NewCoding and Compliance Auditor South Shore HealthCoding and Compliance AuditorBraintree, MAThe Coding & Compliance Auditor evaluates medical record documentation and coding accuracy, identifies opportunities for improvement, and designs and delivers coding education and training programs for clinical staff, coders and other key stakeholders. Support all departments of the Health System with coding guidance: Pertaining to compliance training / education as requested from providers and/or staff related to coding, billing and documentation in the inpatient, outpatient, professional, surgical and Home Health divisions of the Health System to ensure accuracy and support program objectives.
Medical Physician Coder Boston Children's HospitalMedical Physician CoderWestwood, MA$26.62–$42.59 / hourKnowledge of medical terminology, anatomy and physiology, pathophysiology, ICD-9/10-CM and CPT-4 or ASA classification systems, and regulatory agency requirements related to primary or non-surgical services. Establishes and maintains working relationships with Physicians to resolve specific case issues, as well as general questions and or principles.
Professional Coder South Shore HealthProfessional CoderWeymouth, MA$26.30–$37.60 / hourResponsibilities if Required: Education if Required: License/Registration/Certification Requirements: Certified Coding Specialist- Physician Based- American Health Information Management Association (AHIMA), Certified Professional Coder (CPC)- American Academy of Professional Coders (AAPC). This role reviews clinical documentation, assigns appropriate diagnoses and procedures, identifies documentation gaps, and queries providers as needed to ensure coding accuracy, compliance, and optimal reimbursement.
Certified Professional Coder, Full Time Days, 40 Hours, Central Business Office Day Kimball Healthcare IncCertified Professional Coder, Full Time Days, 40 Hours, Central Business Officeputnam, CTCertified Professional Coder Job Summary Under the general supervision of the Director of Professional Revenue Cycle, the Certified Professional Coder performs all phases of abstracting, diagnosis coding, charge capture and posting through record analysis. Conduct quarterly chart audits; in collaboration with the Director of Professional Fee Revenue Cycle, provide one-on-one or small group education to clinical staff on audit results while maintaining professionalism.
HIM Certified Coder Per Diem Care New England Health SystemHIM Certified Coder Per DiemPawtucket, Rhode IslandPer diemAbout Us: Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical research, attracts the nation’s top specialty-trained doctors, hones renowned services and innovative programs, and engages in the important discussions people need to have about their health and end-of-life wishes. All work carried out in accordance with the rules, regulations and coding conventions of the American Hospital Association (Coding Clinic), ICD9 (ICD10 when applicable), AMA CPT and CMS coding guidelines.
Coding Specialist Outpatient Telecommute-Surgical Coder Brown University HealthCoding Specialist Outpatient Telecommute-Surgical CoderRI$24.29–$40.07 / hourMonitors and resolves rejected accounts on the Claims Edit Report and e Clinical Works error reports by established timeframe researching coding conflicts including chargemaster, medical necessity and various other coding and billing issues. Reviews the outpatient clinical documentation of extract data and assign appropriate ICD-10-CM and CPT codes in accordance with the outpatient ICD-10-CM Official Guidelines for Coding and Reporting and the AHA HCPCS Coding Clinics.
Outpatient Certified Coder Care New England Health SystemOutpatient Certified CoderWarwick, Rhode IslandFull timeAbout Us: Care New England Health System (CNE) and its member institutions, Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, is a trusted, integrated health care organization that fuels the latest advances in medical research, attracts the nation’s top specialty-trained doctors, hones renowned services and innovative programs, and engages in the important discussions people need to have about their health and end-of-life wishes. The role of a Certified Outpatient Coder at Care New England is to ensure accurate assignment of ICD-10 CM, CPT and HCPCS codes on a wide range of patient medical records for outpatient services.
CPC Certified Coder Brown University HealthCPC Certified CoderProvidence, RI$19.97–$32.96 / hourThe core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate RESPONSIBILITIES: Review all denied claims, correct them in the system and send correctedppealed claims asbr / written correspondence, fax or via electronic submission. Brown University Health employees are expected to successfully role model the organization''s values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.
Medical Biller with Coding Experience Child Health AssociatesMedical Biller with Coding ExperienceAuburn, MAFull timeIn this role, you'll play an important part in our revenue cycle by ensuring services are billed accurately, claims are processed efficiently, and outstanding balances are followed through to resolution. If you're an experienced medical billing professional who enjoys solving problems, staying organized, and keeping the revenue cycle moving, we'd love to hear from you.
Coding Specialist III SavistaCoding Specialist IIIMassachusettsYou’ll use your inpatient coding expertise to review complex clinical documentation, assign accurate ICD-10-CM and ICD-10-PCS codes, validate MS-DRG assignments, and help identify and resolve coding-related claim edits. We 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).
