coding specialist

MACT HEALTH BOARD INC

<p></p><div><p>Since 1969, MACT Health Board&rsquo;s mission has been to improve the health status of the American Indian and Alaskan Native population. Our goal is to continue to provide high quality care to our patients throughout a variety of services, including Medical, Behavioral Health, Chiropractic, Dental, Optometry, Massage Therapy, Women&rsquo;s Health, and more.</p><p></p><p><br>
Why MACT Health Care Inc?</p><p>
Are you searching for a career that offers more than just a paycheck? A career where your professional skills directly empower the health and well-being of our local communities? At MACT Health Board, that&rsquo;s not just an idea&mdash;it&rsquo;s our daily mission and we invite you to explore our Career Opportunities. You won&rsquo;t be just another employee; you&rsquo;ll be a valued member of a team committed to making a difference and we know that taking care of our community starts with taking care of our own. We reward our employees with competitive compensation, benefit options and provide training and advancement opportunities to provide you with the skills to succeed in your future! Our careers offer a unique balance of philanthropic opportunities, cultural preservation and individual value! When you join MACT, you&rsquo;ll enjoy:</p><ul><li>
Medical, Dental, Vision, and life insurance benefits at no-cost to the employee</li><li>
403(b) retirement plan, PTO including vacation, sick time, paid holidays and more</li><li>
Balanced working hours; Monday-Friday 8-5pm.</li><li>
Student Loan Repayment Program</li><li>
Direct Student Loan Contributions: Our BenefitED program allows us to make direct quarterly contributions to your student loans to help you pay them off faster</li><li>
Continuing Education credits: We empower our providers to stay at the top of their field. We offer reimbursement for continuing education and licensure fees.</li><li>
Competitive Salary $25.56 - $30.10 hourly</li></ul><p>
Who you are:</p><p>
We are seeking a detail oriented Billing and Coding Specialist for a full time role. As a member of the administrative team, the Billing and Coding Specialist ensures that all patients are registered in the patient billing and collection system in accordance with the billing and collection policy for third party resources. The Billing and Coding Specialist will:</p><ul><li>
Serve as account representative for an assigned location</li><li>
Accurately enter data of patient, provider and payer type</li><li>
Effectively bill private insurance, Medi-cal, Medicare, crossovers, workers compensation, and private paying patients</li><li>
Precise adjudication of claims for patients; the correct administration of benefits; paying attention to adjudication problems and errors, and solving associated problems</li><li>
Post and balance payments into the Electronic Patient Management billing software system</li><li>
Responsible for the correction of monetary amounts posted incorrectly to patients&rsquo; accounts or over payments as they appear on patients&rsquo; accounts. When possible, the credit amounts are reapplied to the account; refunds are issued where necessary</li><li>
Correspond with insurance companies, third party payers, and patients, collecting information, money or settling discrepancies and filing appeals</li><li>
Analyze for completeness, prepare and enter daily charges of super bills</li><li>
Meet deadlines for processing daily billings, contact related medical departments for clarification, receiving updates on Medicare, Medi-Cal and related providers for compliance</li><li>
Research verification of benefits, change of guarantor, other opened encounters, etc</li><li>
Responsible for being current on any billing changes for the above agencies as assigned</li></ul><p>
What you need:</p><ul><li>
Have an AA Degree and/or equivalent, Have a minimum of 3 years&rsquo; experience in medical/dental billing.</li><li>
ICD-10-CM coding knowledge or experience is preferred.</li><li>
Knowledge of the Electronic Patient Management billing system, workflow dynamics, and modifications of the Electronic Patient Management billing software.</li><li>
Knowledge and training in the HIPAA regulations related to patient care documentation, billing process and compliance to the regulations.</li><li>
Knowledge of State and Federal regulation as applies to billing for Medical, Dental and Behavioral Health services.</li><li>
Current Member of AAPC.</li><li>
Current BLS/ALS certificate preferred</li><li>
Must pass Occupational Health Screening.</li><li>
Must possess a valid form of identification as listed on the U.S. Department of Justice I-9 form, verified using the E Verify system.</li><li>
Clean DMV driving record and MACT auto insurance driving eligibility (determined by auto insurance carrier).</li></ul><p></p><p><br>
The position requires an awareness and keen appreciation of American Indian traditions, customs, and socioeconomic needs and the ability at all times to meet and deal effectively in contacts with Indian health organizations which requires tact, courtesy, discretion, resourcefulness and good judgment in handling functions of a sensitive nature.</p><p>
AMERICAN INDIAN PREFERENCE:</p><p>
Preference in filling of a vacancy will be given to qualified American Indian applicants in accordance with the Preference Act (Title 25, U.S. Code, Sections 472 &amp; 473) and Public Law 93-638, provided the applicant has submitted appropriate verification of Indian preference for employment. Other than the aforementioned requirement, the MACT Health Board, Inc. is an Equal Opportunity Employer.</p><p></p><p><br>
NOTICE OF DRUG-FREE WORKPLACE ACT REQUIREMENT:</p><p>
MACT Health Board, Inc. is required to implement the Drug-Free Workplace Act of 1988, 45 CFR Part 79, Subpart F. As such it is unlawful for employees to manufacture, distribute, dispense, possess, or use a controlled substance on the job site. Employees who are reasonably suspected of violating this act may be subject to drug testing as a condition of employment. Employer required fitness examinations shall include drug testing as evidence of employee and employer compliance with the Drug-Free Workplace Act.</p></div><p></p>

