coding and reimbursement specialist

Norton Healthcare

<div>Responsibilities:
<div>
The Coder Specialty Office assures the integrity of the Norton Medical Group billing, insurance, coding, and accounting and referral functions. The incumbent serves as a liaison between the practice and the billing office as well as the accounting department of Norton Healthcare. In performing job functions, utilizes age appropriate principles of growth and development for patients of all ages according to the practice specialty.</div><div></div><div> 
**This position offers a fully remote work opportunity. Employees in this role must reside in one of the following states to be considered for fully remote positions: Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina**</div>
Qualifications:
<div>
Required:</div><ul><li>
One year medical coding in a specialty office</li><li>
One of: CCA or CCS or CIC-ICD or COC or CPC or RHIA or RHIT</li></ul><div>
Desired:</div><ul><li>
Diploma</li><li>
Certified Coding Associate OR Certified Coding Specialist OR Certified Inpatient Coder ICD-10 OR Certified Outpatient Coding OR Certified Professional Coder OR Registered Health Information Administrator OR Registered Health Information Technician</li></ul></div>

Coder - Specialty Office, Revenue Integrity/Coding, Days, Fully Remote

Adam Smith International

<div>AML / CFT Expert
Background
The Revenue Mobilisation, Investment and Trade (REMIT) programme (2021&ndash;2027), funded by the UK&rsquo;s Foreign, Commonwealth and Development Office (FCDO) and implemented by Adam Smith International (ASI), provides technical assistance to the Government of Pakistan to strengthen macroeconomic stability, enhance governance systems, and improve conditions for sustainable economic growth.
A central component of this support is the implementation of the Prime Minister&rsquo;s Economic Governance Reforms (PM-EGR), a comprehensive, time-bound reform programme approved on 31 December 2025. The PM-EGR spans 15 priority reform areas and 141 action items and is recognised as a Structural Benchmark under the IMF Extended Fund Facility (EFF).
A key reform area under PM-EGR focuses on strengthening anti-corruption, anti-money laundering, and countering financing of terrorism (AML/CFT) frameworks, aimed at improving financial integrity, reducing illicit financial flows, and enhancing transparency and accountability across institutions.
To support implementation, a Technical Unit (TU) has been established within the Ministry of Finance to serve as the central coordination, analytical, and reporting hub, alongside structured Policy Dialogue mechanisms (Economic Reform Conferences) to review progress and support reform course correction.
Activity Context
Pakistan has made significant progress in strengthening its AML/CFT regime, including institutional reforms, legislative amendments, and improved coordination mechanisms. However, key challenges remain, including:<ul><li>
Limited integration of AML/CFT measures with broader anti-corruption frameworks</li><li>
Weak institutional coordination across enforcement and oversight bodies</li><li>
Gaps in risk-based approaches to corruption and financial crime</li><li>
Limited use of financial intelligence in enforcement actions</li><li>
Capacity constraints in investigation, prosecution, and asset recovery</li></ul>
Under PM-EGR, AML/CFT reforms aim to:<ul><li>
Strengthen institutional coordination and governance structures</li><li>
Improve risk-based approaches to corruption and financial crime</li><li>
Enhance financial intelligence generation and utilisation</li><li>
Strengthen enforcement capacity and inter-agency collaboration</li><li>
Align AML/CFT reforms with broader governance and anti-corruption objectives</li></ul>
The AML/CFT Expert will provide high-level technical advisory support to ensure that reforms are coherent, outcome-oriented, and aligned with international standards, including FATF recommendations.
Job Summary
The AML/CFT Expert will provide senior technical expertise on anti-money laundering, counter-terrorism financing, and financial integrity reforms under PM-EGR.
The role will support reform design, policy dialogue processes, and implementation guidance, ensuring that AML/CFT reforms are effectively integrated into broader governance and anti-corruption frameworks and aligned with international best practices. 
Duties and Responsibilities
The roles and responsibilities include, but are not limited to:<ul><li>
Provide expert technical advice on AML/CFT frameworks, including institutional arrangements, legal provisions, and enforcement mechanisms.</li><li>
Support design and refinement of AML/CFT-related reform actions under PM-EGR, ensuring alignment with FATF standards and international best practices.</li><li>
Advise on strengthening coordination among key institutions, including financial intelligence, law enforcement, regulatory, and oversight bodies.</li><li>
Support development of risk-based approaches to corruption and financial crime, including identification of high-risk sectors and institutions.</li><li>
Provide technical inputs on strengthening financial intelligence generation, analysis, and utilisation in enforcement actions.</li><li>
Prepare analytical briefs, technical notes, and policy inputs for Technical Committees and Economic Reform Conferences.</li><li>
Contribute to policy dialogue sessions through expert participation, including technical presentations and advisory inputs.</li><li>
Support development of outcome-oriented KPIs and performance indicators for AML/CFT reform tracking.</li><li>
Identify implementation challenges and propose practical, evidence-based solutions to strengthen enforcement and compliance.</li><li>
Advise on strengthening asset tracing, recovery mechanisms, and international cooperation frameworks.</li><li>
Engage with key stakeholders, including Ministry of Finance, FMU, FIA, NAB, FBR, SBP, SECP, and other relevant institutions.</li><li>
Support integration of AML/CFT reforms with broader governance, transparency, and anti-corruption reform efforts.</li></ul> 
Qualifications and Experience<ul><li>
Advanced degree in law, finance, economics, public policy, or a related field.</li><li>
Minimum 12&ndash;15 years of relevant experience in:<ul><li>
AML/CFT frameworks</li><li>
Financial crime prevention and enforcement</li><li>
Governance and anti-corruption reforms</li></ul></li><li>
Strong understanding of:<ul><li>
Pakistan&rsquo;s AML/CFT institutional landscape</li><li>
FATF standards and international compliance frameworks</li></ul></li><li>
Demonstrated experience in:<ul><li>
High-level technical advisory roles</li><li>
Working with government institutions and development partners</li></ul></li><li>
Experience in financial intelligence, regulatory frameworks, or enforcement agencies is highly desirable.</li><li>
Strong analytical, advisory, and communication skills.</li></ul>
Reporting
The consultant will report to:<ul><li>
REMIT Macroeconomic Adviser</li><li>
Governance &amp; Reforms Specialist (Technical Unit Team Lead)</li></ul> 
Duration and Level of Effort<ul><li>
Days: 22</li><li>
Total LOE: 22 Days</li></ul></div>

