coding manager

Medstar Healthcare LLC

Accumed &amp; Fatorah is actively Hiring: IP Medical Coder &ndash; Relocation to UAE (Sharjah)We are currently hiring IP Medical Coders for a large RCM organization based in Sharjah, UAE. Candidates with strong In-patient coding expertise are encouraged to apply.Kindly Note: Candidates must have experience working with Omega or E4E (Mandatory) to be considered. There will be 2 rounds of Interview, the 1st interview will be an Online OP Coding Assessment and final round will be an online Interview with our RCM Director &amp; Coding Manager.Location: Sharjah, UAE Shift: Rotational shifts including Night Shift Experience Required: 3&ndash;5 years of hands-on coding experience Certification: CPC or CCS Certification is mandatoryEligibility Criteria: ✔ Candidates must have experience working with Omega or E4E (Mandatory) ✔ Strong experience in Inpatient (IP) medical coding ✔ Hands-on experience with ICD-10-CM, ICD-10-PCS, DRG assignment, and insurance guidelines ✔ Good understanding of medical terminology, anatomy, physiology, and reimbursement methodologies ✔ Willingness to relocate to UAELanguage Requirements: ✔ Good communication skills in English are mandatory ✔ Hindi, Tamil, or Telugu speaking candidates are preferredKey Responsibilities:<ul><li>Review inpatient medical records and assign accurate diagnosis and procedure codes</li><li>Ensure coding compliance with payer and regulatory guidelines</li><li>Analyze clinical documentation for completeness and accuracy</li><li>Coordinate with physicians and clinical teams for coding clarifications</li><li>Maintain coding quality, productivity, and TAT requirements</li><li>Support audits, denial management, and coding quality improvement initiatives</li></ul>Preference:<ul><li>Candidates who are willing to work in overnight shifts</li><li>Candidates available to join immediately or within short notice are preferred</li></ul>Interested candidates may share their updated CV for consideration.Benefits from the company:Salary budget is AED 5k to 6k (All Included). All depends on assessment score and interview feedback.Visa and Medical Insurance is provided by the company.Yearly flight ticket allowance provided by the company.Professional work environment with career development.Pay: AED5,000.00 - AED6,000.00 per monthWork Location: In person

IP Medical Coder (Omega / E4E experience)

Accumed &amp; Fatorah is actively Hiring: OP Medical Coder &ndash; Relocation to UAE (Sharjah)(Omega / E4E experience)We are looking for OP Medical Coders who are willing to relocate to Sharjah, UAE and join the best RCM team.Kindly Note: Candidates must have experience working with Omega or E4E (Mandatory) to be considered. There will be 2 rounds of Interview, the 1st interview will be an Online OP Coding Assessment and final round will be an online Interview with our RCM Director &amp; Coding Manager.Location: Sharjah, UAEShift: Rotational shifts including Night ShiftExperience Required: 3&ndash;5 years of hands-on medical coding experienceCertification: CPC or CCS Certification is mandatoryEligibility Criteria:✔ Candidates must have prior experience working with Omega or E4E (Mandatory)✔ Strong experience in Outpatient (OP) coding✔ Good understanding of ICD-10, CPT, and HCPCS coding standards✔ Experience handling insurance and claims-related coding processes✔ Willingness to relocate to UAELanguage Requirements:✔ Candidates must be able to communicate in English✔ Hindi, Tamil, or Telugu speaking candidates are preferredKey Responsibilities:Review and accurately code outpatient medical records and proceduresEnsure coding accuracy and compliance with healthcare regulations and insurance guidelinesWork closely with physicians and internal teams to clarify documentation when requiredMaintain productivity and quality standards within assigned timelinesIdentify coding discrepancies and support denial prevention initiativesStay updated with coding regulations and payer requirementsPreference:Candidates who are willing to work in over night shiftsImmediate joiners or candidates with short notice periods are preferredInterested candidates may share their updated CV for further review.Benefits from the company:Salary budget is AED 4k to 5.5k (All Included). All depends on assessment score and interview feedback.Visa and Medical Insurance is provided by the company.Yearly flight ticket allowance provided by the company.Professional work environment with career development.Pay: AED4,000.00 - AED5,500.00 per monthWork Location: In person

