medical billing analyst

Community Bridges, Inc.

Community Bridges, Inc. (CBI) is an integrated behavioral healthcare agency offering a variety of different programs throughout Arizona. CBI provides residential, outpatient, inpatient, patient-centered medical homes, medication-assisted treatment, and crisis services to individuals experiencing crisis, opioid use disorder, homelessness, and mental illness.
 
Medical Billing Analyst
 Community Bridges, Inc. (CB I) is an integrated behavioral healthcare agency offering a variety of different programs throughout Arizona. CBI provides residential, outpatient, inpatient, physical health, medication-assisted treatment, and crisis services to individuals experiencing, substance use disorder, homelessness, and mental illness.
 
CBI is the premiere non-profit fully integrated healthcare provider of substance use and behavioral health programs in Arizona, including prevention, education and treatment using cutting-edge, nationally recognized, evidence-based models.
 
Job Summary
 
The Medical Billing Analyst will be responsible for the qualification, data analysis, data accuracy, preparing and submitting claims to payers. This position is responsible for timely and compliant claim submissions in accordance to the billing requirements set forth by the payers. This position is also responsible for monitoring and analyzing the quality of data reported in billing records to ensure that they are submitted in accordance to standards, policies and procedures and will initiate necessary corrections to ensure the quality of the information billed.
 The ideal candidate will be a self-starter with strong attention to detail and an ability to work in a fast-paced environment.
 
Skills/Requirements
 
<ul>
<li>High School diploma or GED required. Associate Degree or higher preferred.</li>
<li>Minimum 18 months experience with billing medical claims</li>
<li>Minimum 18+ months experience performing healthcare reimbursement,</li>
</ul>
behavioral health insurance/billing or related work.
 <ul>
<li>Knowledge of CPT, HCPCS and Modifier experience required.</li>
<li>Experience with behavioral health claims preferred.</li>
<li>Experience working in a remote environment preferred.</li>
<li>Valid identification required.</li>
<li>Billing certificate preferred.</li>
</ul>
CBI Offers an excellent benefits package!
 
<ul>
<li>Generous PTO accrual (5 weeks!),</li>
<li>Medical, Dental, Vision, Disability, Life, Supplemental plans</li>
<li>Hospital indemnity/ Critical Illness,</li>
<li>Pet Insurance,</li>
<li>Dependent Care Savings, Health Care Savings,</li>
<li>401K with employer match - 100% vested upon enrollment,</li>
<li>Wellness programs,</li>
<li>Tuition Reimbursement and Scholarship Programs, incentives, and more!</li>
<li>Very Competitive pay rates</li>
</ul>
CBI is growing and expanding our services!
 
<ul>
<li>We are experiencing tremendous growth in this time. As an essential service provider, we value all our employees and their careers.</li>
<li>*For the past four years, The Phoenix Business Journal has recognized CBI as one of the top ten healthiest mid-size employers in the Valley! *</li>
</ul>
CBI Values your Career and have lots of growth opportunities!
 
Our staff experience tremendous professional growth through ongoing training and support. Our team is supported by strong and competent leadership. The leadership at CBI is committed to ongoing professional development for their staff. Come join our team of passionate individuals who are serious about making a difference in the lives of our patients and the communities we serve.
 
About our Culture, commitment to employees!
 
<ul>
<li>We are looking for driven and compassionate individuals that thrive in an upbeat and safe working environment. We dedicate a lot of thought and effort into work life balance as well as our competitive composition structure.</li>
<li>We know life happens, that’s why we all start with a 5-week PTO plan as well as a wide range of unique benefits!</li>
</ul>
Our Facilities.
 
Our 26 locations are all state-of-the-art facilities that provides top notch integrated care. We are proud to adhere to a “no wrong door” treatment approach that allows our staff to dramatically improve the quality of life for the patients in their care.
 
CBI treats patients from all different walks of life and believes in maintaining the dignity of human life. Recovery is possible!
 
CBI Offers an excellent benefits package!
 <ul>
<li>Medical, Dental, Vision, Disability, Life, Supplemental plans - Hospital indemnity/ Critical Illness, Pet Insurance, Dependent Care Savings, Health Care Savings, 401K with employer match - 100% vested upon enrollment, Generous PTO accrual, Wellness programs, Tuition Reimbursement and Scholarship Programs, incentives, and more!</li>
<li>For the past four years, The Phoenix Business Journal has recognized CBI as one of the top ten healthiest mid-size employers in the Valley.</li>
</ul>
CBI treats patients from all different walks of life and believes in maintaining the dignity of human life. Recovery is possible!

