certified coding specialist

TEEMA Group

<div><h2 class="jobSectionHeader">Role Summary</h2>
The Senior Clinical Coder serves as a subject matter expert in medical coding and DRG validation, playing a critical role in ensuring coding accuracy, regulatory compliance, and appropriate reimbursement across inpatient and outpatient services.
In this role, you will conduct detailed retrospective claims reviews, provide expert-level coding analysis, and support cross-functional teams including medical directors, claims operations, and quality management. This position is ideal for a highly analytical professional who thrives in a fast-paced, remote environment and is passionate about accuracy, compliance, and continuous improvement in healthcare operations.<h2 class="jobSectionHeader">
Duties &amp; Responsibilities</h2><ul><li>
Serve as a subject matter expert for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding</li><li>
Perform DRG validation and retrospective medical claims reviews</li><li>
Analyze inpatient and outpatient claims for coding accuracy and reimbursement determinations</li><li>
Prepare clear, detailed determination letters and written review outcomes</li><li>
Identify coding discrepancies, potential fraud, and quality concerns</li><li>
Provide training, mentorship, and guidance to clinical coding staff</li><li>
Collaborate with cross-functional teams to support coding inquiries and review findings</li><li>
Research and apply medical policies, benefits, limitations, and current coding guidelines</li><li>
Ensure timely completion of coding reviews in alignment with performance standards</li><li>
Maintain accurate and thorough documentation within medical management and claims systems</li><li>
Escalate complex or high-risk cases to the Medical Director as appropriate</li></ul><h2 class="jobSectionHeader">
Required Qualifications</h2><ul><li>
High School Diploma or GED</li><li>
Active credential in one of the following:<ul><li>
Certified Inpatient Coder (CIC)</li><li>
Certified Coding Specialist (CCS)</li><li>
Registered Health Information Technician (RHIT)</li></ul></li><li>
Minimum of five (5) years of clinical coding experience (facility and/or professional)</li><li>
Minimum of three (3) years of inpatient and/or outpatient claims processing experience</li><li>
Experience working in a fast-paced, production-driven environment</li><li>
Ability to obtain and maintain a favorable background investigation</li><li>
U.S. Citizenship required</li></ul><h2 class="jobSectionHeader">
Desired Qualifications</h2><ul><li>
Experience within managed care, health insurance, or private healthcare industry</li><li>
Familiarity with government healthcare programs and regulatory guidelines</li><li>
Advanced expertise in inpatient facility coding and DRG validation</li><li>
Strong analytical, critical thinking, and problem-solving skills</li><li>
High attention to detail with strong organizational capabilities</li><li>
Ability to manage large volumes of complex information independently</li><li>
Effective communication and collaboration across multidisciplinary teams</li><li>
Proficiency in Microsoft Word, Excel, and multi-system environments</li></ul><h2 class="jobSectionHeader">
Location &amp; Work Type</h2>
100% Remote (must reside in an approved state) 
Full-time position<ul><li>
Independent home office work environment required</li><li>
Prolonged computer use and sitting required</li><li>
Flexibility to support varying work schedules as needed</li></ul>
#Workwolf</div>

