Medical Auditor Jobs Near Me

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. 's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. *Now offering a ***$10,000.00 Commitment Bonus (4 equal installments over 24 months- 6-month increments) The Medical Records Coder II is a certified Coder. Coordinate or review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to ensure specific diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Review the complex (problematic coding that needs research and reference checking) medical records and accurately code the primary and secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions. Coordinate/review the work of designated employees. Ensure quality and quantity of work performed through regular audits. Assist with research, development, and presentation of continuing education programs in areas of specialization. Review medical record documentation and accurately code the primary and secondary diagnoses and procedures using ICD-10-CM and CPT-4 coding conventions. Sequence the diagnoses and procedures using coding guidelines. Ensure the DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate and optimal reimbursement for hospital and/or professional charges. Consult with and educate physicians on coding practices and conventions to provide detailed coding information. Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes, and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures. Maintain a thorough understanding of medical record practices, standards, and regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Health Care and Finance Administration (HCFA), the Medical Review of North Carolina (MRNC), etc. Assist with special projects as required. Perform other related duties incidental to the work described herein. Minimum QualificationsEducation High school diploma required. Experience RHIA certification: no experience required RHIT certification: no experience required CCS certification: one year of coding experience required CPC or HCS-D certification: two years of coding experience required Degrees, licenses, and certifications Must hold one of the following active/current certifications: Registered Health Information Administrator (RHIA) Hospital Coding Registered Health Information Technician (RHIT) Hospital Coding Certified Coding Specialist (CCS) Hospital Coding Certified Professional Coder (CPC) Homecare Coding Specialist-Diagnosis (HCS-D) Homecare Coding Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

*CHRISTUS Health System offers the Specialty Coder Sr position as a remote opportunity. Candidate must reside in the states of Texas, Louisiana, Arkansas, New Mexico, or Georgia to further be considered for this position.* Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise on designated Inpatient or Outpatient high dollar or specialty account types. Specialty Coder is responsible for maintaining current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and or/ Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Specialty Coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines. Coder will work collaboratively with various CHRISTUS Health departments, including but not limited to the HIM and Clinical Documentation Specialists, to ensure accurate and complete physician documentation to support accurate billing and reduce denials. Coder will also assist in other areas of the department, as requested by leadership. Coder will report directly to their Regional Coding Manager, with additional leadership from the Director of Coding Operations and System HIM Director. Responsibilities: Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders. Assign codes for diagnoses, treatments, and procedures according to the ICD-10-CM/PCS Official Guidelines for Coding and Reporting through review of coding critical documentation, to generate appropriate MS/APR DRG. Abstracts required information from source documentation, to be entered into the appropriate CHRISTUS Health electronic medical record system. Validates admit orders and discharge dispositions. Works from assigned coding queue, completing and re-assigning accounts correctly. Manages accounts on ABS Hold, finalizing accounts when corrections have been made, in a timely manner. Meets or exceeds an accuracy rate of 95%. Meets or exceeds the designated CHRISTUS Health Productivity standard per chart type. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA). Assists in implementing solutions to reduce backend errors. Identifies and appropriately reports all hospital-acquired conditions (HAC). Expertly queries providers for missing or unclear documentation, by working with the HIM department and Clinical Documentation Improvement Specialists. Has strong written and verbal communication skills. Able to work independently in a remote setting, with little supervision. Participates in both internal and external audit discussions. All other work duties as assigned by the Manager. Requirements: High school Diploma or equivalent years of experience required. Completion of Accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred. 1 - 3 years of experience preferred. Work Schedule: TBD Work Type: Full Time EEO is the law - click below for more information: ******************************************************************************************** We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at **************.

Become a part of our caring community and help us put health first The Quality Assurance department is looking for Medical Coding Quality Auditor for outpatient setting with Evaluation Management leveling experience, DME and IR. This role will complete quality reviews on the coding processes within the Payment Integrity organization, focusing on the IR and multiple specialties for Outpatient Coding Team and vendor partners. Medical Coding Quality Auditor The Quality Assurance department is seeking a Medical Coding Quality Auditor for the outpatient setting, with experience in Interventional Radiology, Durable Medical Equipment (DME), Multi-Specialty Pro-fee, and Evaluation and Management. This role involves conducting quality reviews of coding processes within the Payment Integrity organization, focusing on Interventional Radiology, DME, Evaluation and Management, and multiple specialties for outpatient coding teams and vendor partners. Key Responsibilities: Develop and implement policies, procedures, and methods to ensure operational quality and continuous improvement. Conduct training and coaching for staff and management in areas such as quality improvement, process management, and reliability science. Maintain effective and collaborative communication with administration, stakeholders, and vendor partners. Understand department, segment, and organizational strategies and operating objectives, including their linkages to related areas. Make decisions regarding work methods, occasionally in ambiguous situations, with minimal direction and guidance as needed. Follow established guidelines and procedures to ensure compliance with federal, state, and payer regulations. So, do you love working on several different projects? Do you take pride in helping others and being flexible? Do you have great attention to detail and a passion for healthcare? Do you have a solid background in medical auditing, coding, and medical record review? If you answered YES to one or more of the above, you should strongly consider this role. Use your skills to make an impact WORK STYLE: Remote/Work at Home WORK HOURS: Full time: Monday-Friday, 8 hours/day, 5 days/week This role will complete quality reviews on the coding processes within the Payment Integrity organization, vendor partners focusing on the Outpatient Coding teams and various processes. This is a full-time remote/work-at-home opportunity. Required Qualifications 5+ years of Evaluation and Management and DME. 7 years of Profee and Surgery Auditing. Medical coding certification from AAPC OR AHIMA (CPC, CCS, CIC, CPMA or equivalent). Strong critical thinking skills. Prior experience reading and coding from medical records. Demonstrated ability to work independently and manage workload. Exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence, and commitment to the profession. Excellent writing, editing, interpersonal, planning, teamwork, and communication skills. Proficient in MS Office applications including Word, Excel, Outlook, PowerPoint. Prior experience working independently and determining appropriate courses of action. Demonstrated experience in effective communication with internal customers through both written and verbal communication. Preferred Qualifications Inpatient experience. Interventional radiology. Process improvement experience. Multi-Specialty Auditing experience. Additional Information Work at Home Requirements • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested • Satellite, cellular and microwave connection can be used only if approved by leadership • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Interview Format As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $65,000 - $88,600 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 03-27-2025 About us Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