CCBO - Medical Billing Analyst

CLS Health

<div>Description:

About CLS Health
CLS Health is a growing healthcare system in Houston, Texas that is taking a different approach to healthcare. We are a physician-led healthcare group that focuses on providing patients with holistic, multispecialty care. We're a dynamic team on a mission to provide better healthcare options for Houstonians!
Job Summary:
The Chargemaster Analyst is responsible for maintaining and updating the organization&rsquo;s chargemaster within the electronic medical record and related billing systems. This position ensures charge codes, descriptions, pricing, and billing components are accurate, compliant, and aligned with current coding and payer requirements. The role works closely with Revenue Cycle, Finance, Compliance, Operations, and IT to support accurate charge capture and reimbursement.
Key Responsibilities:<ul><li>
Update and maintain chargemaster files in the EMR and billing systems</li><li>
Review CPT, HCPCS, ICD 10, modifiers, revenue codes, and pricing for accuracy</li><li>
Implement annual code changes, fee updates, and new service builds</li><li>
Audit chargemaster data for missing, outdated, or duplicate entries</li><li>
Partner with departments to support charge capture and billing workflows</li><li>
Troubleshoot charge-related system issues and assist with testing</li><li>
Maintain documentation of all changes and support audit readiness</li></ul>
Requirements:
<ul><li>3 to 5 years of experience in chargemaster, revenue cycle, coding, or medical billing</li><li>
Experience working in EMR and billing systems</li><li>
Strong knowledge of CPT, HCPCS, ICD 10, modifiers, and reimbursement processes</li><li>
Strong attention to detail, analytical skills, and Excel proficiency</li><li>
Healthcare coding or revenue cycle certification preferred</li></ul></div>

Chargemaster Analyst

Parallon

<div><h5 class="jobSectionHeader">Introduction</h5>
Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a Billing Integrity Analyst Credentialed with Parallon you can be a part of an organization that is devoted to giving back!<h5 class="jobSectionHeader">
Benefits</h5>
Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:<ul><li>
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.</li><li>
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.</li><li>
Free counseling services and resources for emotional, physical and financial wellbeing 
</li><li>
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) 
</li><li>
Employee Stock Purchase Plan with 10% off HCA Healthcare stock 
</li><li>
Family support through fertility and family building benefits with Progyny and adoption assistance. 
</li><li>
Referral services for child, elder and pet care, home and auto repair, event planning and more 
</li><li>
Consumer discounts through Abenity and Consumer Discounts 
</li><li>
Retirement readiness, rollover assistance services and preferred banking partnerships 
</li><li>
Education assistance (tuition, student loan, certification support, dependent scholarships) 
</li><li>
Colleague recognition program 
</li><li>
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) 
</li><li>
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.</li></ul>
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location. 
Would you like to unlock your potential with a leading healthcare provider dedicated to the growth and development of our colleagues? Join the Parallon family! We will give you the tools and resources you need to succeed in our organization. We are looking for an enthusiastic Billing Integrity Analyst Credentialed to help us reach our goals. Unlock your potential!<h5 class="jobSectionHeader">
Job Summary and Qualifications</h5>
The Billing Integrity Analyst (credentialed) is responsible for determining the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPTs, by reviewing the medical record, facility protocol, and other applicable documentation. This review includes the verification of billing data for accuracy and completeness, following regulatory requirements, in order to resolve edits or exceptions detected during system processing of the claim in Patient Accounting, Relay Health or the payer. Applies modifiers when appropriate based on this review, and/or makes necessary adjustments to patient account charges and/or balances. Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and HCA standards. Combines or splits accounts as appropriate. Serves as a liaison between facilities Administration, Shared Services Center, and ancillary department directors regarding charging issues, clinical documentation issues and revenue opportunities. Provides charge review results and develops and coordinates educational in-services for facility staff related to charging/billing issues. Coordinates retrospective, concurrent, patient requested, and external billing audits. Reviews denial trends for documentation and charging opportunities. Serves as a primary contact for charge related SSC and facility inquiries and issues.
In this role you will:<ul><li>
Analyze and resolve specific billing edits that require HCPCS/CPT coding based on the chargemaster expertise and that are delaying claims from processing in the Patient Accounting and/or Relay Health systems. This includes the verification (and/or correction) of billing data for accuracy and completeness, by following regulatory requirements, and reviewing the medical record, facility protocol, and other applicable documentation. This also includes the application of modifiers and condition codes, as appropriate.</li><li>
Identify charging, chargemaster coding, or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues that are identified while working on edits.
</li><li>Serve as charge master liaison to facilitate clinical department education on appropriate charging of CPT codes, Revenue Codes, and communicating with Ancillary Departments to resolve issues. Coordinates updates (activate, inactivate, modification) with Ancillary Departments as necessary
</li><li>Review Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Billing Integrity procedures and implement changes as needed.</li><li>
Maintain billing education, attend webcasts and conference calls as required.</li></ul>
Qualifications:<ul><li>
Associate Degree or above; or healthcare license/certification required.</li><li>
Minimum 1 year directly related Healthcare experience or coding experience required.
</li><li>Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews preferred.</li><li>
Healthcare certification/licensure such as RHIT, CCS, CCP,CPC or other recognized AHIMA certified coding credential, LPN, LVN, RT, PT, etc., can be accepted lieu of degree with work experience.</li></ul>
Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.
HCA Healthcare has been recognized as one of the World&rsquo;s Most Ethical Companies&reg; by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. 
&quot;There is so much good to do in the world and so many different ways to do it.&quot;- Dr. Thomas Frist, Sr. 
HCA Healthcare Co-Founder
Be a part of an organization that invests in you! We are reviewing applications for our Billing Integrity Analyst Credentialed opening. Qualified candidates will be contacted for interviews. Submit your application and help us raise the bar in patient care!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.</div>

