Certified Medical Coder BLUESTONE HEALTH CENTERCertified Medical CoderPrinceton, WVFull timePrevious medical coding experience requiredFQHC billing and coding experience preferredStrong knowledge of ICD-10-CM, CPT, and HCPCS codingUnderstand of Medicare, Medicaid, and commercial insurance requirementsKnowledge of medical terminology, documentation requirements, and coding guidelinesExperience reviewing medical records for accurate and complete codingStrong attention to detail and organizational skillsAbility to maintain patient confidentiality and comply with HIPAA requirementsAbility to work effectively with providers, billing staff, and other members of the healthcare team Job Responsibilities:Review clinical documentation and assign accurate diagnoses and procedure codesEnsure coding is supported by provider documentation and meets applicable coding and billing guidelinesReview records for coding accuracy and resolution of coding-related denialsCommunicate with providers regarding documentation and coding clarification when necessaryStay current with changes to CPT, ICD-10-CM, HCPCS, Medicare, Medicaid, and payer-specific coding requirementsSupport accurate billing practices within the FQHC environmentMaintain confidentiality and compliance with the organizational policies and applicable federal and state requirements Position DetailsEmployment: Full-TimeWork Location: on-siteExperience: FQHC billing/coding experience preferredBluestone Health Association, Inc. offers an opportunity to join a team-based healthcare organization dedicated to serving our patients and communities. Now Hiring: Certified Medical CoderFull-Time On-Site Position Bluestone Health Association, Inc. is seeking a knowledgeable and detailed-oriented Certified Medical Coder to join our team.
Medical Records Coder 1 Charleston Area Medical Center Health System IncMedical Records Coder 1Charleston, WVEffectively utilize the APCpro features of 3M with the 3M encoder and grouper software to identify appropriate assign modifiers, make appropriate changes to charges, notify departments to make changes, identify missing documentation, and prepare the account as a clean claim for billing to the third party payer. Participate in the Coding Hotline by responding to callers+ needs for coding advice, identify callers needs that must be referred to a higher level of coding skill, and overall act as a liaison between coding and other departments that need coding services.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)WV$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.
Trauma Registrar Coder 1 Charleston Area Medical Center Health System IncTrauma Registrar Coder 1Charleston, WVThe employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department's identified patient ages. Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.
Coding Auditor-Educator West Virginia University MedicineCoding Auditor-EducatorBerkeley County, WVEXPERIENCE: Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the "Teaching Physician Guidelines" for Professional Coding Positions preferred. Coordinates audits performed by outside agencies by obtaining accounts to be reviewed, acting as a liaison between agency and HIM personnel to gather data to be reviewed, facilitating exit conferences with Coding Specialists, and providing final reports to Coding Manager.
Professional Coding Auditor-Educator West Virginia University MedicineProfessional Coding Auditor-EducatorMarion County, WVEXPERIENCE: Extensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the "Teaching Physician Guidelines" for Professional Coding Positions preferred. Coordinates audits performed by outside agencies by obtaining accounts to be reviewed, acting as a liaison between agency and HIM personnel to gather data to be reviewed, facilitating exit conferences with Coding Specialists, and providing final reports to Coding Manager.
Supervisor, Profee Enterprise Coding - Surgery & Anesthesia West Virginia University MedicineSupervisor, Profee Enterprise Coding - Surgery & AnesthesiaHampshire County, WVExtensive experience in ICD-10-CM, ICD-10-PCS, CPT, and MS-DRG, HCC and APR-DRG assignment for Hospital Supervising Positions and multi-specialty coding, E&M coding, procedural/surgical coding, as well as knowledge of governmental billing and coding regulations including the "Teaching Physician Guidelines" for Professional Coding Supervisors. Will assist with the implementation and facilitation of ongoing medical coding/abstracting, auditing, monitoring, and physician/coder educational activities for existing and new clinics, locations and hospitals.
HIM Coding Supervisor -- Coding & Data Registry -- Document Center Building Charleston Area Medical Center Health System IncHIM Coding Supervisor -- Coding & Data Registry -- Document Center BuildingCharleston, WVAssociate's Degree (Required) Experience: 5 yrs coding experience with at least 3 of the years with progressive coding; dependent on coding specialty - outpatient coding experience with strong grasp of coding guidelines and rules or inpatient experience with strong grasp of coding and rules; experience in Clinical Documentation Improvement Substitution: May substitute 5 yrs progressive coding experience in addition to required experience for the Associates Degree in Health Information Technology. The position will also act as a liaison with Clinical Documentation Specialists and Coders to settle differences in coding and DRG assignment; with Coders and Patient Accounts to resolve coding and billing issues; and provide clinical and documentation clarification facility-wide.