AML / CFT Expert - REMIT Programme

Keystone Health

<div>At Keystone Health, we aspire for you to feel empowered and fulfilled as you work towards our shared mission of delivering heartfelt care. Earn a living where your heart truly belongs.
The Patient Financial Services Department is seeking a full time Billing and Coding Integrity Specialist to join the team.
This role is fully on‑site and is not eligible for remote work.
Under the direction of the Director of Patient Financial Services the specialist is responsible for implementing and promoting consistent revenue integrity practices that will improve compliance, accurate billing, and charge capture at the point of service to ensure optimal reimbursement for Keystone Health. The specialist is responsible for auditing and monitoring appropriate coding guidelines and regulations. Recommending any corrective action and assists with implementing the corrective action. This position is also responsible for providing billing/coding training and education to providers and staff and maintaining a current knowledge of coding/billing regulations and guidelines.
EDUCATION and/or EXPERIENCE: High School graduate or GED equivalency required. Minimum of two years&rsquo; experience in a similar position in a health care setting is preferred.
LICENSES and CERTIFICATION: AAPC Billing and Coding Certification required.
Keystone Health is an Equal Opportunity Employer</div>

Billing & Coding Integrity Specialist

CPA CLINICS

Billing Specialist - eSuperbill CreationLocation: Lahore, PakistanShift: Evening/Night (aligning with U.S. time zones)Role OverviewWe are a U.S.‑based medical practice (Urgent and Primary are) seeking a Medical Billing Specialist in Lahore to handle eSuperbill creation. This role focuses on converting finalized physician notes into billing claims for U.S. insurance reimbursement.Responsibilities- Review finalized physician notes.- Enter CPT and ICD‑10 codes into billing software (CureMD).- Generate accurate electronic superbills (eSuperbills) for insurance claim submission.- Ensure compliance with U.S. billing standards and minimize claim denials.- Coordinate with physicians/admin staff for missing documentation when needed.Requirements- Bachelor&rsquo;s degree preferred (preferred MBBS or equivalent).- Prior experience in U.S. medical billing strongly preferred.- Familiarity with EMR/EHR systems and billing software (CureMD).- Strong attention to detail and accuracy in coding.- Strong knowledge of ICD‑10, CPT, HCPCS coding systems and U.S. healthcare billing standards.- Good English communication skills (written and spoken).- Ability to work evening/night shifts..Job Type: Full-timePay: Rs90,000.00 - Rs140,000.00 per monthApplication Question(s):<ul><li>Are you proficient in ICD‑10, CPT, and HCPCS coding systems? Please give examples of coding work you&rsquo;ve handled.</li><li>Have you worked with CureMD EMR software before? If not, what EMR/EHR systems are you familiar with?</li><li>What are your salary requirement?</li><li>Are you able to work evening/night shifts aligned with U.S. time zones from our Lahore DHA office ?</li></ul>Education:<ul><li>Middle School (Preferred)</li></ul>Work Location: In person

Billing Specialist - eSuperbill Creation

Tidelands Health

<div>
 Employee Type:
 
 
 Regular
 
 
 Work Shift:
 
 
 Day - 8 hour shift (United States of America)
 
 
 
 Join Team Tidelands and help people live better lives through better health!
 
