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Medical Records Coder II

🔥 22 hours ago

Duke Careers

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📚 Education

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Certified Coder responsible for coding activities in home health and hospice at Duke HomeCare & Hospice. Review and code medical records utilizing ICD-10-CM coding conventions.

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Inpatient Coder/Abstractor – Health Information Management

🔥 22 hours ago

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Inpatient Coder at McLeod Health responsible for coding inpatient discharges and ensuring accurate DRG assignment while maintaining productivity standards.

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Inpatient Coder/Abstractor Sr – Health Information Management

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Senior Inpatient Coder responsible for assigning complex diagnosis and procedure codes for McLeod Health. Maintaining high accuracy and collaborating with clinical documentation specialists.

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Outpatient Coder – Provider Based, Pro-Fee and Hospital Based

🕒 Yesterday

Impact Advisors

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Outpatient Medical Coder reviewing clinical documentation and assigning accurate codes for diagnoses and procedures. Ensuring compliance with payer requirements and optimizing reimbursement.

🇺🇸 United States – Remote

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Medical Billing Specialist – Self Pay

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OCHIN, Inc.

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Billing Specialist providing revenue cycle services for OCHIN's member clients. Aiming to enhance financial health through efficient billing operations and collaborative practices.

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Lead Medical Billing Specialist

• Manage the accounts receivable for timely and maximum reimbursement by adhering to company billing and collection policies.
• Review coding & charges, ensure the completion of team members daily task.
• Follow-up with external and internal customers to ensure remediation of customer issues.
• Communicate with the AR Manager concerning central billing issues, questions, concerns, corrective actions or training needs.
• Perform daily, monthly and special system processing requirements (i.e. batch posting and balancing).

• Coordinate/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 specificity of 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/secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions.
• Ensure quality and quantity of work performed through regular audits.
• Assist with research, development, and presentation of continuing education programs in areas of specialization.
• Sequence the diagnoses and procedures using coding guidelines.
• Ensure DRG/APC assignment is accurate.
• Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges.
• Consult with and educate physicians on coding practices and conventions in order 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, regulations, Joint Commission on Accreditation of Health Organizations (JCAHO), Health Care/Finance Administration (HCFA), Medical Review of North Carolina (MRNC), etc.
• Assist with special projects as required.
• Perform other related duties incidental to the work described herein.

Medical Records Coder II – Ophthalmology

• Evaluates medical records, provides clinical and surgical abstraction and assigns appropriate clinical diagnosis and procedure codes.
• Analyzes medical information from medical records
• Accurately codes diagnostic and procedural information in accordance with national coding guidelines
• Consults with medical providers to clarify missing or inadequate record information and to determine appropriate codes.
• Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards.

Profee Coder – Primary Care

• Examines medical records to determine the proper ICD (diagnosis) and CPT (procedure codes) to be assigned
• Utilizes coding tools & resources to verify the correctness of CPT and ICD codes assigned
• Abstracts data including providers, injury info, quality measures, and others as needed
• Maintains knowledge of current trends and practices in coding principles and government regulations through reading materials and/or attendance at educational meetings or seminars
• Maintains appropriate certification
• Communicates with coworkers and physicians to resolve and clarify questions and documentation discrepancies
• Communicates risk management concerns to appropriate parties
• Completes priority accounts (Holds) daily
• Refers complex issues to designated work queues
• Participates in coder specific training and education based on audit metrics and trends
• Review and analyze content of medical record to accurately assign ICD diagnosis and procedure codes; CPT procedure codes and modifiers according to national coding guidelines, USACS policies and SOPs
• Answer coding and abstracting questions from coding leadership, compliance, clinicians, etc
• Maintain coding accuracy rate of ≥ 95%
• Maintain coding productivity (Milestone based standards) rate of ≥ 95%
• Maintain minimum of 15 CEUs per quarter either through Nthrive and/or other company sponsored webinars and programs
• Accurately identify and enter core abstracting elements such as physician and APP attributions
• Identify documentation trends and topics for education/feedback to physicians and APPs
• Keep current with coding and industry changes through participation in educational opportunities