📷URGENT HIRING! MEDICAL AUDITORS📷 This is a 100% work-from-home position. You must have strong internet, a good home office,- and work US Time. Qualifications: 📷 Experience with the following software: Kinnser, Axxess, and Alora 📷 Have training/certification on Board Certified Home Health Coder (BCHH-C) 📷 MUST have Oasis experience 📷 Familiar with Medicare/ Medicaid standards 📷 Has a medical background (MEDICAL BILLING EXPERIENCE IS A PLUS) If you are interested or have the skills mentioned above, please APPLY. We will conduct the interview ASAP! Thank you.

Hi, we're Oscar. We're hiring a Medical Coding Auditor, SIU, to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves-one that behaves like a doctor in the family. About the role The Senior Specialist, Medical Coding Auditor, SIU, works to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to audit prepayment and/or post payment claims. The Senior Specialist runs and coordinates activities across Oscar to reduce the incidence and effect of fraud, waste, and/or abuse (“FWA”) on all our operations. You will report to the Associate Director, SIU. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role. You must reside in one of the following states: Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $63,200 - $82,950 per year. The base pay for this role in all other locations is: $56,880 - $74,655 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities Develops and maintains a depth of expertise on CPT, HCPCS, and ICD-10 Coding guidelines and other insurance billing submission requirements. Perform complex policy updates or audits of assigned documentation (i.e. medical records or claims) on both a prepayment and/or post payment basis to determine accuracy of claims submitted to Oscar. Document findings including reference to sources used to support decision making and in a way that can be easily understood by non clinicians or coders. Create reports and reference guides that can be used by other team members to communicate findings or more effectively perform similar reviews. Help draft written communications to providers to convey findings. Participate in educational calls with providers. Help train new team members. Develop and document processes to improve the effectiveness of the team. Compliance with all applicable laws and regulations Other duties as assigned Qualifications 1+ years of coding or auditing experience across multiple specialties. Bachelor's degree or 4+ years of work experience Bonus Points Certified Professional Coder (CPC) designation or similar certification (required for SIU) Certified Professional Medical Auditor Additional certification applicable to this work such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), other coding certifications or similar Knowledge of applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity Demonstrated experience translating technical jargon to non-technical end users. Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting. Experience with HIPAA, data privacy, and/or data security processes Experience working with regulators governing (public or private) health insurance carriers This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here. At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Notice to Job Applicants.

Fathom is on a mission to use AI to understand and structure the world's medical data, starting by making sense of the terabytes of clinician notes contained within the electronic health records of the world's largest health systems. Our deep learning engine automates the translation of patient records into the billing codes used for healthcare provider reimbursement, a process today that costs hospitals in the US $15B+ annually and tens of billions more in errors and denied claims. We are a venture-backed company that completed a Series B round of financing for $46M in late 2022. We are seeking a Medical Coding Auditor to contribute to Fathom's next stage of growth. This role is a unique opportunity for an experienced medical coder with robust multi-specialty auditing experience, excellent communication and self-presentation skills, the drive to help a high-growth startup scale, and the desire to transform the future of medical coding. If this speaks to you, we want to hear from you. While this is a fully remote position open to candidates across the United States, we expect employees to work consistently from a single, fixed location within the US. Your role and responsibilities will include: Reviewing medical records across an array of outpatient specialties to ensure that the correct diagnosis and procedure codes were assigned Reviewing physician documentation and performing audits to determine accuracy Preparing audit results reports as requested by the engineering and client success teams Providing coding insights, education, and examples to Fathom engineering and client success teams to accelerate product development Tracking, aggregating and summarizing the changing coding and billing rules for the engineering and client success teams We are looking for a teammate with: A current AAPC or AHIMA coding certification(s) 3+ years recently auditing procedure and diagnosis codes 3+ years of recent auditing experience in emergency department, primary care, and/or E/M leveling 3+ years of recent auditing experience in a professional fee outpatient setting Experience in a professional fee and/or a facility setting Deep understanding of current coding guidelines, reimbursement guidelines, medications, and documentation requirements Strong knowledge of anatomy/physiology, diseases, and medical terminology Strong verbal and written communication skills Enthusiasm for technological innovation in medical coding Bonus points if you have: Multi-specialty auditing experience beyond ED and primary care Experience with inpatient coding and risk adjustment auditing Experience building and implementing audit plans Experience working with external clients Experience in an entrepreneurial/startup environment Prior encoder experience Compensation: Salary: $70,000 USD - $100,000 USD Company Equity Benefits: PTO and Uncapped Sick Days Medical/Dental/Vision Coverage 401k Matching $1,500 USD Home Office Budget Support for ongoing medical coding education and certification Virtual and Local Office (San Francisco, New York City and Toronto) Team Building Events Annual Company Off-site