Billing and Coding Specialist

UMass Memorial Health

<div><div>Are you a current UMass Memorial Health caregiver? <div>Apply now through Workday.</div></div><div></div><div>
Exemption Status:</div>
Non-Exempt<div></div><div>
Hiring Range:</div>
$25.83 - $43.91<div>
Please note that the final offer may vary within this range based on a candidate&rsquo;s experience, skills, qualifications, and internal equity considerations.</div><div></div><div>
Schedule Details:</div>
Monday through Friday<div></div><div>
Scheduled Hours:</div>
7am-3:30pm<div></div><div>
Shift:</div>
1 - Day Shift, 8 Hours (United States of America)<div></div><div>
Hours:</div>
40<div></div><div>
Cost Center:</div>
99940 - 5446 Professional Billing Coding<div></div><div>
Union:</div>
SHARE (State Healthcare and Research Employees)<div></div><div>
This position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.</div><div></div><div>
Everyone Is a Caregiver</div><div></div><div>
At UMass Memorial Health, everyone is a caregiver &ndash; regardless of their title or responsibilities. Exceptional patient care, academic excellence and leading-edge research make UMass Memorial the premier health system of Central Massachusetts, and a place where we can help you build the career you deserve. We are more than 20,000 employees, working together as one health system in a relentless pursuit of healing for our patients, community and each other. And everyone, in their own unique way, plays an important part, every day.</div><div></div>
Responsible for interpreting medical record data in order to process physician and/or facility charges. Assigns appropriate ICD-CM (current edition), CPT codes and modifiers as appropriate. Coordinates and performs work of assigned Coding Specialists and monitors progress and work quality. Trains employees, provides employee performance data, and fosters process improvements.<div></div><div>
I. Major Responsibilities:</div><div>
1. Distributes and monitors the flow of work for coding staff. Provides training and technical assistance to employees within the assigned work area. Assists supervisor in ensuring that assigned employees are provided with appropriate resources, materials, and methods. Provides recommendations to manager or supervisor for the most efficient utilization of assigned personnel. Relays work instruction from the supervisor. Reviews coded records for coding quality assurance. Provides instruction and feedback to coding staff regarding proper coding assignment as necessary.<br>
2. Acts as a point person/department resource for special projects/programs and responds to coding related questions and issues.<br>
3. Assists in MD, Resident and Nursing documentation reviews, audits, and educational sessions as applicable.<br>
4. Performs analysis on medical record documentation to include review of tests/reports, and determines appropriate codes, as defined by coding guidelines and other recognized reference materials.<br>
5. Abstracts and enters all codes and required demographic information into the UMMHC computer system and/or onto encounter forms.<br>
6. Assists in resolving incomplete and missing chart documentation in order to expedite chart abstraction and billing.<br>
7. Participates in improvement efforts and documentation training for medical and clinical staff as it relates to coding practices and guidelines.<br>
8. Participates in quality assurance and performance measurement reviews and reporting.<br>
9. Communicates to supervisor when backlog situations arise or necessary documents are either incorrect or are not being received in a timely manner.<br>
10. Informs management of any coding irregularities or trends contrary to policy or procedure, and communicates with clinical staff if necessary and appropriate.<br>
11. Maintains direct and ongoing communications with other coding and billing personnel to maximize overall effectiveness and efficiency of the operation.</div><div></div><div>
Standard Staffing Level Responsibilities:</div><div>
1. Complies with established departmental policies, procedures and objectives.<br>
2. Attends variety of meetings, conferences, seminars as required or directed.<br>
3. Demonstrates use of Quality Improvement in daily operations.<br>
4. Complies with all health and safety regulations and requirements.<br>
5. Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.<br>
6. Maintains, regular, reliable, and predictable attendance.<br>
7. Performs other similar and related duties as required or directed.</div><div>
All responsibilities are essential job functions.</div><div></div><div>
II. Position Qualifications:</div><div></div><div>
License/Certification/Education:<br>
Required:<br>
1. High School education, plus medical coding certification and training in medical terminology from an accredited program. Recognized programs include: AHIMA, NHA, and AAPC.</div><div></div><div><br>