OP Medical Coder (Omega / E4E experience)

Alignment Healthcare

<div>Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.
This is a remote position. 
The MRA Coding Auditor supports departmental Quality Assessment audits of internal Coding Analyst team and vendors to ensure accurate and complete data is submitted to CMS. Assists in Risk Adjustment related data audits (RAF, prevalence, clinical documentation improvement, P360, process) audits to identify areas of opportunity for improvement (training, data integrity, chart reviews).
GENERAL DUTIES/RESPONSIBILITIES: 
1. Supports regular quality assurance (QA) audits of internal Coding Analyst Team to validate and confirm coding &amp; abstracting quality (95% HCC accuracy). These ongoing audits ensure coding quality &amp; performance improvement standards are maintained, achieved &amp; improved per department policies and procedures. 
2. Tracks and reports progress of QA audits performed on the coding vendors to verify the coding accuracy and quality of the data submitted to AHP is accurate for submission to CMS. 
3. Works with Risk Adjustment Management on any MRA data validation / coding audit to ensure completeness and coding accuracy of all submissions to CMS. This work may encompass reviews of data for reconciliation, data flow integrity, UAT testing, high cost / low risk score members, retrospective chart reviews, or other risk adjustment related data review as directed by Manager. 
4. Analyzes and shares audit results with Manager. This information may be used for training physicians and clinical staff, documentation improvement, and system / process improvement. 
5. Utilizes, protects, and discloses Alignment Healthcare patients&rsquo; protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards. 
6. Ensures compliance with all applicable federal, state &amp;local regulations, as well as with institutional/organizational standards, practices, policies &amp; procedures.
7. Maintains professional / technical knowledge by attending appropriate educational workshops; reviewing professional publications; establishing personal networks; and participating in professional societies. Stay current of industry coding, compliance, and HCC issues. Required to maintain relevant continuing education units (CEUs) in relation to individual coding certifications. 
8. Other duties as assigned to meet the organization&rsquo;s needs.
Job Requirements:
Experience:<ul><li>Required: Minimum three years of Medicare Risk Adjustment coding in a medical group or health plan setting required</li><li>Preferred:</li></ul>
Education:<ul><li>Required: High School Diploma or GED. Completion of a Medical Coding training program.</li><li>Preferred: Bachelor&rsquo;s degree in Business Administration, health Care Management or in a related field</li></ul>
Training:<ul><li>Required: Technical School or courses that are required to become a certified coder.</li></ul>
Specialized Skills:<ul><li>Required:</li></ul><ul><li>
Knowledge of</li><li>
Proficient user in MS office suite &ndash; Excel, Word, Outlook</li><li>
Previous use of Epic, Allscripts, EZCap</li><li>
Ability to communicate positively, professionally and effectively with others; provide leadership, teach and collaborate with others.</li><li>
Effective written and oral communication skills; ability to establish and maintain a constructive relationship with diverse members, management, employees and vendors;</li><li>
Mathematical Skills: Ability to perform mathematical calculations and calculate simple statistics correctly</li><li>
Reasoning Skills: Ability to prioritize multiple tasks; advanced problem-solving; ability to use advanced reasoning to define problems, collect data, establish facts, draw valid conclusions, and design, implement and manage appropriate resolution.</li><li>
Problem-Solving Skills: Effective problem solving, organizational and time management skills and ability to work in a fast-paced environment.</li><li>
Report Analysis Skills: Comprehend and analyze statistical reports.</li></ul>
Licensure:<ul><li>Required: Certified Coder required, CCS, CCS-P, CPC, or CRC</li></ul>
Work Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Essential Physical Functions:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Pay Range: $64,384.00 - $96,577.00
Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.
Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.<ul><li>DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health&rsquo;s talent acquisition team, please email careers@ahcusa.com.</li></ul></div>