Billing Integrity Analyst Credentialed

Optum

<div>Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
As a Coding Compliance Analyst, you will be responsible for procedure and diagnostic coding of professional charges. Works closely with clinical department physicians and staff to ensure accurate and compliant coding and maximization of revenue through initial coding.
Schedule (FT, 40 hours): Will work 8-hr shifts, Monday-Friday. Must be flexible with schedule changes depending on business need. Typical business hours range from 6am - 6pm. (Preferably EST or CST).
Role is fully remote.
You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.
Primary Responsibilities:<ul><li>
Participates in the identification and resolution of areas requiring additional intervention through established Coding/Billing and Corporate Compliance work plans</li><li>
Develops and implement clinic-wide training programs geared towards educating clinical and non-clinical support staff regarding compliance related topics and/or deficiencies identified through documentation/coding and billing compliance audits</li><li>
Develops and delivers clinic-wide memorandums/educational materials pertaining to relevant revenue integrity initiatives</li><li>
Identifies trends that result in lost revenue and educates provider as appropriate</li><li>
Assist in the review and update of annual Revenue Integrity &amp; Education work plan and audit schedule</li><li>
Performs formal review of annual CPT/Diagnosis/HCPCS changes and prepares educational documents by specialty highlighting significant changes</li><li>
Trains providers, staff, and others in small and large group sessions</li><li>
Meet deadlines, productivity targets as defined in the Coding/Billing Compliance work Plan</li><li>
Communicates effectively at all levels in the organization, including clinical and non-clinical support staff, managers, physicians, and medical leadership</li><li>
Conducts random and scheduled internal audits of physician billing and medical records documentation to ensure: Correct Coding (CPT, ICD-10, HCPCS, Modifiers), Accurate Data Entry, Accurate Charge Preparation/Processing, Compliance with governmental and third-party billing regulations</li><li>
Conducts quarterly audits of Coding staff to ensure correct coding and to identify training opportunities</li><li>
Utilizes Microsoft Excel / Word, to document and report audit results to the appropriate personnel, including physicians/providers and Medical Leadership</li><li>
Works collaboratively with clinical department physicians, mid-level providers, and other staff to ensure appropriate and compliant documentation, coding, and billing practices</li><li>
Develops and tracks progress of internal audit schedules</li><li>
Serves as an internal compliance resource for Patient Accounts, Clinical departments, and for coding and documentation questions</li><li>
Utilizes the Internet, intranet, internal reference library, available workshops and/or seminars and other sources to stay current with government and local third-party payer coding, specialty specific and reimbursement rules, and requirements</li><li>
Measures and reports coding trends as compared to national standards; or claim/documentation reviews. Documents and reports result to all appropriate parties</li><li>
Monitors and productivity reports and other data as requested by manager</li><li>
Participate in all governmental and third-party insurance audits</li><li>
Assist in developing Revenue Integrity and Education Policies and Procedures</li><li>
Comply with all established departmental policies, procedures, and objectives</li><li>
Maintains all Professional certifications</li><li>
Attends a variety of meetings as required or directed</li><li>
Performs other similar and related duties as required or directed</li><li>
Must be able to work as a team and independently as needed</li><li>
Regular, reliable, and predicable attendance is required</li></ul>
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:<ul><li>
Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays</li><li>
Medical Plan options along with participation in a Health Spending Account or a Health Saving account</li><li>
Dental, Vision, Life&amp; AD&amp;D Insurance along with Short-term disability and Long-Term Disability coverage</li><li>
401(k) Savings Plan, Employee Stock Purchase Plan</li><li>
Education Reimbursement</li><li>
Employee Discounts</li><li>
Employee Assistance Program</li><li>
Employee Referral Bonus Program</li><li>
Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)</li></ul>
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
Required Qualifications:<ul><li>
High School Diploma/GED (or higher)</li><li>
Certified Professional Coder (CPC, CCS-P, CEMC, CPMA or COC)</li><li>
1+ years of experience utilizing standard scoring (CMS) methodologies to report findings to providers</li><li>
1+ years of experience employing clinical references with the auditing process</li><li>
1+ years of experience with Apply CPT and ICD-10 coding convention to documentation guidelines</li><li>
1+ years of experience with Apply CMS and other payer constraints to final code and documentation determination</li><li>
1+ years of demonstrated experience in a physician/professional billing environment</li><li>
1+ years of demonstrated experience with third party payer guidelines</li><li>
Ability to obtain CPMA within 1 year of employment</li></ul>
Preferred Qualifications:<ul><li>
Experience with ICD-10, CPT and HCPCS coding</li><li>
Experience with auditing physician medical records utilizing E+M guidelines</li><li>
Experience with Microsoft Office Suite (Excel, Word, Power Point) or successful completion of related courses. Must show proficiency in current billing software within six (6) months</li><li>
Demonstrated experience in the application of medical terminology, anatomy and physiology or successful completion of related college courses</li><li>All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.</li></ul> 
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $23.89 to $42.69 per hour based on full-time employment. We comply with all minimum wage laws as applicable. 
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. 
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. 
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. 
#RPO #GREEN</div>