Experience/Skills:<br>
Required:<br>
1. Five years of medical abstraction and coding experience or related work experience.<br>
2. Knowledge of ICD-CM (current edition) and CPT HCPCS coding systems, 3rd party payer requirements and federal/state guidelines and regulations pertaining to coding and billing practices.<br>
3. The ability to lead, organize, and support the work of less senior Coding Specialists is a primary function of this position.<br>
4. Requires good interpersonal and communications skills and maintains a professional manner when working with team members, management and other staff members.<br>
5. Requires intermediate level computer skills with the ability to use standard office software applications, such as Microsoft Office Excel and Word.</div><div></div><div>
Unless certification, licensure or registration is required, an equivalent combination of education and experience which provides proficiency in the areas of responsibility listed in this description may be substituted for the above requirements.</div><div></div><div>
Department-specific competencies and their measurements will be developed and maintained in the individual departments. The competencies will be maintained and attached to the departmental job description. Responsible managers will review competencies with position incumbents.</div><div></div><div>
III. Physical Demands and Environmental Conditions:</div><div>
Work is considered sedentary. Position requires work indoors in a normal office environment.</div><div></div><div>
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.</div><div></div><div>
We&rsquo;re striving to make respect a part of everything we do at UMass Memorial Health &ndash; for our patients, our community and each other. Our six Standards of Respect are: Acknowledge, Listen, Communicate, Be Responsive, Be a Team Player and Be Kind. If you share these Standards of Respect, we hope you will join our team and help us make respect our standard for everyone, every day.</div><div></div><div>
As an equal opportunity and affirmative action employer, UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences, perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, gender identity and expression, protected veteran status or other status protected by law.</div><div></div><div>
If you are unable to submit an application because of incompatible assistive technology or a disability, please contact us at talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.</div></div><div></div>

Coding Specialist III- remote

Invisible Agency

Are you a Kotlin expert eager to shape the future of AI? Large-scale language models are evolving from chatbots into powerful developer assistants capable of reasoning about complex software systems. With high-quality engineering data, tomorrow's AI can support developers in solving real-world problems faster and more accurately. That training data begins with you—your coding expertise will help power the next generation of AI.
<br><br>
We're looking for Kotlin specialists who can take real-world engineering scenarios—such as bug reports or feature requests in a Git repository—and produce clean, efficient, and idiomatic solutions using the Kotlin programming language. You'll create high-quality code patches that reflect modern Android development practices and ensure technical correctness, maintainability, and clarity.
<br><br>
You should have hands-on experience with modern Android and Kotlin development, including Jetpack Compose, Kotlin Coroutines, and Jetpack libraries such as Room, WorkManager, Datastore, ViewModel, and Hilt. Familiarity with build.gradle configuration, dependency management, and networking libraries such as OkHttp, Retrofit, and Coil is also important. Experience with Android multimedia tools (CameraX, ExoPlayer, Media3) is a plus.
<br><br>
On a typical day, you'll evaluate AI-generated code, correct errors, implement optimized Kotlin solutions, and document best practices that demonstrate modern Android design patterns and coding conventions.
<br><br>
A strong background in Android software development is required, with demonstrable experience building and maintaining production-level Kotlin applications. Clear, structured communication and the ability to explain technical decisions are essential.
<br><br>
We offer a pay range of $35+ per hour, with the exact rate determined after evaluating your experience, expertise, and geographic location. Final offer amounts may vary from the pay range listed above. As a contractor, you'll supply a secure computer and high-speed internet; company-sponsored benefits such as health insurance and PTO do not apply.
<br><br>
<b>Job title:</b> Master - Kotlin Coding Specialist – AI Trainer
<br><b>Employment type:</b> Contract
<br><b>Workplace type:</b> Remote
<br><b>Seniority level:</b> Mid - Senior Level

