Medical Coder - Audit Specialist BriljentMedical Coder - Audit SpecialistIndianapolis, INRemoteThis role is responsible for reviewing medical records and claims-related documentation for coding accuracy, identifying billing and compliance issues, preparing audit documentation and reports, and supporting appeals activities. Brijlent is seeking a detail-oriented Certified Medical Coder / Medical Record Audit Specialist to support coding accuracy, medical record review, and billing compliance activities for Indiana Medicaid programs.
NewCertified Medical Coder University Health Services IncCertified Medical CoderGREENWOOD, INOperating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the U.S. States, Washington, D.C., Puerto Rico and the United Kingdom. Avoid and Report Recruitment Scams At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skill set and experience with the best possible career path at UHS and our subsidiaries.
Medical Coder - Audit Specialist BrijlentMedical Coder - Audit SpecialistIndianapolis, IndianaRemoteThis role is responsible for reviewing medical records and claims-related documentation for coding accuracy, identifying billing and compliance issues, preparing audit documentation and reports, and supporting appeals activities. Brijlent is seeking a detail-oriented Certified Medical Coder / Medical Record Audit Specialist to support coding accuracy, medical record review, and billing compliance activities for Indiana Medicaid programs.
NewMedical Coder Ascension Health AllianceMedical CoderIndianapolis, INOur legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you'll find an inclusive and supportive environment where your contributions truly matter.
NewMedical Coder AscensionMedical CoderIndianapolis, IndianaFull timeOur legitimate email communications will always come from an @ascension.org email address; do not trust other domains, and an official offer will only be extended to candidates who have completed a job application through our authorized applicant tracking system. Recognized as one of the Best 150+ Places to Work in Healthcare and a Military-Friendly Gold Employer, you’ll find an inclusive and supportive environment where your contributions truly matter.
NewProfessional Coder Auditor and Educator Health and Hospital CorporationProfessional Coder Auditor and EducatorIndianapolis, INProblem Solving: Utilizes available resources appropriately to maintain quality and consistency in coding, abstraction, and charge entry processes; follows a defined process to query the medical staff for completion and/or clarification of documentation necessary to ensure coding compliance and accuracy; brings any concerns/issues to managements attention with examples within the same date of discovery; routinely meets with providers to help educate and review compliant billing practices. Medical Necessity: Recognizes cases that require specific medical necessity coverage diagnoses, and applies Local Coverage Determination (LCD) policies as necessary, and assists in educating providers and clinic sites to understand these rules; assists with workflow suggestions to Leadership to help improve the process and reduce denials.
NewCoder II - Professional Services Billing Eskenazi HealthCoder II - Professional Services BillingIndianapolis, INMedical Necessity: Recognizes cases that require specific medical necessity coverage diagnoses, and applies Local Coverage Determination (LCD) policies as necessaryHelps Accounts Receivable Specialists with questions and concerns to ensure claims are compliant and accurate for submission and paymentAssists with training of new team membersSoftware Applications: Utilizes applicable software to retrieve documentation, abstract data/codes, and retrieve work listsJob RequirementsRequires a minimum of High School diploma and coding credential from AHIMA or AAPCRequires a minimum of 3 years of coding experience in ICD-10, CM, CPT-4, and HCPCS coding classification systems, preferably in a physician and/or mental health physician office//hospital setting. The Professional Coder is responsible for the coding, abstraction, and charge entry (as applicable) of one or more of the following: professional and facility services which may include evaluation and management services, ancillary/diagnostic services, and behavioral health services.
Coder II Healthcare Outcomes Performance CompanyCoder IICarmel, IndianaUtilizes individual hospital medical record systems and coordinates with physicians and staff to obtain clinical documents and demographics required for appropriate coding and billing for all hospital procedures. Abstracts data in compliance with national, regional, and local policies, and interprets and reviews medical record documentation to assign accurate ICD-10 diagnosis and CPT procedure codes.
Coder II The Center for Orthopedic and Research ECoder IICarmel, INPart timeUtilizes individual hospital medical record systems and coordinates with physicians and staff to obtain clinical documents and demographics required for appropriate coding and billing for all hospital procedures. Abstracts data in compliance with national, regional, and local policies, and interprets and reviews medical record documentation to assign accurate ICD-10 diagnosis and CPT procedure codes.
Coder Ambulatory Certified RIVERVIEW HOSPITAL ASSOCIATIONCoder Ambulatory CertifiedNoblesville, INJob Responsibilities: Review, code, data entry and interpret with accuracy and complete patient data for medical office, outpatient, inpatient, handwritten chart entries, practitioner orders and other related documentation to ensure accurate information is being submitted for billing. Consistently supports the compliance and principles of responsibility by maintaining confidentiality, protecting the assets for the organization, acting with integrity, reporting observed fraud and abuse and complies with applicable state, federal and local laws, program policies and procedures and serves as an expert for coding and compliance.
