NewMedical Coder SIGNATURE PERFORMANCE, INC.Medical CoderOmaha, NEYou are a person who is passionate about accurate Evaluation and Management (E&M) ICD-10-CM, ICD-10- PCS, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes, modifiers and quantities derived from medical record documentation (paper or electronic) for encounters dependent upon record type. Ensure the diagnoses and procedures are sequenced in order of their clinical significance to accurately assign the appropriate DRG, APC or payment tier under the Prospective Payment system to guarantee accurate reimbursement.
Medical Coder - FT (In Office) Nebraska Orthopaedic CenterMedical Coder - FT (In Office)Lincoln, NebraskaOur commitment to the University of Nebraska Athletic Department (Husker Team Physicians), area high schools, and recreational athletes shows our motivation to minimize an athlete’s downtime so they can compete to the best of their ability. Essential Duties: (This list may not include all the duties assigned) Reviews operative reports and assigns and sequences accurate CPT codes, modifiers, and ICD-10 codes to surgical procedures.
Full-time Certified Medical Coder Lexington Regional Health CenterFull-time Certified Medical CoderLexington, NEWorkers are required to remove a shred paper bag from its enclosure, which weighs up to 90 pounds, and requires 2 people to remove and transport the bag 15 feet; this is completed approximately 1 time per month. Review medical records to assign accurate diagnostic and procedure codes to patient records, which will play a key role in determining reimbursement and adherence to coding compliance regulations and corporate policies developed to ensure accurate billing.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)NE$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.
Clinic Coder II CommonSpirit HealthClinic Coder IIOmaha, NEWork closely with practice staff with regards to coding and assignment of a MS-DRGs (Diagnosis Related Group) and APCs (Ambulatory Payment Classification). From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy.
Certified Coder I Nebraska Methodist Health SystemCertified Coder IOmaha, NEReviews Current Procedural Terminology (CPT) procedure codes and CPT charge codes to ensure all accounts reflect appropriate charges for services provided by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account. Certification as Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Associate (CCA) or Certified Coding Specialist-Physician-based (CCS-P) or registration as Registered Health Information Tech (RHIT) required.
NewCertified Coder I Nebraska Methodist HospitalCertified Coder IOmaha, NebraskaReviews Current Procedural Terminology (CPT) procedure codes and CPT charge codes to ensure all accounts reflect appropriate charges for services provided by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account. Certification as Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or Certified Coding Associate (CCA) or Certified Coding Specialist-Physician-based (CCS-P) or registration as Registered Health Information Tech (RHIT) required.
Certified Surgical Coder Nebraska Methodist Health SystemCertified Surgical CoderOmaha, NEReviews Current Procedural Terminology (CPT) procedure codes and Healthcare Common Procedure Coding System (HCPCS) device codes in the code summary and charge viewer to ensure all accounts reflect appropriate charges for services and devices provided; by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account. Enters ICD-10-CM diagnosis code(s) and Current Procedural Terminology (CPT) procedure code(s) into the code summary to maintain disease and operation index, to allow for timely submission of claims to insurance companies by assigning correct diagnosis and procedure codes and the reason for the encounter per department procedure.
NewCertified Surgical Coder Nebraska Methodist HospitalCertified Surgical CoderOmaha, NebraskaReviews Current Procedural Terminology (CPT) procedure codes and Healthcare Common Procedure Coding System (HCPCS) device codes in the code summary and charge viewer to ensure all accounts reflect appropriate charges for services and devices provided; by reviewing Correct Coding Initiative (CCI) edits, attaching modifiers and adding or modifying charges to the account. Enters ICD-10-CM diagnosis code(s) and Current Procedural Terminology (CPT) procedure code(s) into the code summary to maintain disease and operation index, to allow for timely submission of claims to insurance companies by assigning correct diagnosis and procedure codes and the reason for the encounter per department procedure.
NewCertified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)NE$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
Coder Lead CommonSpirit HealthCoder LeadOmaha, NEReporting- Charge lag weekly report out, Bi-weekly report out to clinics, quality reporting, production reporting, running special reporting as requested by clinic or revenue cycle leaders. From primary to specialty care, as well as walk-in and virtual services, CHI Health Clinic delivers more options and better access so you can spend time on what matters: being healthy.
Surgical Coder - FT (In Office) Nebraska Orthopaedic CenterSurgical Coder - FT (In Office)Lincoln, NebraskaOur commitment to the University of Nebraska Athletic Department (Husker Team Physicians), area high schools, and recreational athletes shows our motivation to minimize an athlete’s downtime so they can compete to the best of their ability. Essential Duties: (This list may not include all the duties assigned) Reviews operative reports and assigns and sequences accurate CPT codes, modifiers, and ICD-10 codes to surgical procedures.
Medical Policy & Special Project Clinical Analyst - RN Blue Cross Blue Shield of NebraskaMedical Policy & Special Project Clinical Analyst - RNNebraskaThe analyst partners across Medical Management, Provider Network, Claims Operations, Information Services, Configuration, Compliance, and Clinical Leadership to evaluate emerging healthcare trends, assess business impacts, and implement enterprise-wide policy and system enhancements. This position leads complex cross-functional initiatives, provides expert consultation on highly specialized clinical issues, and ensures medical policies align with organizational strategy, regulatory requirements, and industry best practices.
CAC Medical Biller OneStaff Medical LLCCAC Medical BillerOmaha, NEThis role is responsible for reviewing patient care reports, applying proper ambulance billing codes, ensuring compliance with federal and state regulations, and submitting clean claims for timely reimbursement. Required: Certification as a Certified Ambulance Coder (CAC), Certified Ambulance Documentation Specialist (CADS), or equivalent EMS billing certification.