Coding Specialist I, Emergency Medicine

• Ensure 100% charge capture by reviewing physician dictated notes and operative reports and properly code all services performed utilizing appropriate CPT, ICD-10-CM codes and modifiers.
• Daily review of EPIC Charge Review Work queues is essential.
• Monitor and report on accounts receivable issues related to payer compliance and/or billing processes.
• Act as a resource to providers, office staff, administration and the Central Business Office.
• Participation in coding training and education is also required.
• Maintain yearly certification as a Certified Professional Coder is required with the American Academy of Professional Coders.

Senior Billing Liaison, Coder

• Assign and sequence ICD-10-CM, ICD-10-PCS, and CPT-4 codes for inpatient, outpatient, ambulatory, and emergency room records while ensuring accuracy for billing, reimbursement, and compliance
• Review medical records for DRG/APC assignment, verify charge accuracy, abstract clinical data, and collaborate with providers and hospital departments to ensure proper documentation and regulatory compliance
• Accurately reflects the diagnosis and procedures per department procedure within the medical records
• Proactively communicates with providers, staff, leadership and hospital departments to ensure adequate documentation to support services
• Performs Charge capture and data entry per department protocol and procedure
• Ensures accurate abstracting of clinical data and meets regulatory and compliance requirements

Certified Facility Coder

• Utilize technical coding expertise to assign appropriate ICD-10-CM and CPT-4 codes to outpatient visit types.
• Review the medical record thoroughly, utilizing all available documentation to code appropriate diagnoses and procedures.
• Interpret health record documentation using knowledge of anatomy, physiology, clinical disease process, pharmacology, and medical terminology to report appropriate diagnoses and/or procedures.
• Send appropriate physician queries when required for documentation clarification.
• Follow Coding Clinic for HCPCs, CPT Assistant, and interpret coding conventions and instructional notes to select appropriate diagnoses and procedures with a minimum of 95% accuracy.

Outpatient Coder II, HB Coding

• Ability to comprehend medical record documentation to accurately assign codes for both concurrent and discharged accounts across multiple specialties.
• Meets minimum requirements for production and quality monthly.
• Requires a working knowledge of code sequencing for grouper-related payers with attention to detail to avoid rework and waste with charge capture assessment component.
• Requires understanding and application of M.E.A.T. criteria (i.e., monitoring, evaluation, assessment, treatment) using ICD 10 CM transaction data set to capture diagnoses.
• Analyzes high-risk encounters for accurate and/or missing charges gaps prior to encounter completion (i.e., missing charges from anesthesia, surgery) when manual charge capture occurs.
• Understand complexity of billing requirements and incorporates payer specific trends into day-to-day reviews to reduce “take backs” associated with unclear, or unsubstantiated care rendered. (i.e., varying modifier assignment for EAPG vs. Non-EAPG payer specificity)
• Requires excellent coding knowledge of ICD 10 CM, CPT 4, and modifier application, with expectations to maintain certification (i.e., CCS, CPC, RHIT, or RHIA) and apply ICD 10 CM Coding Guidelines specific to both inpatient and outpatient encounters.
• Facilitate modifications to clinical documentation through query interaction to ensure that the information captured supports the level of service rendered, with attention towards chronic conditions, hierarchical condition categories (HCC), and risk adjustment factors (RAF).
• Demonstrates an excellent working knowledge of hospital information systems to retrieve data specific information (i.e., order diagnosis, patient type) within a complicated filing schema including non-hospital data (i.e., Media Tab, Office Visits etc)

Outpatient Surgery Coder

• Prepare, review, and submit clean medical claims to commercial payers.
• Verify claim accuracy, including coding, modifiers, eligibility, EAP authorizations, and provider details
• Monitor claim rejections and take timely corrective actions
• Manage denial resolution: research root cause, correct and resubmit, or prepare appeals
• Conduct proactive follow-up on outstanding A/R and aging claims
• Support patient billing activities and inquiries when needed
• Document all billing activities clearly and accurately in internal systems
• Ensure compliance with HIPAA, payer regulations, and state/federal billing guidelines
• Collaborate with credentialing, eligibility/benefits, clinical operations, and internal RCM teammates
• Identify trends and recommend process improvements to reduce denials and rework