Coding Compliance Analyst

ABIC

Job Title: Medical Billing Executive &ndash; Multi-Specialty PracticesLocation: Karachi, Pakistan Department: Revenue Cycle Management (RCM) Experience: 1&ndash;3 Years (Fresh candidates with strong communication skills may also apply)Job SummaryWe are seeking a detail-oriented Medical Billing Executive to support billing and revenue cycle operations for multiple healthcare practices across various medical specialties in the US healthcare system.The candidate will be responsible for insurance claim submission, accounts receivable management, denial resolution, payment posting, and payer follow-ups to ensure timely reimbursements and compliance with payer policies.Supported Medical SpecialtiesThe Medical Billing Executive will support billing operations for the following multi-specialty healthcare practices:<ul><li>Family Medicine</li><li>Internal Medicine</li><li>Urgent Care</li><li>Cardiology</li><li>Orthopedics</li><li>Pain Management</li><li>Dermatology</li><li>Gastroenterology</li><li>Neurology</li><li>Psychiatry / Behavioral Health</li><li>Physical Therapy &amp; Rehabilitation</li><li>Radiology</li><li>Podiatry</li><li>Dental / Oral Surgery</li></ul>Key Responsibilities<ul><li>Review patient demographics, insurance eligibility, and billing information for multiple specialties and providers.</li><li>Submit clean claims to insurance companies and clearinghouses in a timely manner.</li><li>Perform Accounts Receivable (AR) follow-up on unpaid or underpaid claims.</li><li>Manage denial management and appeals to recover unpaid claims.</li><li>Verify insurance payments and ensure accuracy according to payer contracts and fee schedules.</li><li>Process primary, secondary, and tertiary insurance claims.</li><li>Communicate with insurance companies regarding claim status, discrepancies, and payment issues.</li><li>Post insurance and patient payments accurately in the billing system.</li><li>Respond to patient and insurance billing inquiries professionally.</li><li>Maintain accurate documentation and billing records for each practice.</li><li>Ensure compliance with US healthcare billing regulations and HIPAA standards.</li><li>Collaborate with providers, clients, and internal teams across multiple practices.</li></ul>Requirements<ul><li>Bachelor&rsquo;s degree required.</li><li>1&ndash;3 years of experience in US Medical Billing / Dental Billing preferred.</li><li>Knowledge of CPT, ICD-10, and HCPCS coding systems.</li><li>Experience with Accounts Receivable (AR), Denial Management, and Appeals.</li><li>Familiarity with major US insurance payers (Medicare, Medicaid, BCBS, Aetna, Cigna, UnitedHealthcare, etc.).</li><li>Strong communication and problem-solving skills.</li><li>Ability to manage multiple providers and specialties simultaneously.</li></ul>Preferred Skills<ul><li>Experience with EHR / Practice Management systems (Kareo, Athena, eClinicalWorks, AdvancedMD, etc.)</li><li>Knowledge of specialty-specific billing guidelines</li><li>Strong attention to detail and analytical skills</li><li>Ability to work in a fast-paced RCM environment</li></ul>Job Type: Full-timePay: Rs80,000.00 - Rs110,000.00 per monthWork Location: In person