Network Service Consultant - Peak Health West Virginia University MedicineNetwork Service Consultant - Peak HealthCabell County, WVEducates providers regarding policies and procedures related to credentialing, contracting, authorizations, referrals, claims and/or encounters, grievances and appeals, health education, provider education, population health management, care management, pharmacy management, Electronic Health Records and medical record submissions, Health Information Exchange, data exchange and electronic Data Interface and regulatory updates. Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management, Credentialing, Contracting, Legal, Analytics, Compliance, Sales and Marketing and Member and Provider Service, to resolve issues and facilitate team and business priorities/opportunities.
Nurse Investigator The Health PlanNurse InvestigatorWheeling, WVRequired: Registered Nurse; Certified Coder (or eligible within 12 months)or similar certification; Basic knowledge of ICD-9/10, CPT, HCPCS, DRG and/or Rev codes; Proficiency with Office products, including Word and Excel; Critical problem-solving skills and attention to detail. The successful candidate will utilize their unique blend of coding, claims payment, clinical, and payment integrity/investigations expertise to assist the SIU in achieving its mission to prevent, detect, investigate, and resolve healthcare fraud, waste, and abuse.
Professional Coding Specialist II-(Interventional Radiology) West Virginia University MedicineProfessional Coding Specialist II-(Interventional Radiology)Preston County, WVRemoteAccurately codes and/or audits complex surgical procedures as part of daily workload (85%-95% of workload) including but not limited to: Bariatric surgery, Cardiothoracic surgery, Gynecologic surgery, Oncology surgery, Orthopaedics surgery, Thoracic surgery, Transplant surgery, Trauma and burn surgery, and Open Vascular surgery. Reviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified.
Clinical Denial Specialist - Diagnosis Related Grouping (DRG) West Virginia University MedicineClinical Denial Specialist - Diagnosis Related Grouping (DRG)Monongalia County, WVMINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Associate degree in healthcare administration, Nursing, Health Information Management, or related field AND Five (5) years of experience in hospital billing, acute care setting, CDI, inpatient coding, or revenue cycle'. Current Licensed Practical Nurse license issued by the state in which services will be provided or current multi-state Licensed Practical Nurse license through the enhanced Nurse Licensure Compact (eNLC).
Enterprise Provider Compliance Auditor-Educator West Virginia University MedicineEnterprise Provider Compliance Auditor-EducatorWVEvaluates the scope of the audit and develops/completes the required compilation of data analytical reports (independently of IT and/or Data Analytics) from the appropriate application or software in order to identify the audit universe and then select the appropriate sample based on the scope of the audit criteria. MINIMUM QUALIFICATIONS: EDUCATION, CERTIFICATION, EXPERIENCE, AND/OR LICENSURE: High School Diploma or Equivalent AND Seven (7) Years of experience in multi-specialty coding, E&M coding, procedural/surgical coding OR; Associate's Degree AND Five (5) years experience in multi-specialty coding, E&M coding, procedural/surgical coding.
Hospital Coding Spec II Cancer Center West Virginia University MedicineHospital Coding Spec II Cancer CenterWetzel County, WVReviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program.
Hospital Coding Spec II PBB West Virginia University MedicineHospital Coding Spec II PBBMarion County, WVReviews and accurately interprets medical record documentation from all hospital accounts in order to identify all diagnosis and procedures that affect the current outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. PREFERRED QUALIFICATIONS: EDUCATION, CERTIFICATION, AND/OR LICENSURE: Graduate of Health Information Technology (HIT) or equivalent program OR Medical Coding Certification Program.
HB-PB Coding Spec II West Virginia University MedicineHB-PB Coding Spec IIMercer County, WVReviews and accurately interprets medical record documentation from all accounts in order to identify all diagnosis and procedures that affect the current inpatient stay or outpatient encounter and assigns the appropriate ICD-10, CPT, or modifier codes for each diagnosis and procedure that is identified. This position is an integral part of an overall compliance program effort as it pertains to hospital/physician coding and billing functions, as such will interact with physician and non-physician providers to maximize correct coding initiatives along with hospital coding.
NewInpatient Coding Manager Huron Consulting Group IncInpatient Coding ManagerCharleston, WV$90,000–$130,000 / yearREQURIED SKILLS: Effective and efficient organization and planning skills with the proven ability to manage complex multi-workstream performance improvement projects or multiple concurrent client engagements, while delegating and overseeing the work of junior team members. is directly responsible for the daily oversight of coding operational processes and workflow, including but not limited to delivering timely and accurately coded cases for facility billing and for reporting hospital and provider quality metrics.