 
 
 
 Clinical Documentation Improvement Specialist (RN) (3419)
 
 
 
 Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day.
 
 
 
 A Brief Overview
 
 
 
 The Clinical Documentation Improvement Specialist (RN) is a hybrid role that combines the expertise of clinical documentation improvement (CDI) and outpatient Hierarchical Condition Category (HCC) coding. This position will report to the Outpatient CDI Program Manager. This position focuses on improving the accuracy, quality, and completeness of clinical documentation in outpatient medical records while ensuring compliance with coding guidelines. The specialist will work collaboratively with providers, coding teams, and other healthcare professionals to facilitate accurate coding, improve risk capture, and optimize reimbursement while reflecting the true severity of illness and care provided.
 
 
 
 Education Qualifications
 
 
 
 <ul>
 <li>
 BSN and a minimum of five years clinical nursing experience Required
 
 
 </li>
 </ul>
 
 Experience Qualifications
 
 
 
 <ul>
 <li>
 At least 3 or more years' experience either in the clinical field (RN), CDI field, or coding field Required
 </li>
 <li>
 Experience in an outpatient or acute care setting Required
 </li>
 <li>
 1 or more years' experience in HCC/Risk Adjustment Preferred
 </li>
 <li>
 Minimum of 3 years of experience in clinical documentation improvement, outpatient Hierarchical Condition Category (HCC), or a combination of both Preferred
 
 
 </li>
 </ul>
 
 Skills And Abilities
 
 
 
 <ul>
 <li>
 Strong clinical experience and critical thinking skills required
 </li>
 <li>
 Extensive knowledge of patient care, and knowledge of clinical measurement, tools, and clinical outcomes
 </li>
 <li>
 Ability to establish cooperative, working relationships with diverse groups and individuals, medical staff and other healthcare disciplines
 </li>
 <li>
 Ability to work independently, be resourceful, and possess strong organizational skills
 </li>
 <li>
 Ability to communicate effectively with physicians and other clinical staff; be courteous and professional
 
 
 </li>
 </ul>
 
 Licenses and Certifications
 
 
 
 <ul>
 <li>
 Registered Nurse - South Carolina Department of Labor, Licensing and Regulation Required
 </li>
 <li>
 Certified Professional Coder - American Academy of Professional Coders within 1 Year Required or
 </li>
 <li>
 Certified Coding Specialist - American Health Information Management Association within 1 Year Required or
 </li>
 <li>
 Certified Clinical Documentation Specialist - Association of Clinical Documentation Integrity Specialist within 1 Year Required
 
 
 </li>
 </ul>
 
 Physical Demand
 
 
 
 Light Physical Demand
 
 
 The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a contract for employment nor a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform tasks other than those specifically presented in this description.
 
 
 Tidelands Health is an 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.
 
 
 Tidelands Health is an equal opportunity employer (EOE). Tidelands Health does not discriminate against employees or applicants for employment on the basis of race, color, creed, religion, age, national origin, disability, marital status, veteran status, gender, genetic information, familial status, or any other legally protected status.
</div>

Outpatient CDI Specialist (RN)