Kotlin Coding Specialist - AI Trainer

THE KIDNEY CENTRE

<p>The Kidney Centre is a centrally located specialty hospital, offering a collegial workplace experience with balanced work hours and competitive compensation packages. We invite applications from interested and suitably qualified candidates to fill the following position:</p><p><b>Position Overview:</b></p><p>We are currently seeking a detail-oriented and experienced <b>Medical Coder</b> to join our healthcare team. The ideal candidate will be responsible for reviewing clinical documentation and assigning accurate medical codes for diagnoses, procedures, and services, ensuring compliance with all regulations and optimizing reimbursements.</p><p><b>Key Responsibilities:</b></p><ul><li>Review and analyze patient medical records and documentation</li><li>Assign appropriate ICD-10, CPT, and HCPCS codes based on medical documentation</li><li>Ensure coding accuracy and compliance with federal regulations and insurance requirements</li><li>Collaborate with physicians, billing staff, and other healthcare providers to clarify diagnoses or obtain additional information</li><li>Assist in audits and provide coding education when needed</li><li>Maintain confidentiality of patient records and adhere to HIPAA regulations</li></ul><p><b>Qualifications:</b></p><ul><li>Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent certification required</li><li>Minimum [1-2] years of medical coding experience (preferred)</li><li>Strong knowledge of anatomy, physiology, and medical terminology</li><li>Experience with electronic medical records (EMR) and coding software</li><li>High attention to detail and accuracy</li><li>Excellent communication and organizational skills</li></ul><p>Interested candidates can apply at <b>careers@kidneycentre.com</b></p><p>Please mention the position applied for in the subject line, or you can submit it to the Human Resources Department. For inquiry Tel # 0213-5661000, Ext#271.</p><p>Job Types: Full-time, Contract</p><p>Work Location: In person</p>