TruHealth is the clinical arm of the health plan and supplies the model of care. The Coding and Medical Records Auditor will be responsible for conducting coding audits prior to claims submission. This position will ensure appropriate and accurate coding is applied for each member of the plan. Additionally, post-payment coding reviews may be performed with coding education correspondence sent to providers The Coding and Medical Records Auditor will be responsible for conducting coding audits prior to claims submission. This position will ensure appropriate and accurate coding is applied for each member of the plan. Additionally, post-payment coding reviews may be performed with coding education correspondence sent to providers. ESSENTIAL JOB DUTIES: To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation. * Review claims prior to billing to provide a proactive level of accuracy. * Assess trends; communicate appropriate education both individually to staff and collectively as an organization. * Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries as needed to verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered. * Conduct pre-claim and post-claim coding audits to ensure accurate claims' denials. * Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment. * Assist with validation audits to evaluate medical record documentation to ensure coding accurately reflects and supports relevant coding based on the ICD-10 code submitted to CMS and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC) conditions applicable to Medicare Risk Adjustment reimbursement initiatives. * Work assigned coding projects to completion. * Provide a high level of customer service to internal and external customers by consistently meeting and/or exceeding expectations including but not limited to quality and productivity. * Escalate appropriate coding audit issues to management as required and follow departmental/organizational policies and procedures. * Maintain required levels of production and quality standards as established by management. * Work directly with provider representatives and executive directors on Letters of Agreement (LOAs) to ensure appropriate coding methodology and reimbursement. * Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of coding standards. * Follow all appropriate Federal and State regulatory requirements and guidelines applicable to Health Plan operations or as documented in company policies and procedures. * Participate in and support ad-hoc coding audits as needed. * Other duties as assigned EXPERIENCE: * 3 years HCC coding and/or coding and billing required * 5 years HCC coding and/or coding and billing preferred * 2+ years of complex claims processing and/or coding auditing experience in the health insurance industry or medical health care delivery system recommended. * 2 + years of experience in managed healthcare environment related to claims' and/or coding audits recommended. * 2 year(s): Knowledge of standard coding and reference materials used in a claim setting, such as CPT4, ICD10, HCPCS and others * 2 year(s): Knowledge of CMS requirements regarding claims processing and coding; especially Skilled Nursing Facility and other complex claim processing rules and regulations * 2 year(s): Coding/auditing claims for Medicare and Medicaid plans. * 2 year(s): Experience in managed healthcare environment related to coding audits * 2 year(s): Complex claims processing and/or coding experience in the health insurance industry or medical health care delivery system LICENSE/CERTIFICATION: REQUIRED (any of the following): * Certified Professional Coder (CPC) * Certified Risk Coder (CRC) · Certified Coding Specialist (CCS) * Certified Documentation Integrity Practitioner (CDIP) * Certified Clinical Documentation Specialist ( CCDS) * Registered Health Information Technician (RHIT)

ABOUT PERFORMANT: At Performant, we're focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most - quality of care and healthier lives for all . If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture - then Performant is the place for you! ABOUT THE OPPORTUNITY: Hiring Range:$61,300.00 - $71,000.00 The Medical Coding Auditor-Outpatient is responsible for ensuring the accuracy, integrity, and compliance of medical coding practices within the organization, with a primary focus on Outpatient services. This role involves auditing medical records, coding data, and billing information to verify adherence to coding guidelines and regulations. The Medical Coding Auditor plays a crucial role in minimizing coding errors, preventing fraudulent activities, and ensuring that the organization meets all applicable standards and requirements. Key Responsibilities to include: Audit Medical Records: Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes. Compliance Monitoring: Ensure that coding practices comply with federal, state, and payer-specific regulations and guidelines, including HIPAA and CMS standards. Identify and Correct Errors: Detect discrepancies and coding errors, provide feedback, and collaborate with coding staff to correct inaccuracies in medical documentation. Education and Training: Provide training and support to coding staff on best practices, coding updates, and compliance standards. Conduct workshops and seminars as needed. Report Generation: Prepare detailed audit reports that highlight findings, trends, and areas for improvement. Present reports to management and relevant stakeholders. Policy Development: Assist in developing and updating coding policies, procedures, and guidelines to ensure ongoing compliance and efficiency. Collaboration: Work closely with medical billing, compliance, and clinical teams to ensure that coding supports accurate billing and reimbursement processes. Stay Current: Keep abreast of changes in coding regulations, industry trends, and best practices. Participate in continuing education to maintain coding certifications. Knowledge, Skills and Abilities Needed: Extensive knowledge of ICD-10, CPT, and HCPCS coding systems. Familiarity with healthcare regulations, including HIPAA, CMS guidelines, and payer-specific requirements. Understanding of medical terminology, anatomy, and physiology. Strong analytical and problem-solving skills. Excellent attention to detail and accuracy. Effective communication and interpersonal skills. Ability to work independently and as part of a team. Ability to work remotely from a home office without on-site Supervision Proficiency in coding software and electronic health record (EHR) systems. Required and Preferred Qualifications: High school diploma or equivalent GED required. Associate's or Bachelor's degree in Health Information Management, Medical Coding, or a related field preferred. Active certification is required. Certified Professional Coder (CPC) and/or Certified Coding Specialist (CCS) are preferred, while CPC-H, CPC-P, RHIA, RHIT, or CCS-P are all generally accepted as well. Other Medical Coding certifications may also qualify. At least three (3) years of direct experience in coding/auditing applicable services, and medical chart review for all provider/claim types. Coding for emergency care, observation, and same day surgery is preferred. Prior auditing experience desirable in either a provider setting, or payer experience in claim processing, edit development, and/or coding and reimbursement policy a plus. Previous payer experience in a claim processing, edit development, and/or coding and reimbursement policy a plus. WHAT WE OFFER: Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). Regularly sit/stand 8 or more hours per day. Occasionally lift/carry/push/pull up to 10lbs. Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. Other requirements may apply. All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant's Human Resources team to discuss further. Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law. THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED

**Become a part of our caring community and help us put health first** The Quality Assurance department is looking for Medical Coding Quality Auditor for outpatient setting with Evaluation Management leveling experience, DME and IR. This role will complete quality reviews on the coding processes within the Payment Integrity organization, focusing on the IR and multiple specialties for Outpatient Coding Team and vendor partners. **Medical Coding Quality Auditor** The Quality Assurance department is seeking a Medical Coding Quality Auditor for the outpatient setting, with experience in Interventional Radiology, Durable Medical Equipment (DME), Multi-Specialty Pro-fee, and Evaluation and Management. This role involves conducting quality reviews of coding processes within the Payment Integrity organization, focusing on Interventional Radiology, DME, Evaluation and Management, and multiple specialties for outpatient coding teams and vendor partners. **Key Responsibilities:** + Develop and implement policies, procedures, and methods to ensure operational quality and continuous improvement. + Conduct training and coaching for staff and management in areas such as quality improvement, process management, and reliability science. + Maintain effective and collaborative communication with administration, stakeholders, and vendor partners. + Understand department, segment, and organizational strategies and operating objectives, including their linkages to related areas. + Make decisions regarding work methods, occasionally in ambiguous situations, with minimal direction and guidance as needed. + Follow established guidelines and procedures to ensure compliance with federal, state, and payer regulations. **So, do you love working on several different projects? Do you take pride in helping others and being flexible? Do you have great attention to detail and a passion for healthcare? Do you have a solid background in medical auditing, coding, and medical record review? If you answered** **_YES_** **to one or more of the above, you should strongly consider this role** . **Use your skills to make an impact** **WORK STYLE:** Remote/Work at Home **WORK HOURS:** Full time: Monday-Friday, 8 hours/day, 5 days/week This role will complete quality reviews on the coding processes within the Payment Integrity organization, vendor partners focusing on the Outpatient Coding teams and various processes. This is a full-time remote/work-at-home opportunity. **Required Qualifications** + 5+ years of Evaluation and Management and DME. + 7 years of Profee and Surgery Auditing. + Medical coding certification from AAPC OR AHIMA (CPC, CCS, CIC, CPMA or equivalent). + Strong critical thinking skills. + Prior experience reading and coding from medical records. + Demonstrated ability to work independently and manage workload. + Exhibit professionalism, flexibility, dependability, desire to learn, commitment to excellence, and commitment to the profession. + Excellent writing, editing, interpersonal, planning, teamwork, and communication skills. + Proficient in MS Office applications including Word, Excel, Outlook, PowerPoint. + Prior experience working independently and determining appropriate courses of action. + Demonstrated experience in effective communication with internal customers through both written and verbal communication. **Preferred Qualifications** + Inpatient experience. + Interventional radiology. + Process improvement experience. + Multi-Specialty Auditing experience. **Additional Information** **Work at Home Requirements** - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information **Interview Format** As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Hire Vue (formerly Modern Hire) to enhance our hiring and decision-making ability. Hire Vue (formerly Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes. If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews. **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $65,000 - $88,600 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. **Description of Benefits** Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. Application Deadline: 03-27-2025 **About us** Humana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. **Equal Opportunity Employer** It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ***************************************************************************

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! **What You Will Do:** + Review medical records and assign accurate codes for diagnoses and procedures. + Assign and sequence codes accurately based on medical record documentation. + Assign the appropriate discharge disposition. + Abstract and enter the coded data for hospital statistical and reporting requirements. + Communicate documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution. + Maintain a 95% coding accuracy rate and a 95% accuracy rate for APC assignment and meet site-designated productivity standards. + Be responsible for tracking continuing education credits to maintain professional credentials. + Attend Datavant Health sponsored education meetings/in-services. + Demonstrate initiative and judgment in the performance of job responsibilities. + Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues. + Function in a professional, efficient, and positive manner. + Adhere to the American Health Information Management Association's code of ethics. + Be customer-service focused and exhibit professionalism, flexibility, dependability, and a desire to learn. + Handle a high complexity of work function and decision-making. + Possess strong organizational and teamwork skills. + Be willing and able to travel when necessary if applicable. + Comply with all HIM Division Policies. **What You Need to Succeed:** + Excellent written and verbal communication skills + AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC). + Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills. + Experience in computerized encoding and abstracting software. + Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually + Proficiency with most or all of these coding specialties (Emergency Department, Same Day Surgery, Ancillary, Observation, Injections/Infusions, E/M leveling) + Must be able to communicate effectively in the English language. + 2+ years of coding experience in a hospital and/or coding consulting role. + Experience in computerized encoding and abstracting software + Passing annual Introductory HIPAA examination and other assigned testing to be given annually in accordance with employee review **What We Offer:** + Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays + Free CEUs every year + Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable + Equipment: monitor, laptop, mouse, headset, and keyboard + Comprehensive training led by a credentialed professional coding manager + Exceptional service-style management and mentorship (we're in this together!) Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $30 - $35 an hour. Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $30-$35 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here (************************************************** . Know Your Rights (*********************************************************************** , explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please contact us at *********************** . We will review your request for reasonable accommodation on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy (**************************************** .

