medical insurance coding specialist

Baptist Health System KY & IN

<div>Summary
Job Description:
Baptist Health Medical Group is looking for an Ambulatory CDI Specialist to join our team! This is a remote work position that requires residency in KY or IN
<div><div><div><div><div><div><div><div><div>The BHMG Ambulatory CDI Specialist I is responsible for the evaluation of documentation utilizing their coding and clinical expertise to ensure specificity of coding and coding accuracy. They identify HCC diagnosis codes, ensure documentation accurately reflects the medical necessity and acuity of the patients. They provide guidance/education to the providers, medical assistants, practice managers and ancillary staff on clinical documentation best practices. Position requires a self-motivated, flexible, confident presenter that is able to travel and work remotely as well as attend internal meetings.
Minimum Education, Training, and Experience Required
<ul><li>2 years&rsquo; professional medical group coding experience
</li><li>Experience with:
<ul><li>ICD-10-CM coding principles and procedures,
</li><li>HCPCS, CPT, CPT II and modifier coding,
</li><li>CMS HCC, HHS HCC, Rx HCC coding and risk adjustment assignment as it relates to provider documentation,
</li><li>Knowledge of Microsoft Office (Outlook, PowerPoint, Excel)
</li></ul></li></ul><ul><li>Preferred Experience
<ul><li>HCC (CMS, HHS, Rx HCC) coding and risk adjustment assignment as it relates to provider documentation,
</li><li>Proficient experience with Epic and/or other major EMR vendor software, and
</li><li>Presenting education to coders, providers and/or other caregivers.
</li><li>Clinical experience a plus
</li></ul></li></ul>Certification/Licenses:
<ul><li>Active Certification Required:
<ul><li>Certified Professional Coder (CPC)
certification or Certified Coding Specialist-Physician based (CCS-P) or equivalent
certification from AAPC, AHIMA or other
acceptable professional organization.
</li></ul></li><li>A minimum of one additional advanced certification, required within one year of hire.
<ul><li>CRC = Certified Risk Adjustment Coder (certification)
</li></ul></li></ul></div></div></div></div></div></div></div></div></div>Work Experience
Education
<h3 class="jobSectionHeader">If you would like to be part of a growing family focused on supporting clinical excellence, teamwork and innovation, we urge you to apply now!
</h3><h3 class="jobSectionHeader">Baptist Health is an Equal Employment Opportunity employer.</h3></div>

BHMG Ambulatory CDI Specialist

Parallon

<div>Last year our HCA Healthcare colleagues invested over 156,000 hours volunteering in our communities. As a(an) Clinical Denials Coding Review Specialist with Parallon you can be a part of an organization that is devoted to giving back!
This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).
<h5 class="jobSectionHeader">Job Summary and Qualifications</h5>
As a work from home Clinical Denials Coding Review Specialist, you will be responsible for applying correct coding guidelines and payor requirements as it relates to researching, analyzing, and resolving outstanding clinical denials and insurance claims. This job requires regular outreach to payors and Practices.
What you will do in this role:<ul><li>
Triage incoming inventory, validating appeal criteria is met in compliance with departmental policies and procedures
</li><li>Review Medicare Recovery Audit Contractor (RAC) recoupment requests and process or appeal as appropriate
</li><li>Compose technical denial arguments for reconsideration, including both written and telephonically
</li><li>Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument
</li><li>Identify problem accounts/processes/trends and escalate as appropriate
</li><li>Utilize effective documentation standards that support a strong historical record of actions taken on the account
</li><li>Post denials, post or correct contractual adjustments, and post other non-cash related Explanation of Benefits (EOB) information
</li></ul>Requirements:<ul><li>
Minimum two years related experience in accounts receivable follow-up, insurance follow-up and appeals, insurance posting, professional medical/billing, medical payment posting, and/or cash application preferred</li><li>
Prior experience reading and interpreting Explanation of Benefits (EOB) required</li><li>
Coding certification through AHIMA or AAPC strongly preferred</li></ul>
<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 benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services</li><li>
Wellbeing support, including free counseling and referral services</li><li>
Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence</li><li>
Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling</li><li>
Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing</li><li>
Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts</li></ul>
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
&quot;
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; 
&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 Clinical Denials Coding Review Specialist 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>

Clinical Denials Coding Review Specialist

Optima Medical

<div>
 
 About Optima Medical:
 
 
 
 Optima Medical is an Arizona-based medical group consisting of 30 locations and 130+ medical providers, who care for more than 200,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation's top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and dedicated professionals aboard. We are currently seeking a Medical Coding Specialist to join our team!
 