Aegis Medical Group

A Billing and Coding Specialist is responsible for auditing and coding medical encounters to insurance companies and payers such as Medicare. It is a position that is critical for the financial cycle of all health care providers. It requires attention to detail and experience with the electronic and paper systems used in medical billing.JOB DUTIES:<ul><li>Responsible for properly auditing and inputting ICD-10, CPT, HCPCS codes into billing software and submitting an accurate claim.</li><li>Handles any claim denials in an efficient and timely manner</li><li>Keeps open communication with team and provider regarding billing concerns. Maintains work operations by following policies and procedures, reporting compliance issues.</li><li>Maintains quality results by following standards.</li><li>Protects practice's value by keeping collection information confidential.</li><li>Updates job knowledge by participating in educational opportunities.</li><li>Enhances billing department by accepting ownership for accomplishing new and different requests, exploring opportunities to add value to job accomplishments.</li></ul>JOB REQUIREMENTS:Education and/or Experience<ul><li>Minimum High School Diploma or GED equivalent</li><li>Medical Coding: 3 years preferred</li><li>Certified Coder: CPC, CRC or AHIMA Certification</li><li>Knowledgeable about health care practices, terminology and different clinical specialties, preferably primary care and Medicare Advantage plans.</li><li>Knowledgeable about record keeping, billing and reimbursement processes</li></ul>Job Type: Full-timePay: $16.00 - $20.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible schedule</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Parental leave</li><li>Professional development assistance</li><li>Referral program</li><li>Retirement plan</li><li>Tuition reimbursement</li><li>Vision insurance</li></ul>Application Question(s):<ul><li>How many years of ICD-10 experience do you have?</li><li>How many years of medical coding experience do you have?</li><li>Have you ever worked for Aegis Medical Group and/or Lakeview Healthcare System?</li></ul>Experience:<ul><li>risk coding/HCC: 3 years (Preferred)</li></ul>License/Certification:<ul><li>Certified Professional Coder (Required)</li></ul>Work Location: In person

Coding Specialist

Jordan Young Institute

<div>Title: AR Follow-up and Denial Specialist
Location: Onsite &ndash; Virginia Beach, VA (Hybrid)
Who we are:
Aligned Orthopedic Partners is a well-respected private orthopedic team comprised of highly trained, board-certified orthopedic surgeons devoted to delivering patients with the highest orthopedic care possible. Our commitment to finding the best solutions for individual needs sets us apart from the competition. We take pride in providing exceptional care while remaining friendly, courteous, and efficient.
Aligned Orthopedic Partners is recruiting an experienced AR Follow-up and Denial Specialist. The ideal candidate is experienced with analyzing and resolving insurance claim denials, correcting errors, and securing accurate reimbursement from payers. This role requires strong analytical, coding, and communication skills, with a focus on denial prevention, timely appeals, and collaboration across the revenue cycle team.
What you will do:
Claims Review &amp; Correction<ul><li>
Review denied and unpaid claims to verify coding and billing accuracy.</li><li>
Correct errors and submit revised claims when necessary.</li><li>
Investigate claims with no payer response to confirm receipt and follow up.</li></ul>
Denial Management &amp; Appeals<ul><li>
Analyze denials and generate effective, well-researched written appeals.</li><li>
Appeal denials through coding review, contract interpretation, medical record review, and direct payer interaction.</li><li>
Maintain detailed knowledge of payer websites and appeal processes for commercial and government payers.</li><li>
Ensure appeals and reconsideration requests are completed accurately and on time.</li></ul>
Trend Analysis &amp; Communication<ul><li>
Identify recurring denial trends or payer policy changes affecting reimbursement.</li><li>
Communicate trends to management and recommend process improvements to prevent reoccurrence.</li><li>
Support and participate in process and quality improvement initiatives.</li></ul>
Collaboration &amp; Education<ul><li>
Confer with coders, billing staff, and revenue cycle managers on coding or claim issues.</li><li>
Provide education to team members on payer policies and denial prevention.</li><li>
Collaborate on special projects and assist management with additional tasks as assigned.</li></ul>
Account Reconciliation<ul><li>
Work assigned follow-up queues, including identification of missing payments, overpayments, and credits on accounts.</li><li>
Document all actions taken in the practice management system.</li></ul>
What you bring to the table:
You are a detail-oriented and dependable professional with a strong grasp of accounts receivable and denial processes. You take ownership of your work, communicate clearly, and consistently meet deadlines in a fast-paced environment. You bring:<ul><li>
Minimum of 3 years&rsquo; experience in a medical billing department (orthopedic or surgical experience strongly preferred).</li><li>
In-depth knowledge of healthcare billing, claims processing, payer follow-up, and appeals.</li><li>
Proficiency with payer websites, Microsoft Outlook, Word, and Excel.</li><li>
Coding knowledge sufficient to process denied claims and support appeals.</li><li>
Strong reasoning, critical thinking, analytical, and mathematical skills.</li><li>
Ability to work independently with high productivity and attention to detail.</li><li>
CPC certification preferred but not required.</li><li>
High School Diploma or GED required.</li></ul>
Equal Opportunity Employer
Aligned Orthopedic Partners is an equal opportunity employer. We promote diversity of thought, culture, and background. We celebrate what makes us different and committed to building a team that represents a variety of experiences. All employment is decided on the basis of qualifications, merit, and business need.</div>

AR Follow-up and Denial Specialist

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