Sr. Inpatient Clinical Coder

Caban Resources

<div>Starts out onsite, then transitions to REMOTE 4 days/week.
Job Summary:
Required Services provide single path medical coding services and related medical records functions. Single path coding combines facility coding and professional coding and allows one coder to code facility and professional codes for the same patient utilizing a single coding platform. perform technically complex professional services coding for medical conditions and assign the correct International Classification of Diseases, ICD-10-CM, Procedure Coding System (PCS) Current Procedural Terminology (CPT), Health Care Financing Administration Common Procedure Coding System (HCPCS), and Evaluation and Management (E&amp;M) codes for diagnosis, acuity of care and procedures for a wide range of medical specialties to include coding of complicated cases identified as difficult to classify such as treatment of burn injuries, combat related injuries, orthopedic surgery, cardiothoracic surgery, interventional radiology, new diseases, new and experimental treatments or therapies and infections, etc.
Duties:<ul><li>
Accurately assigns Evaluation and Management (E&amp;M) codes, International Classification of Diseases, Clinical Modification (ICD-CM) diagnoses, ICD-10 Procedure Coding System (ICD-10-PCS), Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities derived from medical record documentation (paper or electronic) for the professional and institutional (facility) components of inpatient facility discharges (stays); inpatient professional services to include attending (also known as &quot;Rounds&quot;), consultations, and concurrent services, and inpatient surgical and anesthesia procedures; and inpatient External Resource Sharing Agreement (ERSA) encounters. May also code ambulatory (i.e. Coder II) or outpatient (i.e. Coder I) encounters as directed.</li><li>
Reviews encounter and/or record documentation to identify and resolve inconsistencies, ambiguities, or discrepancies that may cause inaccurate coding, medico-legal repercussions or impacts quality patient care.</li><li>
Educates and provides feedback to providers and clinical staff to resolve documentation issues to support coding compliance.</li><li>
Assigns accurate codes to encounters based upon provider responses to coding queries.</li><li>
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) to provide clarity and understanding. Collaborates with and supports medical coding auditors, trainers, and compliance specialists in providing education and feedback to providers and staff.</li><li>
Supports DHA coding compliance by performing due diligence in ethically and appropriately researching and/or interpreting existing guidance, including seeking clarification through appropriate channels.</li><li>
Upon DHA-MCPB direction, utilizes MHS computer systems to remotely access patient records and assign codes for patient encounters in support of other MTFs.</li><li>
Achieve and maintain DHA coding productivity and accuracy standards for the position.</li></ul>
Qualifications:<ul><li>
Education: Post-high school education through a university or technical school program resulting in completion of ONE of the following: 1) An Associate's degree or higher in Health Information Management, Healthcare Administration, or a biological science; OR 2) A university certificate in medical coding; OR 3) At least 30 semester hours' university/college credit that includes relevant coursework such as anatomy/physiology, medical terminology, health information management, and/or pharmacology; OR 4) Successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology; OR 5) Successful completion of a training course beyond apprentice level for medical technicians, hospital corpsmen, medical service specialists, or hospital training, obtained in a training program given by the Armed Forces or the U.S. Maritime Service under close medical and professional supervision. General medical ethics, telephone etiquette, and excellent communication and customer service skills.</li><li>
Certification: ONE of the following recognized professional coding certifications: Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist &ndash; Physician (CCS-P); AND ONE of the following recognized institutional coding certifications: Certified Inpatient Coder (CIC), Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS).</li></ul></div>

Medical Coder III (Inpatient Coder)

NKC Health

<div>
 
 Summary
 
 
 
 Here at
 
 NKC Health
 
 our mission is to
 
 
 empower hope and healing in every life we touch
 
 
 . Whether you are serving patients at a primary care clinic, specialty clinic, or in a support capacity, every team member works together to complete this mission.
 
 
 
 NKC Health Coding and Denial
 
 team is hiring a
 
 Non-Certified Coder
 
 ! If you&rsquo;re looking for a great opportunity to impact our communities, join our NKC Health team!
 
 
 
 Why NKC Health Medical Group?
 
 
 
 <ul>
 <li>
 Comprehensive Benefits (Medical, Dental, Vision, Life, FSA)
 </li>
 <li>
 Employer matched retirement plan
 </li>
 <li>
 Competitive wages
 </li>
 <li>
 Paid time off for personal/vacation/sick
 </li>
 <li>
 Six paid holidays per year
 </li>
 <li>
 Educational assistance
 </li>
 <li>
 Day shift schedules
 
 
 </li>
 </ul>
 
 What does a Non-Certified Coder do?
 
 
 
 As part of the coding team, you will have the opportunity to focus solely on coding processes. Your daily mission would be to review medical records for the correct ICD/CPT codes, posting charges and having meaningful communication with the practice team.
 
 
 
 What does a typical day on the job look like?
 
 
 
 <ul>
 <li>
 Review procedures, HCPCS, and diagnosis coding for accuracy.
 </li>
 <li>
 Assigns proper codes based upon medical record documentation.
 </li>
 <li>
 Works with denials team and central billing office to resolve claims denials, and billing issues.
 </li>
 <li>
 Posts charges accurately and timely.
 </li>
 <li>
 Work with providers to ensure coding accuracy.
 </li>
 <li>
 Knowledge of risk adjustment processes and coding is a plus, but not required.
 
 
 </li>
 </ul>
 
 What are the requirements for the job?
 