Medical Billing Executive

ExamWorks

<div>
 
 Exam Works is looking for a Medical Coding Specialist to join our team remotely!
 
 
 
 <ul>
 <li>
 Must possess current coding certification in CPC. CPMA certification &amp; Certified Life Care Planner certification preferred.
 
 
 </li>
 </ul>
 The
 
 Medical Coding Specialist
 
 (Internally called a Coding Specialist) is responsible to create and write reports based on medical records and appropriate guideline criteria. This position utilizes the system database to determine usual and customary and/or state fee schedule allowances and this position is responsible for analyzing provider billing for proper coding and billing guidelines across all provider types and ensures reviews are completed with highest quality and integrity and that all work is in full compliance with client contractual agreements, regulatory agency standards and/or federal and state mandates.
 
 
 Schedule for this role is:
 
 Monday - Friday 8am-5pm EST
 
 
 
 
 Essential Job Functions
 
 
 
 <ul>
 <li>
 Receive and input client and examinee data in the system database.
 </li>
 <li>
 Sort and verify each claim.
 </li>
 <li>
 Process and review each claim and address all necessary modifications manually. Contact Client as needed
 </li>
 <li>
 Perform quality assurance on every case prior to completion.
 </li>
 <li>
 Ensure all medical records and reports are properly documented and saved in the appropriate location and available for audit at all times.
 </li>
 <li>
 Process client invoicing in accordance with the client&rsquo;s fee schedule.
 </li>
 <li>
 Handle and responds promptly to incoming calls, emails or faxes from clients requesting report status and/or information.
 </li>
 <li>
 Provide notification to the Supervisor of any provider appeals and follow directions as given to resolve the claim.
 </li>
 <li>
 Provide testimony in court as to the content of prepared reports, as required. Travel as necessary.
 </li>
 <li>
 Ensure all practices are carried out in accordance with HIPAA compliance practices, state and federal safety standards and legal regulations.
 </li>
 <li>
 Perform quality assurance on various coding related reviews.
 </li>
 <li>
 Perform other duties as assigned.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 
 Education and/or Experience
 
 
 
 <ul>
 <li>
 High school diploma or equivalent required.
 </li>
 <li>
 Minimum one year medical billing experience; or equivalent combination of education and experience required.
 
 
 </li>
 </ul>
 
 Certificates, Licenses, Registrations
 
 
 
 
 Must Possess Current Coding Certification In
 
 
 