MRA Coding Auditor - Remote

Mineral Community Hospital

<div>Job Summary
*Applicants must be a Certified Professional Coder (CPC) and have 1 year of relevant work experience*
The focus of this position is to enhance patient care and safety while working and collaborating positively as a member of the MCH team.
Responsible for coding clinic and hospital claims, inpatient and outpatient encounters or a mixture as assigned by Business Office Manager. These records include emergency room, short stays, endoscopy, physical therapy, inpatient, outpatient surgery, diagnostic services, and clinic encounters. Communicate appropriately with coworkers to ensure all documentation requirements are being met for services billed. Help with chart analysis for physician or nursing deficiencies or missing reports.
Responsibilities
<ul><li>Review and analyze patient medical records to assign appropriate codes for diagnoses and procedures.
</li><li>Utilize coding systems such as ICD-9 and DRG to ensure accurate documentation.
</li><li>Collaborate with healthcare providers to clarify any discrepancies in medical records.
</li><li>Maintain up-to-date knowledge of coding guidelines and regulations to ensure compliance.
</li><li>Assist in the management of medical billing processes and collections as needed.
</li><li>Ensure the confidentiality and security of patient information in accordance with HIPAA regulations.
</li><li>Generate reports related to coding accuracy and billing efficiency for management review.
</li></ul>Skills
<ul><li>Ability to process work using both alphabetical and numerical filing systems.
</li><li>Fluent in English.
</li><li>Possess basic clerical background including computer skills, basic filing skills and general knowledge of office procedures.
</li><li>Able to organize and prioritize workload.
</li><li>Able to work under pressure and perform multitasking duties under pressure with accuracy.
</li><li>Must have manual dexterity.
</li><li>Able to complete tasks within a given time frame.
</li><li>Able to work with minimal supervision.
</li><li>Must be able to code ambulatory, inpatient, emergency and or surgery encounters or a mix there of.
</li></ul>We invite qualified candidates who are passionate about healthcare coding to apply for this vital role within our organization. Join us at MCH in creating an inviting atmosphere that enhances the experience of every guest! Submit a resume today and/or fill out our application here: https://mineralcommunityhospital.com/career-search/</div>