Schedule: Full-time, M-F (Day shift) Fully remote Analyzes and reviews medical records and assigns appropriate codes for billing and statistical purposes. Ensures accuracy and compliance with coding guidelines and regulations. Job Description: Essential Functions: Analyzes medical records and utilizes coding books to accurately assign codes for diagnoses, procedures, and other medical services or charges. Reviews claims denials and appeals to identify coding errors. Performs coding and billing corrections and charge reconciliations. Researches newly identified diagnoses and procedures for code assignments. Maintains compliance with current coding guidelines and regulations. Communicates with physicians, parents, and third-party payors to ensure billing and reimbursement accuracy. Assists customers and staff with billing and coding questions. Conducts billing and coding audits to ensure accuracy and identify missed opportunities. Reports the results and recommends quality improvements. Education Requirement: As required by listed licensure and/or certification requirement. Licensure Requirement: (not specified) Certifications: RHIT, RHIA, CPC, CCS, CCS-P, or COC, required. Skills: (not specified) Experience: Two years ofcoding experience, required. Three years computer experience in a data processing capacity, required. Physical Requirements: OCCASIONALLY: Bend/twist, Climb stairs/ladder, Lifting / Carrying: 0-10 lbs, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking FREQUENTLY: (none specified) CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Flexing/extending of neck, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing - Far/near, Sitting Additional Physical Requirements performed but not listed above: Ability to multi-task within a demanding environment. "The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"

San Mateo County Health is seeking a Medical Records Coder III for the San Mateo Medical Center to provide coding of inpatient services. Services provided at San Mateo County Health which require coding include inpatient, outpatient facility, emergency room, long term care, psychiatric, ancillary services, and clinic visits. The Medical Records Coder III is responsible for reviewing medical records and accurately coding encounters within established timeframes, following national, state, and local coding guidelines. This is a remote position; however, work must be performed within the State of California. The incumbent may be required to report on-site occasionally with reasonable notice. As a public employee, the incumbent is designated as a Disaster Service Worker and may be required to respond to emergencies as needed. In such events, they must be prepared to report for duty on short notice. The ideal candidate for the position will be familiar with most or all of the following: ICD-10 diagnosis and procedures, CPT procedures, HCPCS procedures, CCI edits, DRG, APC, MCC/CC, HCC coding, and modifiers; has at least three years' experience in inpatient facility coding; ability to work independently with minimal supervision using sound independent judgement within established guidelines; embraces change; able to organize work, set priorities and meet critical deadlines; can communicate effectively (both verbal and written) and establish and maintain effective working relationships with those contacted in the course of work. Additionally, the ideal candidate has Epic experience, is detail-oriented, enjoys working in a fast-paced environment, and is a team player. The current vacancy is a full-time, regular vacancy. NOTE: The eligible list generated from this recruitment may be used to fill future extra-help, term, unclassified, and regular classified vacancies. Duties may include, but are not limited to, the following: * Assign or verify correct International Classification of Diseases Clinical Modification System and Current Procedural Terminology (ICD10/CPT) codes to outpatient or inpatient medical records. * Utilize technical coding principles and APC reimbursement expertise to assign appropriate ICD-10-CM diagnoses and ICD-10-CM/CPT procedures. * Review narrative records of patient treatments and surgical procedures to determine what information is appropriate for coding purposes, and prepares case abstracts. * Enter coded medical records data on computer terminal; select diagnosis and operations codes from computer designated abstracting system. * Assist in implementing solutions to reduce back-end billing errors. * Track weekly and follow up on all accounts that cannot be coded. * Contact doctors, nurses, laboratory and other auxiliary personnel for information needed to complete, correct or clarify medical records and to resolve discrepancies. * Perform related duties as assigned. Note: The level and scope of the knowledge and skills listed below are related to job duties as defined under Distinguishing Characteristics. Licensure/Certification: All Levels Possession of at least one of the following certifications: * Certified Coding Specialist (CCS) issued by the American Health Information Management Association (AHIMA). * Registered Health Information Technician (RHIT) issued by the American Health Information Management Association (AHIMA). * Registered Health Information Administrator (RHIA) issued by the American Health Information Management Association (AHIMA). * Certified Professional Coder-Hospital (CPC-H) issued by the American Academy of Professional Coders (AAPC). * Certified Professional Coder (CPC) issued by the American Academy of Professional Coders (AAPC). Knowledge of: * ICD10 and CPT classification coding systems. * Fundamentals of anatomy, physiology, and the study of diseases. * Extensive medical terminology, and hospital accreditation and regulatory standards. * ICD10 coding guidelines and Ethical Coding standards. * NCCI edits and hospital modifiers (for the journey level Coders) * Standard clerical office procedures and equipment including Windows-based software use. If working at the Medical Coder III level, must also have knowledge of: * Impact of severity of illness on CC/MCC assignments. * MS-DRG assignment and complex comorbidities. * Governmental regulations pertaining to billing and coding. Skill/Ability to: * Competently select ICD10 to code diagnoses, treatments and procedures for outpatient or inpatient services either by use of coding books or encoder product. * Competently code procedure using CPT logic. * Abide by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines. * Maintain Continuing Education for certifications * Abstract pertinent information from medical records. * Follow oral and written instructions. * Operate computer and appropriate coding software and abstract package. * Effectively communicate technical information to medical and administrative personnel. * Maintain effective working relationships with others. If working at the Medical Coder III level, must also have the skills and ability to: * Assign appropriate evaluation/management level for professional services. * Analyze and resolve billing edits. Education and Experience: Any combination of education and experience that would likely provide the required knowledge, skills and abilities is qualifying. A typical way to qualify is: * I Level: Completion of the RHIT/RHIA program or 6 months experience in coding hospital related services. * II Level: Three years of experience in coding hospital related services. * III Level: Three years of coding inpatient records. Open & Promotional. Anyone may apply. Current County of San Mateo and County of San Mateo Superior Court of California employees with at least six months (1040 hours) of continuous service in a classified regular, probationary, extra-help/limited term positions prior to the final filing date will receive five points added to their final passing score on this examination. The examination process will consist of an application screening (weight: pass/fail) based on the candidates' application and responses to the supplemental questions. Candidates who pass the application screening will be invited to a panel interview (weight: 100%). Depending on the number of applicants an application appraisal of education and experience may be used in place of other examinations or further evaluation of work experience may be conducted to group applicants by level of qualification. All applicants who meet the minimum qualifications are not guaranteed advancement through any subsequent phase of the examination. All examinations will be given in the County of San Mateo, California and applicants must participate at their own expense. IMPORTANT: Applications for this position will only be accepted online. If you are currently on the County's website, you may click the "Apply" button. If you are not on the County's website, please go to ************************ to apply. Responses to the supplemental questions must be submitted in addition to our regular employment application form. A resume will not be accepted as a substitute for the required employment application and/or supplemental questionnaire. Online applications must be received by the Human Resources Department before midnight on the final filing date. TENTATIVE RECRUITMENT TIMELINE Final Filing Date: Tuesday, April 8, 2025, by 11:59 p.m. PST Application Screening: Week of April 8, 2025 Panel Interviews: Week of April 21, 2025 About the County San Mateo County is centrally located between San Francisco, San Jose, and the East Bay. With over 750,000 residents, San Mateo is one of the largest and most diverse counties in California and serves a multitude of culturally, ethnically, and linguistically diverse communities. The County of San Mateo, as an employer, is committed to advancing equity to ensure that all employees are welcomed in a safe and inclusive environment. The County seeks to hire, support, and retain employees who reflect our diverse community. We encourage applicants with diverse backgrounds and lived experiences to apply. Eighty percent of employees surveyed stated that they would recommend the County as a great place to work. The County of San Mateo is an equal opportunity employer committed to fostering diversity, equity, and inclusion at all levels. Analyst: Debbie Kong (03242025) (Medical Records Coder II - E306)