Medical Coder

FMOL Health

<div><p>The Oncology Claims Analyst 1 will coordinate coding audits and educational functions for FMOLHS and the Oncology Service Line. This individual will be responsible for drug authorizations, managing and working the edit and denial coding work queues for inpatient, outpatient clinic, and hospital based infusion departments and will provide coding and reimbursement feedback for education opportunities identified to the Service Line and FMOLHS. Prepares and presents coding education to providers and works in collaboration with various hospital and FMOLHS departments as a liaison related to NCCN, ASCO, and FDA guidelines. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, reviews principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient, outpatient, and infusion records based on knowledge of coding systems. Additionally serves as business/reimbursement specialist for oncology drug regimens for both the Service Line and FMOLHS.</p></div>
<br><div><div><ul><li><b>Coding/Program Management
</b><ul><li>Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients.
</li><li>Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line.
</li><li>Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line.
</li><li>Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins.
</li><li>Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial.
</li><li>Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others.
</li></ul></li></ul><ul><li><b>Coding/Program Management
</b><ul><li>Reviews and audits codes (CPT, ICD 10, HCPC, Level II, and modifier coding, etc.) and is expert on prior authorization using FDA, National Comprehensive Cancer Network (NCCN), and American Society of Clinical Oncology (ASCO) for specialty practices like inpatient chemotherapy hospitalizations, outpatient oncology visits, hospital based outpatient infusion centers for both oncology and non-oncology patients.
</li><li>Is consultant/expert for FMOLHS business office and external agencies in clarification of coding regarding reimbursement infusion issues, especially new FDA and new clinical pathways of National Comprehensive Cancer Network (NCCN). Manages data gathering and chart auditing as necessary for FMOLHS Revenue Cycle, LPG, and Oncology Service Line.
</li><li>Works closely and consistently with major pharmaceutical companies on new drug treatment guidelines/pathways, drug replacement programs, and Southern Oncology Association of Practices (SOAP) to determine business best practices and clinical education opportunities for physicians/providers. Reports findings consistently to Director of Pharmacy and VP of Oncology Service Line.
</li><li>Advises the executive team on best practices for drug purchase opportunities to ensure potential profitability is maximized while working with FMOLHS contract director to verify profitability of managed care contracts related to drug margins.
</li><li>Works with various national oncology specific institutions, like MD Anderson, Bone Marrow transplant centers, etc. alongside physicians/payers directly whether clinical pathways/treatment regimens fall within proper coding/maximum reimbursement of clinical trials, off label, NCCN guideline, etc. to manage proper clean claims and decrease likelihood of claim denial.
</li><li>Works directly with business, administrative team, and physicians/providers to perform at least monthly education on chart audits, new treatment pathways, governmental payer requirements, and others.
</li></ul></li></ul><ul><li><b>Analysis and Collaboration
</b><ul><li>Proactively researches and understands payer issues. Troubleshoots and resolves issues that impact revenue. Works collectively with FMOLHS denial management team to audit Medicare, Medicaid, and Insurance claims for accurate coding, charging, and modifier usage as requested by the FMOLHS. Considered expert for high dollar drug appeals across FMOLHS.
</li><li>Considered expert for the Physician Group, Revenue Management Department, Pharmacy, and other financial departments in clarification of coding regarding reimbursement issues to resolve claim edits and assure clean claim submission. Monitors and evaluates compliance with documentation standards to identify trends, issues, risk areas, and opportunities for performance improvement.
</li><li>Continually analyzes reports/margin analyzers to communicate business performance to the administrative team, revenue cycle team, physician practice managers, and physicians to determine efficacy and suggests opportunities for improvement.
</li><li>Acts as a liaison for Professional Billing and FMOLHS Central Billing Office Management assisting in any special requests/research for information/proper documentation to aid in billing processes especially high dollar denials/write offs/analysis.</li></ul></li></ul></div></div>
<br><div><ul><li>Experience: 3 years of medical revenue cycle experience
</li><li>Education: High School Diploma</li></ul></div>

Oncology Claims Analyst 1

Healthrix

<p><b>Overview</b><br/>As an RCM Specialist, you will play a pivotal role in the revenue cycle management process, ensuring that our healthcare operations run smoothly and efficiently. You will be responsible for managing medical billing, coding, and collections to optimize revenue flow while maintaining compliance with industry standards. Your expertise in medical terminology and coding systems will be essential in facilitating accurate documentation and processing of medical records.</p><p><b>What you&rsquo;ll do</b></p><ul><li>Review and analyze patient records to ensure accurate coding using ICD-9, ICD-10, CPT coding, and DRG (Diagnosis-Related Group) methodologies.</li><li>Process medical billing and collections efficiently to maximize revenue recovery.</li><li>Collaborate with healthcare providers to clarify documentation and coding discrepancies.</li><li>Utilize EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems for data entry and retrieval of patient information.</li><li>Maintain up-to-date knowledge of medical terminology, coding guidelines, and billing regulations.</li><li>Conduct audits of medical records to ensure compliance with legal and regulatory requirements.</li><li>Provide support in resolving billing inquiries from patients or insurance companies promptly.</li><li>Assist in training staff on best practices related to medical coding and billing processes.</li></ul><p><b>Basic qualifications</b></p><ul><li>Proven experience in medical office settings with a focus on RCM processes.</li></ul><p><b>Preferred qualifications</b></p><ul><li>Proficiency in DRG, CPT coding, ICD-9, ICD-10, and general medical coding practices.</li><li>Familiarity with EMR and EHR systems for effective patient data management.</li><li>Strong understanding of medical terminology and documentation standards.</li><li>Excellent communication skills for effective collaboration with healthcare teams and patients.</li></ul><p><b>Why you&rsquo;ll love it here</b><br/>We are dedicated to fostering an environment where our employees can thrive both professionally and personally. Our commitment extends beyond just the workplace; we offer a range of benefits designed to support your overall well-being.</p><p><b>Our benefits include:</b></p><ul><li>Comprehensive health coverage options that cater to your needs.</li><li>Opportunities for professional development and continuous learning.</li><li>A supportive workplace culture that values teamwork and collaboration.</li><li>Resources aimed at enhancing your physical and mental health. Join us as we strive to enhance the quality of care through effective revenue cycle management! Your contributions as an RCM Specialist will directly impact our mission to provide exceptional healthcare services while ensuring financial sustainability.</li></ul><p>Job Type: Full-time</p><p>Work Location: In person</p>