Medical Billing Specialist

• Abstracts and codes physician professional services and diagnosis codes (inpatient admissions, outpatient procedures, diagnostic services)
• Assigns appropriate CPT and ICD9 codes
• Completes coding and billing worksheet
• Ensures charges are captured by performing various reconciliations (procedure schedules, clinical system reports, fatal edit reports)
• Provides documentation feedback to physicians
• Maintains coding reference information
• Trains physicians and other staff regarding documentation, billing and coding
• Reviews and communicates new or revised billing and coding guidelines and information
• Resolves pre-accounts receivable edits and monitors reasons for missed billing opportunities

Coding Specialist

• Responsible for accurately and timely coding of moderately complex encounters following established coding, CMS regulations and hospital guidelines.
• Reviews moderately complex medical records to identify sequence, code diagnoses and procedures according to established coding, CMS and hospital guidelines.
• Responsible for accurately coding hospital same day surgery, observations, ancillary, ED encounters and/or professional services.
• Ensures optimal CPT, ASC, APC, APG assignment as applicable.
• Understanding and ability to resolve coding specific edits such as CCI, LCD, NCD, and MUE.
• Supports OP Clinical Documentation Improvement program.
• Maintains productivity and quality rate according to established standards.
• Works within UH Billing time frames.
• Maintains up to date credentials.
• Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA).

Outpatient Coding Specialist II

• Accurately assigns appropriate ICD-10-CM and CPT-4 codes to outpatient records
• Abstract essential data elements for tracking, reporting, and reimbursement purposes
• Keying, billing and collections for assigned client databases
• Review and analyze medical records for document deficiencies
• Ensure accurate coding and compliance with Federal and State regulations
• Verify accuracy of patient account, type, and demographic data
• Meet productivity standards set by Revenue Integrity Coding department

Certified Professional Coder

• Reviews complex inpatient documentation at a highly skilled and proficient level to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS
• Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations utilizing an EMR and/or Computer Assisted Coding software
• Responsible for coding high dollar and long length of stay cases for all patient types
• Serves as a subject matter expert to Coding department leaders and peers
• Recommends modifications to current policies and procedures as needed to coincide with government regulations
• Collaborates with the Clinical Documentation Improvement and Quality teams to ensure a match in the DRG and reconciles each Medicare case from a CDI perspective
• Responsible for clinician communication related to disease processes on a clinical level to ensure accurate coding
• Participates in payer audits and meetings by acting as a resource for coding-related audits, as requested

Inpatient Coder Specialist – Community Facility

• Accurately assigns diagnosis and procedure codes for inpatient facility and professional services.
• Performs necessary tasks within MHS GENESIS and other military coding systems.
• Accurately assign Evaluation and Management (E&M) codes, ICD-CM diagnoses, CPT and HCPCS, modifiers, and quantities derived from medical record documentation.
• Reviews encounter and/or record documentation to identify and resolve inconsistencies, ambiguities, or discrepancies.
• Assigns accurate codes based on provider responses to coding queries.
• Supports DHA coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance.
• Utilizes MHS computer systems to remotely access patient records and assign codes for patient encounters in support of other MTFs.
• Achieve and maintain DHA coding productivity and accuracy standards for the position.
• Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance.
• Acts as a source of reference to medical staff having questions, issues, or concerns related to coding.
• Responds to provider questions and provides examples of appropriate coding and documentation reference(s).

Medical Coder II

• Under the general supervision of the Coding Supervisor, the Outpatient Coder supports Dayton Children’s reimbursement goals through accurate and timely diagnosis and procedural coding for emergency department, specialty clinic, inpatient, observation, and outpatient ancillary services.
• Responsibilities include reviewing and interpreting electronic medical documentation to assign and report appropriate diagnostic and procedural codes for clean claim submission.