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina, Virginia, South Carolina, Tennessee, Florida, and Texas. *Now offering a ***$10,000.00 Commitment Bonus (4 equal installments over 24 months- 6-month increments) The Medical Records Coder II is a certified Coder. Coordinate or review the work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-10-CM and CPT-4 coding conventions. Review the medical record to ensure specific diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and procedures. Review the complex (problematic coding that needs research and reference checking) medical records and accurately code the primary and secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions. Coordinate/review the work of designated employees. Ensure quality and quantity of work performed through regular audits. Assist with research, development, and presentation of continuing education programs in areas of specialization. Review medical record documentation and accurately code the primary and secondary diagnoses and procedures using ICD-10-CM and CPT-4 coding conventions. Sequence the diagnoses and procedures using coding guidelines. Ensure the DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate and optimal reimbursement for hospital and/or professional charges. Consult with and educate physicians on coding practices and conventions to provide detailed coding information. Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes, and surgical techniques through participation in continuing education programs to effectively apply ICD-10-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures. Maintain a thorough understanding of medical record practices, standards, and regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Health Care and Finance Administration (HCFA), the Medical Review of North Carolina (MRNC), etc. Assist with special projects as required. Perform other related duties incidental to the work described herein. Minimum Qualifications Education High school diploma required. Experience RHIA certification: no experience required RHIT certification: no experience required CCS certification: one year of coding experience required CPC or HCS-D certification: two years of coding experience required Degrees, licenses, and certifications Must hold one of the following active/current certifications: Registered Health Information Administrator (RHIA) Hospital Coding Registered Health Information Technician (RHIT) Hospital Coding Certified Coding Specialist (CCS) Hospital Coding Certified Professional Coder (CPC) Homecare Coding Specialist-Diagnosis (HCS-D) Homecare Coding Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Under the supervision of the Lead Coder, the Medical Records Coder analyzes, codes abstracts and assigns DRG's to hospital records for the purpose of reimbursement, research and compliance with regulatory agencies, using the ICD-10-CM/PCS classification system and CPT-4 procedural coding. Opportunity for remote work upon completion of training period. Minimum Qualifications: RHIT/RHIA or eligible required. Will also consider candidates enrolled in an accredited Health Information Management (HIM) program who have successfully completed anatomy, physiology and required coding courses as evidenced by an official transcript. RHIT/RHIA eligible candidates will be required to obtain certification within two years of hire date. Preferred Qualifications: Two or more years of coding experience preferred. Work Days: Monday - Friday Message to Applicants: This position does not require a Civil Service Exam. Recruitment Office: Human Resources Executive Order: Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor's Office of Employee Relations at ************** or via email at ****************.