RCM Specialist

CVS Health

<div><p>At CVS Health, we&rsquo;re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.</p><p></p><p>
As the nation&rsquo;s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues &ndash; caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.</p><p></p><p><b>
Position Summary</b></p><p>
Responsible for performing second level quality inter-rater review audits of medical records coded by internal team, as well as external vendor (if applicable) to ensure the ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures.</p><p></p><ul><li>
Proven ability to support coding judgment and decisions using industry standard evidence and tools.</li><li>
Ability to confidently speak to such evidence across internal stakeholders with varying knowledge and clinical expertise in either written or verbal forms including communication with clinical or coding staff, federal regulators and vendor coding resources.</li><li>
Acts as mentor to provide education to internal staff based on audit findings; provides general education on ICD codes as appropriate</li><li>
Conducts process audits to ensure compliance with internal policies and procedures and existing CMS regulations.</li><li>
Ability to work independently as well as in a cross functional role within other teams for collaboration on best practices.</li><li>
Adhere to stringent timelines consistent with project deadlines and directives.</li><li>
Possesses a genuine interest in improving and promoting quality; demonstrates accuracy and thoroughness and assists others to achieve the same through mentoring and instruction.</li><li>
Conducts process audits to ensure compliance with internal policies and procedures as well as regulatory guidance from CMS, OIG or other Regulatory body.</li><li>
Thorough knowledge of coding guidelines and regulations to meet compliance requirements, such as establishing medical necessity.</li><li>
Identify and communicate documentation deficiencies to allow for continuous education opportunities for peers.</li><li>
Extensive knowledge of medical documentation, fraud, abuse and penalties for documentation and coding violations based on governmental guidelines.</li></ul><p></p><p><b>
Required Qualifications</b></p><ul><li>
Minimum of 3 years recent and related experience in medical record documentation review, diagnosis coding, and/or auditing.</li><li>
Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work history/on the job experience equal to approximately 3 years for CPC.</li><li>
CPC (Certified Professional Coder) or CCS-P (Certified Coding Specialist-Physician) required.</li>
CRC (Certified Risk Adjustment Coder) required within the first six months.<br>
<li>
</li></ul><p><br>
<b>Education</b></p><ul><li>
AA/AS or equivalent experience</li></ul><p></p><p><b>
Anticipated Weekly Hours</b></p>
40<p></p><p><b>
Time Type</b></p>
Full time<p></p><p><b>
Pay Range</b></p><p>
The typical pay range for this role is:</p><p></p>
$21.10 - $36.78<p></p><p>
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.</p><p><br>
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p></p><p><b>
Great benefits for great people</b></p><p></p><p>
We take pride in our comprehensive and competitive mix of pay and benefits &ndash; investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:</p><ul><li><p><b>
Affordable medical plan options,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p><b>
No-cost programs for all colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p><b>
Benefit solutions that address the different needs and preferences of our colleagues</b> including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</p></li></ul><p></p><p>
For more information, visit https://jobs.cvshealth.com/us/en/benefits</p><p></p>
We anticipate the application window for this opening will close on: 11/25/2025<p></p><p>
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p></div>

Analyst, Coding Data Quality Auditor

Search 6720+ Coding specialist jobs near you this November. New roles added regularly across leading industries. Apply today.