Supervisor Coding CommonSpirit HealthSupervisor CodingOmaha, NEActing as a key liaison, you will coordinate with physicians, practice managers, and other stakeholders to resolve issues related to coding, billing, and documentation, contributing directly to coding compliance and charge capture optimization. Your ability to effectively manage staff, troubleshoot difficult coding challenges, and ensure adherence to all regulatory guidelines will be key to driving 'coding excellence' and contributing to the financial health and operational integrity of our organization.
Coding Educator & Auditor Nebraska Methodist Health SystemCoding Educator & AuditorOmaha, NEOutpatient Education Coordinator/Auditor will resolve APC Edits using CSG Edit Report to ensure all accounts reflect appropriate Current Procedure Terminology (CPT) codes, modifiers, and units of services to facilitate correct outpatient billing as defined by Medicare. Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) and/or Certified Coding Specialist (CCS) or Certified Procedural Coder (CPC) or Certified Outpatient Coder (COC) required.
NewCoding Educator & Auditor Nebraska Methodist HospitalCoding Educator & AuditorOmaha, NebraskaOutpatient Education Coordinator/Auditor will resolve APC Edits using CSG Edit Report to ensure all accounts reflect appropriate Current Procedure Terminology (CPT) codes, modifiers, and units of services to facilitate correct outpatient billing as defined by Medicare. Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) and/or Certified Coding Specialist (CCS) or Certified Procedural Coder (CPC) or Certified Outpatient Coder (COC) required.
NewBH Coding Specialist II BryanLGH Medical CenterBH Coding Specialist IILincoln, NEGENERAL SUMMARY: Responsible for accurate and compliant assignment of CPT and ICD 10 codes supported by provider documentation in the medical record utilizing the current year International Classification of Diseases Manual (ICD-10) and the current year American Medical Association's Current Procedural Terminology manual (CPT) ensuring optimal reimbursement. Regularly advises direct report supervisor/director of concerns including but not limited to provider documentation content and timeliness to complete, payer performance, system functionality and any other identifiable barriers to performance thus negatively influencing the organizational goals and metrics.
NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorNE$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for 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. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
CDI Specialist ImmanuelCDI SpecialistOmaha, NebraskaCollaborate and provide on-going education and training with providers and interdisciplinary team members to clarify documentation and improve coding accuracy and the importance of complete, accurate chart documentation to support reimbursement. Immanuel Pathways PACE® is seeking a Clinical Documentation Integrity Specialist to join our team at our Home Office, located at 1044 North 115th Street in Omaha, NE.
Charge Entry Specialist FT (In Office) Nebraska Orthopaedic CenterCharge Entry Specialist FT (In Office)Lincoln, NebraskaOur commitment to the University of Nebraska Athletic Department (Husker Team Physicians), area high schools and recreational athletes shows our motivation to minimize an athlete’s downtime so they can compete to the best of their ability. Essential Duties: (This list may not include all the duties assigned) Reviews CPT and ICD-10 codes from providers for office charges for accuracy.
CDI Analyst - On Site Great Plains HealthCDI Analyst - On SiteNorth Platte, Nebraska4. Serve as the primary liaison between clinical providers and the GPH Coding Team to enhance documentation accuracy, ensuring proper support for billing levels and coding requirements. Assist the RAC Coordinator in reviewing designated cases and provide ongoing educational outreach to clinical providers.
RAC Specialist Great Plains HealthRAC SpecialistNorth Platte, NebraskaThe role is accountable for maintaining audit readiness, developing appeal strategies, identifying reimbursement and compliance trends, and providing consultative guidance to interdisciplinary partners to reduce avoidable denials and support accurate, compliant reimbursement. This position independently interprets CMS and payer requirements, evaluates audit risk, manages audit responses and appeals, and provides financial data analysis to support internal and external reporting.
Payment Integrity Analyst SIGNATURE PERFORMANCE, INC.Payment Integrity AnalystOmaha, NEOur performance-driven philosophy boasts competitive pay and additional position specific incentives, where world-class training and development, resources, and events drive our award-winning culture where everyone thrives. In the role of Payment Integrity Analyst, you will be responsible for ensuring the accuracy and compliance of healthcare claim payments across commercial, Medicare, and Medicaid lines of business.
Program Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Omaha, NERemoteFull 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.
NewInpatient Audit Specialist FT- Sign on Bonus DatavantInpatient Audit Specialist FT- Sign on BonusLincoln, NERemote$35–$45 / hourAs an Inpatient 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.
NewInpatient Audit Specialist FT DatavantInpatient Audit Specialist FTLincoln, NERemote$35–$45 / hourAs an Inpatient 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, andlife sciences companies.
NewProfee Audit Specialist - FT DatavantProfee Audit Specialist - FTLincoln, NERemote$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.
Bryan Heart Pre-Authorization Specialist BryanLGH Medical CenterBryan Heart Pre-Authorization SpecialistLincoln, NEAccurately and completely documents all actions taken regarding the pre authorization process including documenting the pre authorization number/code in the appropriate tracking system (Practice Management). *Works closely with business office team (coders and billers) to ensure accurate procedure and diagnosis codes are being utilized in the pre authorization process.
Specialist, Appeals & Grievances (Must live in TX and Medicaid experience) Molina Healthcare IncSpecialist, Appeals & Grievances (Must live in TX and Medicaid experience)Omaha, NERequests 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.
Senior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)NE$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.
Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpInvestigator, Special Investigations Unit (Aetna SIU)NE$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.
Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)NE$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.