Silver Cross Hospital is an extraordinary place to work. We're known for our culture of excellence and delivery of unrivaled experiences for our patients, their families, the communities we serve…and for each other. Come join us! It's the way you want to be treated. Position Summary Codes accurately and productively with abstraction to assigned outpatient medical records to meet the reimbursement, indexing and statistical requirements of the hospital. Consistently maintaining production and accuracy standards at all times. Essential Duties and Responsibilities: Accurately codes and sequences all diagnoses and procedures documented in the medical record according to established official coding guidelines, principles and appropriate reimbursement standards Utilizes Computer Assisted Coding software program following assigned workflows Accurately abstracts required data entering into Computer Assisted Coding system Issues accurate coding queries following AHIMA compliant coding query guidelines and assisting medical staff member documentation clarification Assists with special projects and reports as requested Remote position only following training and production/quality standards are met Promotes a clean and safe environment of care, utilizing the SAFE error prevention habits Provides the highest standard of privacy and confidentiality in matters involving patients, coworkers and the hospital by abiding by the Standards of Conduct Required Qualifications: Education and Training: Associate Degree in Registered Health Information Technician (RHIT) or Bachelor Degree in Registered Health Information Administrator (RHIA) required. APC/EAPG knowledge required, 2-3 Years Acute Care Hospital Outpatient Coding experience required 3M Encoder experience preferred, Cerner, Meditech, Optum System experience preferred. Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Or Certified Coding Specialist (CCS) required. Work Shift Details: Days, Days Department: MEDICAL RECORDSBenefits for You At Silver Cross Hospital, we care about your health and well-being and that is why we work hard to provide quality and affordable benefit options for you and your eligible family members. Silver Cross Hospital and Silver Cross Medical Groups offer a comprehensive benefit package available for Full-time and Part-time employees which includes: · Medical, Dental and Vision plans · Life Insurance · Flexible Spending Account · Other voluntary benefit plans · PTO and Sick time · 401(k) plan with a match · Wellness program · Tuition Reimbursement Silver Cross Management Services Org. - Premier Suburban Medical Group benefits offered to Full-time and Part-time employees include: · Medical, Dental and Vision plans · Life Insurance · Health Savings Account · Flexible Spending Account · Other Voluntary benefit plans · PTO bank · 401(k) plan with a match · Wellness program · Tuition Reimbursement Registry employees who meet eligibility may participate in one of our 401(k) Savings plan with a potential match. However, registry employees are ineligible for Health and Welfare benefits. The expected pay for this position is listed below: $23.71 - $29.64 The final offered salary will take several factors into consideration, including but not limited to: licensure, certifications, work experience, education, knowledge, demonstrated abilities, internal equity, market data, and more.

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career! Company Job Description/Day to Day Duties: Job Summary Directly responsible and accountable for performing chart reviews, physician education, and development of tools to ensure that our provider partners are compliant with Risk Adjustment. Provide overall coding expertise as well as administrative and technical oversight to ensure successful integration of Molina Medicare's Risk Adjustment initiatives. May require some travel to various provider partner locations • Performs on-going chart reviews and abstracts diagnoses codes under the HCC Model. • Develop an understanding of current billing practices in provider offices to ensure that diagnoses codes are submitted accordingly. • Documents results/findings from chart reviews and provides feedback to management, providers, and office staff. • Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education. • Monitor HCC Coding Accuracy at various levels of detail (e.g., by state, by product, by demographic segmentations). Extract information necessary to identify where there are low performing physicians; follow up with plan for education and training. Continue to audit to ensure training is implemented. • Resolve and track escalated issues. Track any coding issues identified either at the provider level (including Molina sites) or vendor; manage any non-compliance situation or potential fraud or abuse. • Utilize discretion and autonomy to select provider for further training or audits; coordinate efforts with internal clients such as Coding Manager, RAMP Director, State Medicare Directors and Provider Services. • Determine coding quality as it relates to CMS standards; selects physicians or vendors that require an audit. Qualifications Minimum Education/Qualifications/Licensures: Coding Certification - Active CCS, CCS-P, or CPC credentialing Coding guidelines knowledge Travel required (with mileage) Claims experience Additional Information Employment Type: Contract 6 months. With possibility of going perm.

Job Details Columbus, OH AccountingDescription Do you want to make a difference every day? Are you passionate about providing excellent customer service and patient care? PrimaryOne Health is dedicated to improving quality of life through providing access to the highest possible quality healthcare. Come find your next professional home at PrimaryOne Health! WORK FOR US! PrimaryOne Health is currently seeking a Certified Coder for our administrative office. Essential Job Responsibilities: Research and resolution of coding projects as assigned. 2 Perform ongoing analysis of medical record charts, for multiple specialties and provider types, for appropriate coding compliance. Coder is responsible for meeting quality coding goal of averaging 95% accuracy rate on a monthly basis. Attend meetings as necessary to provide information relating to Coding and Compliance Work closely with CCO in creating a training environment for providers. Communicate effectively with all provider types and become a resource for billing and coding compliance. Other duties or special projects as assigned. Successful candidates must possess a high school diploma or equivalent, CPA-A, RHIT, CCS, CCS-P, CPC-H, or CPC. Minimum three years of medical coding experience. WHAT WE OFFER PrimaryOne Health offers competitive wages and an extremely attractive benefits package, including generous Paid Time Off, Paid Holidays, Medical/Dental/STD/LTD/Life, Tuition Reimbursement, paid Professional Development / Professional Education, and company contribution to retirement plan. Other perks, such as discount programs, EAP, and worksite wellness are also available. Most benefits are available on the first of the month following date of hire. EOE

