outpatient coding specialist

ECLARO

<div>
 <strong>
  Job Number: 26-00718
  <br/>
  <br/>
 </strong>
 Progress on your journey to success! ECLARO is currently recruiting for an
 <strong>
  Outpatient Coder
 </strong>
 in the
 <strong>
  Chicago, IL
 </strong>
 area for one of our clients.
 <br/>
 <br/>
 ECLARO&rsquo;s client is a leading provider of healthcare workforce software and solutions. If you&rsquo;re up to the challenge, then take a chance at this rewarding opportunity!
 <br/>
 <br/>
 <strong>
  Position Overview:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Outpatient Coder - specifically ED coding and strong hospital charge related ED.
  </li>
  <li>
   AHIMA Certification required - RHIA, RHIT, or CCS. Strong academic and regional medical center coding experience required.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Responsibilities:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Review clinical documentation in order to assign diagnostic and procedural codes for outpatient medical records according to the appropriate classification system
  </li>
  <li>
   Ensures accurate, timely, and appropriate assignment of ICD-10, CPT/HCPCS, and modifiers for the purposes of billing, internal and external reporting, research, and compliance with regulatory and payer guidelines
  </li>
  <li>
   Monitors documentation turnaround time and productivity, and follows up on deferred accounts or with physicians and other clinical staff as needed
  </li>
  <li>
   May be tasked with generating reports and/or analyzing data related to evaluation and management code utilization, CPT code application, denials, reimbursement per contracted terms, etc.
  </li>
  <li>
   Provides coding feedback to providers, clinical department leadership, and revenue cycle team
  </li>
  <li>
   Assist coding educators with education regarding documentation improvement
  </li>
  <li>
   Escalate coding and documentation issues to revenue cycle leadership, and assist facilitating corrective action plans
  </li>
  <li>
   Assists with design and implementation of workflow updates and coding tools
  </li>
  <li>
   Support denial team on coding related denials
  </li>
  <li>
   Special projects as assigned
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Pay Rate:
 </strong>
 $33.00-$36.00/Hour
 <br/>
 <br/>
 <strong>
  Shift:
 </strong>
 Day 5x8-Hour (08:00 - 16:30);
 <strong>
  Job Duration:
 </strong>
 26 weeks
 <br/>
 <br/>
 <strong>
  If hired, you will enjoy the following ECLARO Benefits:
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   401k Retirement Savings Plan administered by Merrill Lynch
  </li>
  <li>
   Commuter Check Pretax Commuter Benefits
  </li>
  <li>
   Eligibility to purchase Medical, Dental &amp; Vision Insurance through ECLARO
   <br/>
   <br/>
  </li>
 </ul>
 If interested, you may contact:
 <br/>
 <br/>
 <strong>
  Sofia Dela Torre
  <br/>
  <br/>
 </strong>
 <strong>
  Sofia.DelaTorre@eclaro.com
  <br/>
  <br/>
 </strong>
 <strong>
  (332) 206-0779
  <br/>
  <br/>
 </strong>
 <strong>
  Sofia Dela Torre | LinkedIn
  <br/>
  <br/>
 </strong>
 <strong>
  Equal Opportunity Employer:
 </strong>
 ECLARO values diversity and does not discriminate based on Race, Color, Religion, Sex, Sexual Orientation, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status, in compliance with all applicable laws.
</div>