 <ul>
 <li>
 OASIS, RAC-CT, CCS, CPC, RHIT or RHIA. CPMA certification preferred.
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Must have minimum of one year medical billing experience; or equivalent combination of education and experience required.
 </li>
 <li>
 Must have a full understanding of aspects of medical billing.
 </li>
 <li>
 Must demonstrate understanding of the various types of medical billings and ability to identify which system database should be used.
 </li>
 <li>
 Must be able to cross reference different types of billings to ensure consistency in the review process.
 </li>
 <li>
 Must possess knowledge of standard fee schedule review, UC&amp;R review, drug and supply charges, rarity, utilization review, CPT guidelines, ICD 10, bundling/unbundling, duplicate billing and CMS reimbursement guidelines.
 </li>
 <li>
 Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
 </li>
 <li>
 Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
 </li>
 <li>
 Must have a full understanding of HIPAA regulations and compliance.
 </li>
 <li>
 Must be a qualified typist with a minimum of 35 W.P.M.
 </li>
 <li>
 Ability to follow instructions and respond to managements&rsquo; directions accurately.
 </li>
 <li>
 Ability to work independently, prioritize work activities and use time efficiently.
 </li>
 <li>
 Must be able to maintain confidentiality.
 </li>
 <li>
 Must be able to demonstrate and promote a positive team -oriented environment.
 </li>
 <li>
 Must be able to stay focused and concentrate under normal or heavy distractions.
 </li>
 <li>
 Must be able to work well under pressure and or stressful conditions.
 </li>
 <li>
 Must possess the ability to manage change, delays, or unexpected events appropriately.
 </li>
 <li>
 Ability to follow all company policies and procedures in effect at time of hire and as they may change or be added from time to time.
 
 
 </li>
 </ul>
 
 ExamWorks
 
 is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers' compensation insurance coverages.
 
 
 
 ExamWorks, LLC
 
 is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
 
 
 
 Equal Opportunity Employer - Minorities/Females/Disabled/Veterans
 
 
 
 
 
 ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.
 
 
 
 
 TAGS
 
 
 CPC, CPMA, Medical Billing, Medical Billing Specialist
</div>

Medical Coding Specialist (31620)

iSolve RCM LLC

<div>
 
 
 MIPS Reporting Officer (Healthcare RCM)
 
 
 
 
 Company:
 
 iSolve RCM
 
 
 
 Location:
 
 Gulberg Greens
 
 
 
 Job Type:
 
 Full-Time | Onsite
 
 
 
 Shift:
 
 Night Shift
 
 
 
 
 
 
 Role Overview
 
 
 
 The MIPS Reporting Officer will lead the end-to-end management of MIPS (Merit-based Incentive Payment System) reporting. This role is critical in ensuring data accuracy, CMS compliance, and optimizing performance scores that directly impact provider reimbursements.
 
 
 
 
 
 
 Key Responsibilities
 
 
 <ul>
 <li>
 Own and manage the complete MIPS reporting cycle
 </li>
 <li>
 Ensure accurate, timely submission in line with CMS regulations
 </li>
 <li>
 Monitor and analyze provider performance across MIPS measures
 </li>
 <li>
 Collaborate with Billing, AR, and clinical teams for data validation
 </li>
 <li>
 Identify performance gaps and recommend improvement strategies
 </li>
 <li>
 Maintain detailed documentation and audit-ready reporting records
 </li>
 <li>
 Stay updated with CMS changes and MIPS program updates
 </li>
 </ul>
 
 
 
 
 
 Required Skills and Experience
 
 
 <ul>
 <li>
 Proven hands-on experience in MIPS Reporting (
 
 Mandatory).
 
 </li>
 <li>
 Strong background in Healthcare RCM / Medical Billing.
 </li>
 <li>
 In-depth understanding of CMS guidelines and quality measures.
 </li>
 <li>
 Strong analytical mindset with attention to detail.
 </li>
 <li>
 Ability to interpret data and drive performance improvements.
 </li>
 <li>
 Effective communication and cross-team coordination skills.
 </li>
 <li>
 Willingness to work night shift onsite.
 </li>
 </ul>
 
 
 
 
 
 Preferred
 
 
 <ul>
 <li>
 Experience with US healthcare billing systems and workflows.
 </li>
 <li>
 Familiarity with EHR/EMR systems and quality reporting tools.
 </li>
 <li>
 Experience working with multi-specialty practices.
 </li>
 </ul>
 
 
 
 
 
 Benefits
 
 
 
 Medical / Health Insurance
 
 
 Fuel Cards
 
 
 Pick &amp; Drop for Females
 
 
 Gym Membership
 
 
 2 Monthly Umrah Lucky Draws
 
 
 Daily Dinner at the Office
 
 
 
 
 
 
 Apply
 
 
 
 Apply via LinkedIn Easy Apply or share your resume at:
 
 
 📩 hr@isolvercm.com
 
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MIPS Reporting Officer

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