Medical Records Coder

AMPLA HEALTH

<div>GENERAL PURPOSE:
The Coding Research and Training assistant is responsible for providing medical coding training and support for providers and staff based on needs identified by the Corporate Compliance Officer/Health Information Manager.
MAIN RESPONSIBILITIES &amp; DUTIES:<ul><li>
Works with Revenue Cycle, Operations and Clinical departments to provide provider and staff trainings including but not limited to the following areas:<ul><li>
ICD-10 application and guidelines</li><li>
Evaluation and Management selection</li><li>
Centricity Practice Solution training specific to ICD 10-and procedural coding</li><li>
Auditing of provider diagnosis, procedural coding and documentation.</li></ul></li><li>
Acts as a resource for questions related to HCPCS, CPT and ICD 10-coding.
</li><li>Evaluates the record for documentation consistency and adequacy during provider coding audits. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.</li><li>
Researches codes and guidelines as it pertains to various providers, Informatics, billing and other departments as requested, to give accurate information for the purposes of billing, reporting and auditing.
</li><li>Assist in auditing, reviewing and reporting to appropriate parties, any findings on various audits done within the oversight of the Compliance program.</li><li>
Assists with training for all departments involving ICD-10-CM and CPT CM including, but not limited to Evaluation and Management section, Centricity Practice Solution.
</li><li>Collects and records data accurately on training received by staff.</li><li>
Trains in various clinical areas (Suboxone, HIV, 340B drugs etc.) to be audited to fully understand the policies and procedures for each area in order to assess, audit and report findings to the Compliance officer.</li><li>
Maintains audit records for outside auditing purposes as well as further internal auditing purposes.
</li><li>Prepares for audits by researching materials, policies, procedures and formulating a plan of action. Setting up spreadsheets for data and recording as required.
</li><li>Communicate audit progress and findings by preparing reports and providing information in meetings when requested.
</li><li>Assists the Compliance/Coding/HIM lead in reporting, educating, creating and implementing any policy and procedure necessary to ensure that all departments follow regulations according to the Compliance program.
</li><li>Assist the Compliance Officer with onsite audits as needed.</li><li>
Enhances compliance department and the organizations reputation by accepting responsibility for accomplishing new and different coding and compliance related requests; exploring opportunities for additional audits/monitoring to ensure the most robust compliance program possible.
</li><li>Also assists with the coding and HIM department with patient complaints, records requests, incident reports, correcting claims as requested by the Coders, and other duties as assigned.
</li><li>Travel as needed</li><li>
Maintains open communication with supervisor and all staff.</li><li>
Maintains confidentiality of all patients/personnel records.</li></ul>
QUALITIES &amp; CHARACTERISTICS<ul><li>
Maintains a professional relationship and positive attitude with co-workers, the public, patients and all Ampla Health&rsquo;s staff, Board of Directors and vendors</li><li>
Maintains the highest professional ethics and is honest in dealing with people; is a model for all employees through his/her actions</li><li>
Strives to learn more and is receptive to learning different ways of doing things</li><li>
Displays enthusiasm toward the work and the mission of Ampla Health
</li></ul>PROFESSIONAL KNOWLEDGE, SKILLS &amp; ABILITIES<ul><li>
High School Diploma or GED</li><li>
Approved Coding certificate required. (CCS, CPC)
</li><li>Experience working in a compliance role preferred, but not required</li><li>
Knowledge of billing practices, auditing practices, various programs utilized in an outpatient clinic setting.
</li><li>Prior medical records review experience</li><li>
Experience in governmental programs as related to FQHC&rsquo;s or other related clinical setting</li><li>
Centricity practice management system experience is a plus</li><li>
Data management responsibilities a plus</li><li>
Able to operate general office equipment, such as copiers, facsimile machine, etc.
</li><li>Working knowledge of Microsoft windows programs such as Word, Excel, Power Point</li><li>
Intermediate computer skills</li></ul>
COMMUNICATION SKILLS:<ul><li>
Must have neat and legible handwriting</li><li>
Must be able to interact with patients/providers courteously and calmly</li><li>
Ability to communicate well with the public</li><li>
Exceptional verbal and written communication skills</li></ul>
WORKING CONDITIONS &amp; PHYSICAL REQUIREMENTS
Works well with patients, co-workers and vendors in a generally comfortable environment office. Employee must possess the following physical requirements:<ul><li>
May require prolonged sitting or standing</li><li>
Travel as needed</li><li>
Vision sufficient to read handwritten, typed and computer printed documents throughout the day</li><li>
Speech and hearing sufficient to receive and communicate detailed information clearly by phone and in person</li><li>
Motor skills sufficient to use and manipulate equipment</li><li>
Must have a high level of manual dexterity</li><li>
Physically able to sit, walk, or otherwise stand for long periods of time, frequent bending, stooping, and stretching. Repetitive hand, arm, and shoulder movements</li><li>
Able to lift up to 40 pounds</li></ul>