 
 
 <ul>
 <li>
 High school graduate or GED equivalent
 </li>
 <li>
 Minimum 2 years&rsquo; of experience in physician coding and billing
 </li>
 <li>
 Knowledge of CPT and ICD-10 coding and medical terminology
 </li>
 <li>
 Proficient computer skills
 
 
 </li>
 </ul>
 
 Our North Star
 
 
 
 Here at NKC Health, we believe in
 
 
 care empowered.
 
 
 Our actions are the concrete things we do to differentiate ourselves: we lead with heart, we always move forward, and we connect to more.
 
 
 
 NKC Health is an Equal Opportunity Employer and values diversity in our organization. We do not discriminate against any applicant for employment or employee on the basis of race, color, religion, gender, age, marital status, sexual orientation, national origin, disability, veteran status or any other classification protected by applicable discrimination laws.
 
</div>

Coder Non-Certified

BILLING & CODING COMPLIANCE ANALYST

Ohio State University Physicians

<div>
 
 Overview
 
 
 
 
 Looking to join our dynamic team at Ohio State University Physicians where excellence meets compassion?
 
 
 
 
 Who We Are
 
 
 
 With over 100 cutting-edge outpatient center locations, dedicated to providing exceptional patient care while fostering a collaborative work environment, our buckeye team includes more than 1,800 nurses, medical assistants, physicians, advanced practice providers, administrative support staff, IT specialists, financial specialists and leaders that all play an important part. As an employee of Ohio State University Physicians (OSUP), you'll be an integral part of a team committed to advancing healthcare, education, and professional growth.
 
 
 
 Our culture
 
 
 
 At OSUP, we foster a culture grounded in the values of inclusion, empathy, sincerity, and determination. We meet our teams where they are, coming together to serve each other and our community.
 
 
 
 Our Benefits
 
 
 
 We know that having options and robust benefit plans are important to you. OSUP prioritizes the wellbeing of our team and that&rsquo;s why we offer our employees a flexible, competitive benefit package. In addition to medical, dental, vision, health reimbursement accounts, flexible spending accounts, and retirement, we also offer an employee assistance program, paid time off, holidays, and a wellness program designed to support our employees so they can live their best lives. As an OSUP employee, you will be eligible for these various benefits depending on your employment status.
 
 
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Determines accurate CPT, HCPCS procedure and professional supply codes and ICD-10-CM diagnosis codes used for billing services provided by physicians and licensed non-physician providers.
 </li>
 <li>
 Performs activities related to physician practice management and coding to maintain compliance with payer reimbursement policies and Federal health care program requirements.
 </li>
 <li>
 Provides training and education on coding and compliance issues to physicians, non-physician providers and staff on an ongoing basis.
 </li>
 <li>
 Interacts with patient care providers regarding billing and documentation policies, procedures, and regulations; obtains clarification of conflicting, ambiguous, or non-specific documentation as well as communication on coding and compliance issues.
 </li>
 <li>
 Performs audits and analyses of payer denials; provides information on compliance issues arising from audits and formulates recommendations to providers regarding improved documentation practices to avoid future claims denials.
 </li>
 <li>
 Researches inquiries from providers and patients about fees, reimbursements, and denials.
 </li>
 <li>
 Monitors data sources to ensure receipt and analysis of all charges.
 </li>
 <li>
 Updates encounter forms/super bills on an annual basis with respect to diagnostic, procedural and supply code changes.
 </li>
 <li>
 Attendance, promptness, professionalism, the ability to pay attention to detail, cooperativeness with co-workers and supervisors, and politeness to customers, vendors, and patients.
 </li>
 <li>
 Other duties or special projects as assigned.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 High School diploma or GED; Certification in CPC, CCS, CCS-P, RHIT; or specialty coding with one to three years&rsquo; experience directly related to coding and reimbursement for physician services; or equivalent combination of education and experience.
 </li>
 <li>
 Knowledge of CPT, HCPCS procedure and professional supply codes and ICD-10-CM (or current version) diagnosis codes used for billing services provided by physicians and licensed non-physician providers.
 </li>
 <li>
 Knowledge of third party fee profiles and reimbursement requirements.
 </li>
 <li>
 Knowledge of current and developing issues and trends in medical coding procedures and requirements.
 </li>
 <li>
 Analytical ability to gather and interpret data and develop, recommends, and implement solutions.
 </li>
 <li>
 Ability to interact and communicate with individuals at all levels of the organization.
 