Outpatient Coder

• Coordinate/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 assure specificity of 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 medical records and accurately code the primary/secondary diagnoses and procedures using ICD-10-CM and/or CPT coding conventions.
• Ensure quality and quantity of work performed through regular audits.
• Assist with research, development, and presentation of continuing education programs on areas of specialization.
• Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes, and surgical techniques through participation in continuing education programs.

Medical Records Coder II – Outpatient

• Responsible for assuring medical records requests are accurate
• Process incoming medical records and assign to appropriate claims
• Support the audit process - error exception reporting
• Make claim payment audit decisions on uncomplicated medical codes
• Research and make payment decisions based on medical coding guidelines
• Refer suspected Fraud, Waste, or Abuse to the SIU when identified
• Identify process improvements and refer system enhancement ideas
• Report claim problems/concerns to management

PI Medical Coding Reviewer I, CPC, RHIT, RHIA required

• Responsible for accurately processing patient billing, managing insurance claims, and ensuring timely reimbursement.
• Duties include reviewing medical records, coding procedures, and collaborating with healthcare providers and insurance companies to resolve discrepancies.
• Strong attention to detail, knowledge of medical terminology, and proficiency in billing software are essential for success in this role.
• Verify insurance benefits and confirm patient eligibility.
• Obtain prior authorization for services as required.
• Review clinician entered charges entered for accuracy before generating claims.
• Prepare and submit claim files.
• Post insurance and clients payments accurately and in a timely manner.
• Analyze and address ERA/EOB denials by taking appropriate corrective action.
• Manage accounts receivable and actively pursue outstanding balances.
• Oversee client collections to ensure timely payment.
• Handle insurance appeals for denied or underpaid claims.
• Stay informed and compliant with payor reimbursement policies, procedures, and guidelines.
• Monitor and apply contracted fee schedules to ensure accurate expected payment.
• Foster positive communication and relationships with patients, clinicians, physicians, third-party payors, and other Boundless staff to ensure exceptional customer service.
• Adheres to company policies and procedures in addition to regulations, laws and other requirements from applicable governing bodies, certification, licensure and/or accreditation entities, etc.
• Other duties as assigned.

Medical Billing and Accounts Receivable Specialist

• Completes electronic and manual billing for all patient accounts in a timely manner.
• Performs electronic billing via electronic health record and clearinghouses.
• Demonstrates knowledge of HCFA 1500 billing criteria.
• Demonstrates comprehensive ability and knowledge of electronic claims processing, electronic remittance advice, electronic payment posting, and clearinghouse functions.
• Demonstrates knowledge of CPT-4, ICD-10, usage of modifiers, and HCPCs coding according to all federal and state regulatory guidelines.
• Demonstrates a thorough knowledge and understanding of benefits and/or coverage as indicated by third party payer requirements.
• Demonstrates in depth knowledge of insurance authorizations with relation to medical billing.
• Performs and regularly updates insurance and physician credentialing to ensure timely processing and payment of claims.
• Communicate with work partners to inform of instructions necessary to complete tasks in a timely fashion.
• Promptly corrects and processes rejected, invalid or denied claims.
• Effectively manages accounts receivable and collections for all assigned clients.

Medical Billing and Coding jobs in Ohio

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Lead Medical Billing Specialist

Lead Medical Billing Specialist

Medical Records Coder II – Ophthalmology

Profee Coder – Primary Care

Coding Specialist I, Emergency Medicine

Senior Billing Liaison, Coder

Certified Facility Coder

Outpatient Coder II, HB Coding

Outpatient Surgery Coder

Medical Billing Specialist

Coding Specialist

Outpatient Coding Specialist II

Certified Professional Coder

Inpatient Coder Specialist – Community Facility

Medical Coder II

Outpatient Coder

Medical Records Coder II – Outpatient

PI Medical Coding Reviewer I, CPC, RHIT, RHIA required

Medical Billing and Accounts Receivable Specialist

Medical Billing Specialist