GENERAL PURPOSE:
The Coding Research and Training assistant is responsible for providing medical coding training and support for providers and staff based on needs identified by the Corporate Compliance Officer/Health Information Manager.
MAIN RESPONSIBILITIES &amp; DUTIES:<ul><li>
Works with Revenue Cycle, Operations and Clinical departments to provide provider and staff trainings including but not limited to the following areas:<ul><li>
ICD-10 application and guidelines</li><li>
Evaluation and Management selection</li><li>
Centricity Practice Solution training specific to ICD 10-and procedural coding</li><li>
Auditing of provider diagnosis, procedural coding and documentation.</li></ul></li><li>
Acts as a resource for questions related to HCPCS, CPT and ICD 10-coding.
</li><li>Evaluates the record for documentation consistency and adequacy during provider coding audits. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.</li><li>
Researches codes and guidelines as it pertains to various providers, Informatics, billing and other departments as requested, to give accurate information for the purposes of billing, reporting and auditing.
</li><li>Assist in auditing, reviewing and reporting to appropriate parties, any findings on various audits done within the oversight of the Compliance program.</li><li>
Assists with training for all departments involving ICD-10-CM and CPT CM including, but not limited to Evaluation and Management section, Centricity Practice Solution.
</li><li>Collects and records data accurately on training received by staff.</li><li>
Trains in various clinical areas (Suboxone, HIV, 340B drugs etc.) to be audited to fully understand the policies and procedures for each area in order to assess, audit and report findings to the Compliance officer.</li><li>
Maintains audit records for outside auditing purposes as well as further internal auditing purposes.
</li><li>Prepares for audits by researching materials, policies, procedures and formulating a plan of action. Setting up spreadsheets for data and recording as required.
</li><li>Communicate audit progress and findings by preparing reports and providing information in meetings when requested.
</li><li>Assists the Compliance/Coding/HIM lead in reporting, educating, creating and implementing any policy and procedure necessary to ensure that all departments follow regulations according to the Compliance program.
</li><li>Assist the Compliance Officer with onsite audits as needed.</li><li>
Enhances compliance department and the organizations reputation by accepting responsibility for accomplishing new and different coding and compliance related requests; exploring opportunities for additional audits/monitoring to ensure the most robust compliance program possible.
</li><li>Also assists with the coding and HIM department with patient complaints, records requests, incident reports, correcting claims as requested by the Coders, and other duties as assigned.
</li><li>Travel as needed</li><li>
Maintains open communication with supervisor and all staff.</li><li>
Maintains confidentiality of all patients/personnel records.</li></ul>
QUALITIES &amp; CHARACTERISTICS<ul><li>
Maintains a professional relationship and positive attitude with co-workers, the public, patients and all Ampla Health&rsquo;s staff, Board of Directors and vendors</li><li>
Maintains the highest professional ethics and is honest in dealing with people; is a model for all employees through his/her actions</li><li>
Strives to learn more and is receptive to learning different ways of doing things</li><li>
Displays enthusiasm toward the work and the mission of Ampla Health
</li></ul>PROFESSIONAL KNOWLEDGE, SKILLS &amp; ABILITIES<ul><li>
High School Diploma or GED</li><li>
Approved Coding certificate required. (CCS, CPC)
</li><li>Experience working in a compliance role preferred, but not required</li><li>
Knowledge of billing practices, auditing practices, various programs utilized in an outpatient clinic setting.
</li><li>Prior medical records review experience</li><li>
Experience in governmental programs as related to FQHC&rsquo;s or other related clinical setting</li><li>
Centricity practice management system experience is a plus</li><li>
Data management responsibilities a plus</li><li>
Able to operate general office equipment, such as copiers, facsimile machine, etc.
</li><li>Working knowledge of Microsoft windows programs such as Word, Excel, Power Point</li><li>
Intermediate computer skills</li></ul>
COMMUNICATION SKILLS:<ul><li>
Must have neat and legible handwriting</li><li>
Must be able to interact with patients/providers courteously and calmly</li><li>
Ability to communicate well with the public</li><li>
Exceptional verbal and written communication skills</li></ul>
WORKING CONDITIONS &amp; PHYSICAL REQUIREMENTS
Works well with patients, co-workers and vendors in a generally comfortable environment office. Employee must possess the following physical requirements:<ul><li>
May require prolonged sitting or standing</li><li>
Travel as needed</li><li>
Vision sufficient to read handwritten, typed and computer printed documents throughout the day</li><li>
Speech and hearing sufficient to receive and communicate detailed information clearly by phone and in person</li><li>
Motor skills sufficient to use and manipulate equipment</li><li>
Must have a high level of manual dexterity</li><li>
Physically able to sit, walk, or otherwise stand for long periods of time, frequent bending, stooping, and stretching. Repetitive hand, arm, and shoulder movements</li><li>
Able to lift up to 40 pounds</li></ul></div>