Coder Ambulatory Certified RIVERVIEW HOSPITALCoder Ambulatory CertifiedNoblesville, INPart timeReview, code, data entry and interpret with accuracy and complete patient data for medical office, outpatient, inpatient, handwritten chart entries, practitioner orders and other related documentation to ensure accurate information is being submitted for billing. Consistently supports the compliance and principles of responsibility by maintaining confidentiality, protecting the assets for the organization, acting with integrity, reporting observed fraud and abuse and complies with applicable state, federal and local laws, program policies and procedures and serves as an expert for coding and compliance.
Risk Adjustment Coder IHCI Community Health NetworkRisk Adjustment Coder IHCIIndianapolis, INRemoteThe Risk Adjustment Coder is responsible for: Timely, accurate, and complete review of patient charts following patient encounters, utilizing a variety of technical platforms to complete workflows. Must obtain one of the following certifications through AAPC and/or AHIMA: CPC, CPC-H, CPC-I, CPC-A, CCSP, CCS, Certified Risk Adjustment Coder (CRC) within 6 months from hire.
Medical Coding Appeals Analyst Elevance Health IncMedical Coding Appeals AnalystIndianapolis, INWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
Medical Coding Appeals Analyst Elevance HealthMedical Coding Appeals AnalystIndianapolis, IndianaWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
Patient Safety DRG Coding Auditor Principal Elevance Health IncPatient Safety DRG Coding Auditor PrincipalIndianapolis, IN$116,128–$210,864 / yearSpecializes in review of DRG coding via medical record and attending physician's statement provided by acute care hospitals on paid DRG, especially on very complex coding cases that are paid using APS-DRG, APR-DRG, AP-DRG, MS-DRG or TRICARE methodology and findings may be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). The Patient Safety DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients.
NewRemote HCC Coding Specialist for Risk Adjustment Highmark HealthRemote HCC Coding Specialist for Risk AdjustmentIndianapolis, INRemote$27.02–$41.85 / hourHighmark Health is looking for a skilled HCC Coder to support risk adjustment for government programs such as Medicare Advantage and ACA in Indianapolis, Indiana. The role demands solid experience in HCC coding, proficiency in coding applications, and adherence to CMS guidelines.
Patient Safety DRG Coding Auditor Principal Elevance HealthPatient Safety DRG Coding Auditor PrincipalIndianaSpecializes in review of DRG coding via medical record and attending physician’s statement provided by acute care hospitals on paid DRG, especially on very complex coding cases that are paid using APS-DRG, APR-DRG, AP-DRG, MS-DRG or TRICARE methodology and findings may be so complex and advanced that disputes or appeals may only be reviewed by other DRG Coding Audit Principals (or Executives). The Patient Safety DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group (DRG) methodology, including case rate and per diem, generating highly complex audit findings recoverable claims for the benefit of the Company, for all lines of business, and its clients.
Patient Safety DRG Clinical Validation Auditor Elevance Health IncPatient Safety DRG Clinical Validation AuditorIndianapolis, IN$86,560–$129,840 / yearPreferred skills, qualifications and experiences: One or more of the following certifications are preferred: Certified Clinical Documentation Specialist (CCDS), Certified Documentation Improvement Practitioner (CDIP), Certified Professional Coder (CPC) or Inpatient Coding Credential such as CCS or CIC. Requires a minimum of 10 years of experience in claims auditing, quality assurance, or clinical documentation improvement, and a minimum of 5 years of experience working with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG; or any combination of education and experience, which would provide an equivalent background.
NewQuality Senior Analyst CVS Health CorpQuality Senior AnalystIndiana, IN$46,988–$112,200 / yearResponsible for conducting complex audits, reviews and assessments of medical records coded by internal teams prior to the submission to the Centers of Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Serves as the training resource and subject matter expert to vendors, providers and other team members for questions regarding ICD coding and documentation requirements.
NewDRG Clinical Validation Lead Elevance Health IncDRG Clinical Validation LeadIndianapolis, IN$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.
Inpatient DRG Validator (Acute Care) Elevance Health IncInpatient DRG Validator (Acute Care)Indianapolis, IN$95,172–$149,556 / yearRequires at least one of the following certifications: RHIA certification as a Registered Health Information Administrator and/or RHIT certification as a Registered Health Information Technician and/or CCS as a Certified Coding Specialist and/or CIC as a Certified Inpatient Coder. Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, billing validation criteria and coding terminology preferred.
Provider Reimbursement Admin Sr- Behavior Health Elevance Health IncProvider Reimbursement Admin Sr- Behavior HealthIndianapolis, INWe are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. Job Description: Location: This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance.
Nurse Practitioner Humana IncNurse PractitionerIndianapolis, IN$123,800–$170,300 / yearAs the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. Our model positions itself to provide higher quality care and better outcomes for seniors, providing a concierge experience, diverse services, coordinated care supported by analytics and tools, and deep community relationships.
NewRCS 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.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)IN$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.
NewInvestigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)IN$43,888–$93,574 / yearExperience with Microsoft Word, Excel, and Outlook products, open source database search tools, social media and internet research. Bachelor's Degree in Criminal Justice, Healthcare Management, Public Health, Biological Sciences, Data Analytics, or other related field preferred or equivalent experience.
NewInvestigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)IN$46,988–$122,400 / yearDemonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.