certified medical coding specialist

BILLING & CODING COMPLIANCE ANALYST

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)

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

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

Al Taie Center for Laparoscopic and Bariatric Surgery

Al Taie Center is a premier healthcare facility specializing in laparoscopic and obesity surgery, led by Dr. Abdulsalam Al Taie, Consultant General, Bariatric &amp; Laparoscopic Surgeon. With locations in Dubai and Abu Dhabi, we are committed to delivering exceptional patient care using the latest medical technologies. We are currently looking for a skilled and experienced Insurance Coder to join our Abu Dhabi team.Role OverviewWe are seeking a detail-oriented Insurance Coder who is experienced in UAE healthcare insurance practices and holds their own valid UAE visa. The ideal candidate will have a minimum of 2 years of hands-on experience in medical coding and insurance claims processing within the UAE.Key Responsibilities<ul><li>Accurately assign ICD-10-CM, CPT, and HCPCS codes for diagnoses, procedures, and medical services.</li><li>Review medical records and documentation to ensure coding accuracy and completeness.</li><li>Process and follow up on insurance claims (pre-authorizations, submissions, rejections, and resubmissions).</li><li>Liaise with insurance companies and HAAD/DOH authorities to resolve claim discrepancies.</li><li>Ensure compliance with UAE healthcare regulations, DOH standards, and payer-specific guidelines.</li><li>Maintain patient confidentiality and adhere to medical ethics and data privacy standards.</li><li>Coordinate with physicians and clinical staff to clarify documentation and coding details.</li><li>Prepare coding and billing reports for management review.</li><li>Stay updated on coding guidelines, payer policy changes, and regulatory updates.</li></ul>Qualifications &amp; RequirementsRequirementDetailsEducationDiploma or Bachelor's degree in Medical Coding, Health Information Management, or a related fieldCertificationCertified Professional Coder (CPC) or Certified Coding Specialist (CCS) &ndash; mandatoryExperienceMinimum 2 years of experience as a Medical/Insurance Coder in the UAEVisa StatusMust have own valid UAE visa (Family/Sponsored visa) &ndash; mandatoryKnowledgeIn-depth knowledge of ICD-10-CM, CPT, HCPCS, DOH/HAAD regulations, and UAE insurance claim processesLanguagesEnglish (fluent) &ndash; Arabic is a plusSkillsStrong attention to detail, analytical thinking, proficiency in medical billing software and EHR systemsAvailabilityImmediate joiners preferredApplication Question(s):<ul><li>Do you have your own Visa?</li></ul>Experience:<ul><li>Insurance coder: 2 years (Required)</li></ul>Work Location: In person

Insurance Coder

Bayhealth

<div>
 
 Location: Kent Campus Hospital
 
 
 
 
 Status:
 
 Full Time 80 Hours
 
 
 
 Shift:
 
 Days
 
 
 
 SALARY RANGE:
 
 22.09 - 33.47HOURLY
 
 
 
 General Summary:
 
 
 
 Position is responsible all aspects of the medical billing process from generating completed medical claims submissions to a completed and paid A/R. Receive encounters from EMR or other means of encounters information and prepare the encounter for submission. Abstract clinical information from a variety of medical records charts and documents and assigns appropriate DX and/or CPT-4 codes. Work with WQ or per supervisor instructions. Correct errors and denials from WQ or from other sources. Maintain AR processes to achieve organization&rsquo;s goals.
 
 
 
 Responsibilities:
 
 
 
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 Review and analyze records to identify and correct errors.
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 Prepare encounter and code correct medical billing claims generated from the EMR to bill insurance carriers or other parties.
 </li>
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 Submit the claims correctly from the first time.
 </li>
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 Determine the correct encounters code from patient records. Codes data from patient records. Manage detailed, specifically coded information. When needed, abstracts data from patients&rsquo; medical records to maintain full diagnosis coding and charges capture.
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 Interact with physicians and assistants to ensure accuracy. As needed, responds to physician inquiries that concern the proper documentation of diagnostic procedural information and questions regarding coding assignments.
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 Track patient data over multiple visits.
 </li>
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 Maintain line of communication with your providers, auditing and providing training as needed.
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 Identifies and verifies documentation and coding complacencies.
 </li>
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 Inform the responsible channels of all issues that create loss of reimbursement, constant errors and other issues pertaining to management issues.
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 Maintain A/R goals and daily A/R functions. Responsible for any revenue cycle issues due to medical billing issues.
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 Correct error and denials from designated WQ.
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 Participate in department meetings. Participate in training sessions or webinars per supervisor request.
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 All other duties as assigned, within the scope and range of job responsibilities.
 
 
 </li>
 </ul>
 
 Required Education, Credential(s) and Experience:
 
 
 
 <ul>
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 Education: High School Diploma or GED
 </li>
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 Credential(s): Certified Professional Coder; Or equivalent (Certified Coding Specialist certification, Registered Health Information Technician, or Registered Health Information Administrator)
 </li>
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 Experience: Required: 2 years&rsquo; experience in medical billing at EMR and PM environment from billing to A/R
 
 
 </li>
 </ul>
 
 Preferred Education, Credential(s) and Experience:
 
 
 
 <ul>
 <li>
 Education:
 </li>
 <li>
 Credential(s):
 </li>
 <li>
 Experience: Preferred: 3-6 years&rsquo; experience with full medical billing functions
 
 
 </li>
 </ul>
 To view a full list of all open position at Bayhealth, please visit:
 
 
 https://apply.bayhealth.org/join/
</div>

Medical Biller/Certified Coder

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9845 certified medical coding specialist jobs Near Me

BILLING & CODING COMPLIANCE ANALYST

Medical Coder III (Inpatient Coder)

Sr. Inpatient Clinical Coder

Sr. Inpatient Clinical Coder

Medical Billing Specialist

Insurance Coder

Medical Biller/Certified Coder