Coding Research & Training Assistant

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)

Vitreous Retina Macula Consultants of New York

<div><h2 class="jobSectionHeader">Working at VRMNY</h2>
Vitreous Retina Macula Consultants of New York (VRMNY) is one of the nation&rsquo;s leading retina practices, known for world‑class physicians, cutting‑edge treatments, and a commitment to exceptional patient care. With multiple locations across NYC, VRMNY combines academic‑level expertise with a collaborative, mission‑driven culture. Team members at VRMNY work alongside top retina specialists, contribute to meaningful patient outcomes, and operate within a dynamic environment that values innovation, accountability, and professional growth. Joining VRMNY means becoming part of a respected organization that sets the standard for retina care in New York and beyond.
The Billing Manager oversees the full revenue cycle operations for a high‑volume, multi‑location retina practice in New York City. This role is responsible for leading the billing and AR department, ensuring accurate and timely claims submission, optimizing collections, and maintaining compliance with payer and regulatory requirements. The ideal candidate has deep experience in ophthalmology/retina billing, strong knowledge of Medicare billing rules and reimbursement, advanced analytical and reporting skills, and the ability to synthesize complex data into actionable insights for leadership.<h3 class="jobSectionHeader">
Key Responsibilities</h3><ul><li>
Lead and manage the billing, AR, and collections teams across multiple practice locations.</li><li>
Oversee full revenue cycle operations including charge capture, coding accuracy, claims submission, payment posting, denials management, and appeals.</li><li>
Manage drug AR, including tracking high‑cost retina pharmaceuticals, reconciling buy‑and‑bill inventory, and ensuring accurate reimbursement.</li><li>
Oversee inventory processes related to retina injectables and surgical supplies, ensuring alignment between clinical usage, billing, and purchasing.</li><li>
Direct and maintain credentialing and re‑credentialing for all providers with commercial payers, Medicare, Medicaid, and managed care plans.</li><li>
Monitor AR aging, establish performance benchmarks, and implement corrective action plans to reduce outstanding balances.</li><li>
Develop and maintain dashboards, KPIs, and financial reports for leadership; provide clear data synthesis, forecasting, and projections to support operational and strategic decisions.</li><li>
Conduct root‑cause analysis on denials, underpayments, and payer trends; implement process improvements to maximize revenue.</li><li>
Ensure compliance with HIPAA, payer policies, Medicare billing guidelines, and retina‑specific coding requirements.</li><li>
Collaborate closely with clinical, administrative, and operational leadership to streamline workflows and support practice growth.</li><li>
Train, mentor, and evaluate billing staff; establish accountability and performance standards.</li></ul><h3 class="jobSectionHeader">
Qualifications</h3><ul><li>
5+ years of medical billing experience, preferably in ophthalmology or retina.</li><li>
Strong knowledge of Medicare billing, coverage policies, and reimbursement methodologies.</li><li>
Deep understanding of retina‑specific coding (e.g., injections, imaging, procedures) and buy‑and‑bill reimbursement.</li><li>
Proven experience managing multi‑site billing operations.</li><li>
Exceptional analytical skills with the ability to interpret data, build reports, and forecast trends.</li><li>
Proficiency in EMR/EHR and practice management systems; experience with reporting tools preferred.</li><li>
Strong leadership, communication, and problem‑solving abilities.</li><li>
Ability to thrive in a fast‑paced, high‑volume environment.</li></ul> 
Salary: $85,000&ndash;$95,000, commensurate with experience
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Billing Manager – Retina Practice (Multi‑Location, NYC)

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