 
 
 This role will transition to a fully remote position after up to 30 days of training. To be eligible, you'll need to complete your initial training onsite at our Scottsdale office and remain in good standing. Must reside in Arizona!
 
 
 
 
 Job Responsibilities:
 
 
 
 <ul>
 <li>
 Review and assign accurate ICD-10-CM, CPT, and HCPCS codes for medical diagnoses and procedures based on clinical documentation.
 </li>
 <li>
 Ensure coding compliance with CMS guidelines, and state/federal regulations.
 </li>
 <li>
 Ability to write precise, professional, and well structured feedback to providers and team members.
 </li>
 <li>
 Assist with claim reviews, denials, and coding-related audits to optimize revenue integrity.
 </li>
 <li>
 Maintain up-to-date knowledge of medical coding guidelines, regulatory changes, and industry best practices.
 </li>
 <li>
 Meet coding productivity and quality standards as required by Optima Medical.
 </li>
 <li>
 High attention to detail and analytical skills to ensure accuracy and compliance.
 </li>
 <li>
 Perform other related job duties as assigned.
 
 
 </li>
 </ul>
 
 Job Qualifications:
 
 
 
 <ul>
 <li>
 Minimum 2 years of experience in medical coding (physician practice or healthcare facility).
 </li>
 <li>
 Certified Professional Coder (CPC) required (AAPC or AHIMA certification). No CPC-A or CCA.
 </li>
 <li>
 Strong understanding of ICD-10-CM, CPT, and HCPCS.
 </li>
 <li>
 Experience with EHR systems, billing software, and Microsoft Office (Outlook, Word, Excel)
 </li>
 <li>
 Strong analytical, problem-solving, and communication skills.
 </li>
 <li>
 Ability to work independently in a fast-paced production environment while maintaining high accuracy.
 </li>
 <li>
 Must demonstrate strong written communication skills to provide clear feedback and improve coding accuracy.
 </li>
 <li>
 Strong knowledge of medical terminology, disease processes, and physiology to ensure accurate interpretation of provider documentation.
 </li>
 <li>
 Must live in Arizona.
 
 
 </li>
 </ul>
 
 Why Join Our Team?
 
 
 
 <ul>
 <li>
 Substantial growth opportunities
 </li>
 <li>
 Leadership and mentoring.
 </li>
 <li>
 Fun work environment (lunches, events, holiday parties)
 </li>
 <li>
 Comprehensive benefits (medical, vision, dental, 401k, paid holidays)
 </li>
 <li>
 Supportive and positive work culture
 </li>
 </ul>
</div>

Medical Coding Specialist (Remote)

Signature Healthcare

<div><div><div><div><div>POSITION SUMMARY:
Under the general direction of the Coding Compliance Manager the Outpatient Coding Specialist is responsible for coding and abstracting services for the full range of hospital services. Reviews diagnosis and diagnostic information and codes and abstracts diagnoses and/or surgical procedures outpatient services, and/or emergency room records using ICD 10 CM and CPT 4 coding classification systems. Ensures ethical and accurate coding in accordance with all regulatory requirements and AHIMA Standards of Ethical Coding.</div> 
</div>
</div></div> 
Location: Signature Healthcare &middot; Health Information Management 
Schedule: Full Time 40 Hours only, Days 1st Shift, flexible</div>