 
 </li>
 </ul>
 
 Preferences:
 
 Experience working with Electronic Medical Records and IDX.
 
 
 
 Pay Range
 
 
 
 USD $23.84 - USD $35.76 /Hr.
</div>

Certified Coder

Progress Weight Management

Medical Billing SpecialistLocation: Fargo, ND (In-Person)Job Type: Full-TimePay Range: $18.00&ndash;$25.00 per hourAbout the RoleWe are seeking a detail-oriented and dependable Medical Billing Specialist to join our growing healthcare team in Fargo, North Dakota. This position plays a critical role in supporting the financial health of our organization by ensuring accurate claim submission, timely reimbursement, and exceptional patient service.The ideal candidate has prior medical billing experience, strong problem-solving skills, initiative, and a collaborative work ethic. They are confident in working with insurance claims, billing processes, revenue cycle management, and EHR systems while contributing to a mission-driven healthcare organization.Key ResponsibilitiesClaims Management &amp; Reimbursement<ul><li>Prepare, review, and submit accurate medical claims to commercial insurance carriers, Medicare, Medicaid, Tricare, and other third-party payers.</li><li>Audit claims for completeness and accuracy prior to submission.</li><li>Monitor claim status and perform follow-up on unpaid, delayed, denied, or rejected claims.</li><li>Research claim issues and coordinate appeals to maximize reimbursement.</li><li>Document all follow-up activities and claim actions within patient account records.</li></ul>Insurance Verification &amp; Eligibility<ul><li>Verify patient insurance eligibility and benefits prior to services.</li><li>Identify authorization and referral requirements when applicable.</li><li>Confirm coverage limitations and patient financial responsibility.</li></ul>Patient Billing &amp; Customer Service<ul><li>Generate and distribute patient statements.</li><li>Assist patients with billing questions, insurance explanations, account balances, and payment options.</li><li>Explain Explanation of Benefits (EOBs) and patient financial obligations in a professional manner.</li></ul>Payment Posting &amp; Account Reconciliation<ul><li>Post insurance payments, patient payments, contractual adjustments, and corrections accurately.</li><li>Reconcile account balances and investigate discrepancies.</li><li>Maintain accurate billing and payment records.</li></ul>Compliance &amp; Reporting<ul><li>Ensure compliance with HIPAA regulations and payer requirements.</li><li>Maintain confidentiality of patient information at all times.</li><li>Stay current on billing regulations, coding updates, and reimbursement guidelines.</li><li>Prepare reports and billing-related documentation as requested.</li></ul>QualificationsRequired<ul><li>High school diploma or equivalent.</li><li>Minimum 1&ndash;3 years of medical billing experience in a clinic, hospital, or healthcare billing environment.</li><li>Experience with medical billing software and Electronic Health Record (EHR) systems.</li><li>Knowledge of medical terminology and healthcare reimbursement processes.</li><li>Familiarity with ICD-10, CPT, and HCPCS coding systems.</li><li>Understanding of Medicare, Medicaid, commercial insurance, and coordination of benefits.</li><li>Strong attention to detail and organizational skills.</li><li>Excellent communication and customer service abilities.</li><li>Ability to multitask and prioritize work in a fast-paced environment.</li><li>Proficiency with computers.</li><li>Ability to maintain confidentiality and professionalism when handling sensitive information.</li></ul>Preferred<ul><li>Certified Professional Biller (CPB), Certified Billing &amp; Coding Specialist (CBCS), or similar credential.</li></ul>Benefits<ul><li>Medical, Dental &amp; Vision Insurance</li><li>Short Term Disability Insurance</li><li>Retirement</li><li>Paid Time Off (PTO)</li><li>Paid Holidays</li></ul>Pay: $18.00 - $25.00 per hourBenefits:<ul><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Retirement plan</li><li>Vision insurance</li></ul>Work Location: In person

Medical Billing Specialist

Search 3734+ Certified coding specialist jobs near you this June. New roles added regularly across leading industries. Apply today.

3734 certified coding specialist jobs Near Me

Sr. Inpatient Clinical Coder

Sr. Inpatient Clinical Coder

Medical Coder III (Inpatient Coder)

Coder Non-Certified

BILLING & CODING COMPLIANCE ANALYST

Certified Coder

Medical Billing Specialist