NewRevenue Cycle Specialist PROVIDENCE COMMUNITY HEALTH CENTERS, INC., THERevenue Cycle SpecialistWarwick, RIOverview: The Revenue Cycle Specialist manages the financial aspects of patient care by accurately coding diagnoses and treatments, submitting claims to insurance companies, addressing billing inquiries, resolving all payment denials, ensuring timely and accurate reimbursement, while meeting department productivity and quality requirements. Employee must be able to give accurate/tactful explanations to visitors, patients, and fellow workers and remain professional in stressful situations; accurately recognize names, detect/avoid errors in scheduling and message taking; exhibit the courtesy required to work productively with others under stressful conditions; exercise patience.
Revenue Integrity Specialist Top Prospect Group LLCRevenue Integrity SpecialistGreater Boston, MARevenue Integrity Specialist (Professional Billing) Position Overview Serves as a Charge Generation Tracker (CGT) and regulatory resource to ensure compliance with coding and billing guidelines. Acts as a primary resource for providers and staff, supporting revenue integrity, charge capture, and coding accuracy.
Payment Integrity Program Development Manager Devoted Health ServicesPayment Integrity Program Development ManagerMassachusettsRemoteThat’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. (Note: We provide modern AI tools to generate and edit SQL scripts; you do not need to be a software expert, but you must possess the ability to read, interpret, and understand data scripts to validate results and analyze proof-of-concept datasets).
Clinical Documentation Specialist Quincy Physician Administrative ServicesClinical Documentation SpecialistQuincy, MaineWorking collaboratively with providers, clinical leaders, coding professionals, and operational teams, you will identify opportunities for documentation improvement, provide individualized education, and help implement best practices that enhance the accuracy and completeness of the medical record. As a Clinical Documentation Specialist at Quincy Medical Group, you will play a key role in advancing our Value-Based Care initiatives by partnering with providers to improve clinical documentation, diagnosis capture, and coding accuracy.
Senior Manager, Corporate Compliance - Risk Adjustment CVS Health CorpSenior Manager, Corporate Compliance - Risk AdjustmentWoonsocket, RI$75,400–$165,954 / yearThis position serves as a key compliance leader and subject matter expert, partnering with Risk Adjustment Operations, Coding, Provider Education, Clinical Documentation Improvement (CDI), Internal Audit, Legal, and Government Affairs teams to ensure organizational adherence to CMS requirements. As a Senior Manager, Medicare Compliance - Risk Adjustment, you are responsible for overseeing and maintaining compliance with CMS regulations related to Medicare Advantage Risk Adjustment, Hierarchical Condition Categories (HCCs), encounter data submission, documentation and coding compliance, and related regulatory requirements.
Grievance and Appeals Coordinator (44872) Neighborhood Health Plan of Rhode IslandGrievance and Appeals Coordinator (44872)Smithfield, RIThe Coordinator maintains organized and secure record-keeping systems, communicates effectively with internal and external stakeholders, and fosters collaborative relationships across departments to ensure compliance and exceptional service. This role ensures timely and compliant correspondence to members and providers, monitors case progress, and alerts staff when deadlines approach.
NewPayment Policy Analyst Point32Health, Inc.Payment Policy AnalystCanton, MA$63,791.53–$95,687.29 / yearWe value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. Scam Alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates.
NewPayment Policy Analyst Point32HealthPayment Policy AnalystCanton, MassachusettsWe value the rich mix of backgrounds, perspectives, and experiences of all of our colleagues, which helps us to provide service with empathy and better understand and meet the needs of the communities where we serve, live, and work. Scam Alert : Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates.
Claims Quality Control Auditor (44912) Neighborhood Health Plan of Rhode IslandClaims Quality Control Auditor (44912)Smithfield, RIResponsibilities include, but are not limited to the following: Review Neighborhood's claim process functions, including auto adjudicated and manually processed claims and issues, based on provider and health plan contractual agreements and claims processing guidelines. This Master IA will be created from results of the weekly Claims Adjustment Committee meeting and be used by adjusters from each delegate to reprocess claims according to the respective configuration changes in each system.
Coding Specialist - Telecommute Brown University HealthCoding Specialist - TelecommuteProvidence, RI$24.29–$40.07 / hourMonitors and resolves rejected accounts on the Claims Edit Report and e Clinical Works error reports by established timeframe researching coding conflicts including chargemaster, medical necessity and various other coding and billing issues. Reviews the outpatient clinical documentation of extract data and assign appropriate ICD-10-CM and CPT codes in accordance with the outpatient ICD-10-CM Official Guidelines for Coding and Reporting and the AHA HCPCS Coding Clinics.