The Senior Care division at BCBST is looking to add a Risk Adjustment Medical Record Coder to our team. Expertise in HCC Coding with a background in MA and ACA is strongly preferred. In this role, you'll complete first past reviews of member medical records to capture active conditions that map to a risk value. This role is a remote, day-shift position with the ability to flex up to 8 hours a workweek per BCBST company policy. Please note an assessment is required for this role. You will take the assessment as part of the job application. After taking the assessment please return to the tab for the application and submit it. Job Responsibilities Maintain compliance with CMS risk adjustment diagnosis coding guidelines. Perform comprehensive 1st pass reviews of medical records and physician assessment forms (HCC coding). Assist with the intake and quality assurance of medical records as necessary. Perform or participate in special projects as directed by management. ICD-10 Coding assessment is required. Job Qualifications Education Associates degree or equivalent work experience required. Equivalent experience is defined as 2 years of professional work experience. Experience 1 year - Progressive medical coding and health care experience required. Skills\Certifications Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA). Must acquire the Certified Risk Adjustment Coder (CRC) certificate from AAPC within one year, after completed training. Ability to work independently with minimal supervision or function in a team environment sharing responsibility, roles and accountability. Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint). Proven analytical and problem-solving skills and ability to perform non-routine analytical tasks. Must be a team player, be organized and have the ability to handle multiple projects. Excellent oral and written communication skills. Strong interpersonal and organizational skills. Understanding of ICD-10 coding standards required. Number of Openings Available: 1 Worker Type: Employee Company: BCBST BlueCross BlueShield of Tennessee, Inc. Applying for this job indicates your acknowledgement and understanding of the following statements: BCBST will recruit, hire, train and promote individuals in all job classifications without regard to race, religion, color, age, sex, national origin, citizenship, pregnancy, veteran status, sexual orientation, physical or mental disability, gender identity, or any other characteristic protected by applicable law. Further information regarding BCBST's EEO Policies/Notices may be found by reviewing the following page: BCBST's EEO Policies/Notices BlueCross BlueShield of Tennessee is not accepting unsolicited assistance from search firms for this employment opportunity. All resumes submitted by search firms to any employee at BlueCross BlueShield of Tennessee via-email, the Internet or any other method without a valid, written Direct Placement Agreement in place for this position from BlueCross BlueShield of Tennessee HR/Talent Acquisition will not be considered. No fee will be paid in the event the applicant is hired by BlueCross BlueShield of Tennessee as a result of the referral or through other means. Tobacco-Free Hiring Statement To further our mission of peace of mind through better health, effective 2017, BlueCross BlueShield of Tennessee and its subsidiaries no longer hire individuals who use tobacco or nicotine products (including but not limited to cigarettes, cigars, pipe tobacco, snuff, chewing tobacco, gum, patch, lozenges and electronic or smokeless cigarettes) in any form in Tennessee and where state law permits. A tobacco or nicotine free hiring practice is part of an effort to combat serious diseases, as well as to promote health and wellness for our employees and our community. All offers of employment will be contingent upon passing a background check which includes an illegal drug and tobacco/nicotine test. An individual whose post offer screening result is positive for illegal drugs or tobacco/nicotine and/or whose background check is verified to be unsatisfactory, will be disqualified from employment, the job offer will be withdrawn, and they may be disqualified from applying for employment for six (6) months from the date of the post offer screening results. Resources to help individuals discontinue the use of tobacco/nicotine products include smokefree.gov or 1-800-QUIT-NOW.

Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, APR-DRG's, SOI, ROM, POA indicators, discharge dispositions and any other clinical data elements required for appropriate reimbursement. Understands and applies reimbursement processes under federal compliance guidelines. Abstracts demographic and clinical data into hospital health information system(s) such as HDM, Epic, or other currently in use. Performs and responds to data quality checks and payer/claims issues. One may specialize in one or more of the standard functions. Specific assignments will vary from day to day based on the needs of the department. Job Requirements: Currently enrolled in an approved program for specific field of study in Within six months of hire, RHIT/RHIA and/or CCS Continuing education pursued in accord with requirements of the accrediting bodies CPC/CCA may be substituted at the hiring manager's discretion Proficiency in ICD and CPT coding DRG's MSDRG's POA indicators Post-acute transfer rules Disposition status Disease process and treatment Anatomy and medical terminology Clinical documentation requirements AHIMA Experience in a related field Job Responsibilities: Reviews and interprets clinical documentation to assign accurate and complete codes, modifiers, MSDRG's, POA indicators, discharge dispositions, and other data elements required for appropriate reimbursement, meeting established quality and productivity standards within 3 days of visit/discharge. Meets stated metrics for on-time completion. Collaborates effectively with associate departments as follows, but not limited to: Performs and responds to data quality checks and payer/claims issues with Billing and Denials teams. Works closely with CDMP toward complete documentation for most descriptive coding and DRG , APR-DRG, SOI, and ROM assignment. Obtains final disposition status from Care Coordination. Supports clinical specialty work teams (i.e. OB and Cardiac Surgery) Abstracts demographic and clinical data into hospital health data management systems. Participates in audits, training of new employees, education, project teams, etc. as needed. Other Job-Related Information: Working Conditions: Climbing - Rarely Concentrating - Consistently Continuous Learning - Consistently Hearing: Conversation - Frequently Hearing: Other Sounds - Frequently Interpersonal Communication - Consistently Kneeling - Rarely Lifting Lifting 50+ Lbs. - Rarely Lifting Pulling - Occasionally Pushing - Occasionally Reaching - Occasionally Reading - Consistently Sitting - Occasionally Standing - Frequently Stooping - Occasionally Talking - Frequently Thinking/Reasoning - Consistently Use of Hands - Frequently Color Vision - Frequently Visual Acuity: Far - Frequently Visual Acuity: Near - Consistently Walking - Frequently TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… • Welcome everyone by making eye contact, greeting with a smile, and saying "hello" • Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist • Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… • Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met • Offer patients and guests priority when waiting (lines, elevators) • Work on improving quality, safety, and service Respect: ALWAYS… • Respect cultural and spiritual differences and honor individual preferences. • Respect everyone's opinion and contribution, regardless of title/role. • Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… • Value the time of others by striving to be on time, prepared and actively participating. • Pick up trash, ensuring the physical environment is clean and safe. • Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… • Acknowledge wins and frequently thank team members and others for contributions. • Show courtesy and compassion with customers, team members and the community