accept direction and feedback, as well as tolerate and manage stress Ability to see, read and hear and for at least 6 hours/day Ability to perform repetitive finger and wrist movement for at least 3-6 hours/day Ability to work effectively with diverse individuals and groups.
VP Claims & Payment Integrity Operations Blue Cross of IdahoVP Claims & Payment Integrity OperationsMeridian, IdahoRequired Education: Bachelor’s Degree in Business Administration, Healthcare Administration, Health Information Management or related field; or equivalent work experience (Two years’ relevant experience is equivalent to one-year college); Master's degree (MBA, MHA, MPH) strongly preferred. Proven track record of driving measurable savings and payment accuracy improvements through payment integrity initiatives and operational efficiency programs, with accountability for first-pass yield, financial accuracy, and payment accuracy benchmarks.
Outpatient Infusion Coding Specialist Kootenai HealthOutpatient Infusion Coding SpecialistCoeur d'Alene, IDAn Outpatient Infusion Coding Specialist accurately assigns ICD-10-CM, CPT, and HCPCS codes for outpatient infusion services, focusing on diagnosis, drug administration (NDC codes), infusion/injection procedures, and modifiers, using EHRs and coding software to ensure compliance and proper billing for therapies like IV hydration, chemotherapy, and other injected medications in clinics or hospitals. Outpatient Infusion Coding Specialist in Coeur d''Alene, ID - Kootenai Health Career site Outpatient Infusion Coding Specialist in Coeur d''Alene, ID - Kootenai Health Career site.
Vice President Claims & Payment Integrity Operations Blue Cross and Blue Shield AssociationVice President Claims & Payment Integrity OperationsMeridian, IDRequired Education: Bachelor's Degree in Business Administration, Healthcare Administration, Health Information Management or related field; or equivalent work experience (Two years' relevant experience is equivalent to one-year college); Master's degree (MBA, MHA, MPH) strongly preferred. Proven track record of driving measurable savings and payment accuracy improvements through payment integrity initiatives and operational efficiency programs, with accountability for first-pass yield, financial accuracy, and payment accuracy benchmarks.