Outpatient Coding Specialist

Keystone Health

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

Billing & Coding Integrity Specialist

Accuracy Plus Medical Laboratory

Accuracy Plus Medical Laboratory (APML) is seeking a detail-oriented and experienced Insurance &amp; Coding Coordinator to join our team in Abu Dhabi. This role is critical in ensuring the accuracy of medical coding, facilitating smooth insurance claim processing, and maintaining compliance with UAE healthcare regulations.The ideal candidate will possess a deep understanding of the Abu Dhabi healthcare landscape and hold professional certifications in medical coding.Key Responsibilities<ul><li>Medical Coding: Review medical records and translate laboratory services, diagnoses, and procedures into appropriate ICD-10, CPT, and DRG codes.</li><li>Claims Management: Prepare, submit, and track insurance claims to ensure timely reimbursement and minimize rejections/denials.</li><li>Regulatory Compliance: Ensure all coding and billing practices adhere to DOH (Department of Health &ndash; Abu Dhabi) regulations and international standards.</li><li>Liaison: Act as the primary point of contact between the laboratory, insurance providers, and healthcare practitioners to resolve queries or claim discrepancies.</li><li>Documentation: Maintain precise records and provide reports on claim status, denial patterns, and revenue cycles.</li></ul>Required Qualifications &amp; Skills<ul><li>Education: Bachelor&rsquo;s degree in Healthcare Administration, Life Sciences, or a related field.</li><li>Certification: Must be a Certified Coder from AAPC (CPC) or AHIMA (CCS).</li><li>Experience: * Minimum of 2 years of medical coding experience within the UAE.</li><li>Prior experience working in a hospital or healthcare facility within Abu Dhabi is highly preferred.</li><li>Technical Proficiency: Advanced knowledge of ICD-10, CPT, and DRG coding systems.</li><li>Communication: Strong written and verbal communication skills in English; ability to communicate complex insurance data clearly.</li><li>Attributes: High attention to detail, strong analytical skills, and the ability to work effectively in a fast-paced environment.</li></ul>Job Type: Full-timePay: AED4,000.00 - AED5,000.00 per monthAbility to commute/relocate:<ul><li>Abu Dhabi: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>What is your notice period?</li><li>What is your visa status?</li></ul>Experience:<ul><li>Medical Coding: 1 year (Required)</li></ul>Work Location: In person

Insurance & Coding Coordinator

Ansible Government Solutions

<div>
 
 Overview
 
 
 
 Ansible Government Solutions, LLC (Ansible) is seeking Medical Billing / Coding Specialists to work in support of Sandia National Laboratories located at 1515 Eubank Blvd SE, Albuquerque, NM 87123. At this time, the Clinic does not bill insurance companies. However, the selected candidate shall have knowledge to process patient data such as treatment records and related insurance information. The selected candidate shall code a patient&rsquo;s diagnosis along with a request for payments from the patient&rsquo;s insurance company.
 
 HIPAA-certified candidates are strongly preferred.
 
 
 
 Ansible is a Service-Disabled Veteran-Owned Small Business (SDVOSB) providing Federal customers with solutions in many arenas. Our customers face wide-ranging challenges in the fields of health care, national security, and information technology. To address these challenges, we employ intelligent and committed staff who take care of our customers&rsquo; success as if it is their own.
 
 
 
 Responsibilities
 
 
 
 <ul>
 <li>
 Review medical record documentation and accurately assign ICD-9/ICD-10 diagnoses and procedure codes, as well as CPT IV and HCPCS codes leading to the assignment of the correct Medicare Severity-Diagnosis Related Group (MS-DRG) or All Patient Refined-Diagnosis Related Group (APR-DRG)
 </li>
 <li>
 Assure assigned codes support the documented reason for the visit and medical necessity of outpatient accounts
 
 
 </li>
 </ul>
 
 Qualifications
 
 
 
 <ul>
 <li>
 Minimum of two (2) years medical billing experience
 </li>
 <li>
 Minimum of two (2) years experience within a healthcare medical office in a registration or clerical position
 </li>
 <li>
 Intermediate knowledge and understanding of medical terminology, third party billing requirements, ICD-10 and CPT/HCPCS coding experience
 </li>
 <li>
 This position requires U.S. Citizenship for DOE contract security clearance
 </li>
 <li>
 No sponsorship available
 
 
 </li>
 </ul>
 
 All candidates must be able to:
 
 
 
 <ul>
 <li>
 Sit, stand, walk, lift, squat, bend, twist, and reach above shoulders during the work shift
 </li>
 <li>
 Lift up to 50 lbs from floor to waist
 </li>
 <li>
 Lift up to 20 lbs
 </li>
 <li>
 Carry up to 40 lbs a reasonable distance
 </li>
 <li>
 Push/pull with 30 lbs of force
 
 
 </li>
 </ul>
 
 All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
 
 
 
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Medical Billing / Coding Specialist

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