Outpatient Coder

BILLING & CODING COMPLIANCE ANALYST

TEEMA Group

<div><h2 class="jobSectionHeader"><b>Role Summary</b></h2><p>
The Senior Clinical Coder serves as a subject matter expert in medical coding and DRG validation, playing a critical role in ensuring coding accuracy, regulatory compliance, and appropriate reimbursement across inpatient and outpatient services.</p><p>
In this role, you will conduct detailed retrospective claims reviews, provide expert-level coding analysis, and support cross-functional teams including medical directors, claims operations, and quality management. This position is ideal for a highly analytical professional who thrives in a fast-paced, remote environment and is passionate about accuracy, compliance, and continuous improvement in healthcare operations.</p><p></p><h2 class="jobSectionHeader"><b>
Duties &amp; Responsibilities</b></h2><ul><li><p>
Serve as a subject matter expert for ICD-10-CM, ICD-10-PCS, CPT, and HCPCS coding</p></li><li><p>
Perform DRG validation and retrospective medical claims reviews</p></li><li><p>
Analyze inpatient and outpatient claims for coding accuracy and reimbursement determinations</p></li><li><p>
Prepare clear, detailed determination letters and written review outcomes</p></li><li><p>
Identify coding discrepancies, potential fraud, and quality concerns</p></li><li><p>
Provide training, mentorship, and guidance to clinical coding staff</p></li><li><p>
Collaborate with cross-functional teams to support coding inquiries and review findings</p></li><li><p>
Research and apply medical policies, benefits, limitations, and current coding guidelines</p></li><li><p>
Ensure timely completion of coding reviews in alignment with performance standards</p></li><li><p>
Maintain accurate and thorough documentation within medical management and claims systems</p></li><li><p>
Escalate complex or high-risk cases to the Medical Director as appropriate</p></li></ul><p></p><h2 class="jobSectionHeader"><b>
Required Qualifications</b></h2><ul><li><p>
High School Diploma or GED</p></li><li><p>
Active credential in one of the following:</p><ul><li><p>
Certified Inpatient Coder (CIC)</p></li><li><p>
Certified Coding Specialist (CCS)</p></li><li><p>
Registered Health Information Technician (RHIT)</p></li></ul></li><li><p>
Minimum of five (5) years of clinical coding experience (facility and/or professional)</p></li><li><p>
Minimum of three (3) years of inpatient and/or outpatient claims processing experience</p></li><li><p>
Experience working in a fast-paced, production-driven environment</p></li><li><p>
Ability to obtain and maintain a favorable background investigation</p></li><li><p>
U.S. Citizenship required</p></li></ul><p></p><h2 class="jobSectionHeader"><b>
Desired Qualifications</b></h2><ul><li><p>
Experience within managed care, health insurance, or private healthcare industry</p></li><li><p>
Familiarity with government healthcare programs and regulatory guidelines</p></li><li><p>
Advanced expertise in inpatient facility coding and DRG validation</p></li><li><p>
Strong analytical, critical thinking, and problem-solving skills</p></li><li><p>
High attention to detail with strong organizational capabilities</p></li><li><p>
Ability to manage large volumes of complex information independently</p></li><li><p>
Effective communication and collaboration across multidisciplinary teams</p></li><li><p>
Proficiency in Microsoft Word, Excel, and multi-system environments</p></li></ul><p></p><h2 class="jobSectionHeader"><b>
Location &amp; Work Type</b></h2><p>
100% Remote (must reside in an approved state)<br>
Full-time position</p><ul><li><p>
Independent home office work environment required</p></li><li><p>
Prolonged computer use and sitting required</p></li><li><p>
Flexibility to support varying work schedules as needed</p></li></ul>
#Workwolf</div>

Sr. Inpatient Clinical Coder

Caban Resources

<div><p>Starts out onsite, then transitions to REMOTE 4 days/week.</p><p>
Job Summary:</p><p>
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.</p><p>
Duties:</p><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><p>
Qualifications:</p><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)

Fred Hutchinson Cancer Center

<div>Overview:
<div>
Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, Fred Hutch is the only National Cancer Institute-designated cancer center in Washington.</div><div></div><div><br>
With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world&rsquo;s leading cancer, infectious disease and biomedical research centers. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states. Together, our fully integrated research and clinical care teams seek to discover new cures to the world&rsquo;s deadliest diseases and make life beyond cancer a reality.</div><div></div><div><br>
At Fred Hutch we value collaboration, compassion, determination, excellence, innovation, integrity and respect. Our mission is directly tied to the humanity, dignity and inherent value of each employee, patient, community member and supporter. Our commitment to learning across our differences and similarities make us stronger. We seek employees who bring different and innovative ways of seeing the world and solving problems.</div><div></div><div><br>
The Coding Specialist complies with the Official Coding Guidelines in ICD-10-CM and CPT coding conventions to assign for diagnoses and procedure codes for Fred Hutch&rsquo;s outpatient facility services. Clinical judgment and high level analytical skills are utilized to code and abstract the legal medical record to support appropriate reimbursement, physician documentation improvement, clinical effectiveness, outcome studies, and research to meet regulatory accreditation requirements for state and federal reporting and other external reporting purposes. This position offers a combination of remote and on-site coding.</div><div></div><div><br>
This position is a full time remote position. The hours of this position is Monday through Friday 8:00 am to 5:00 pm PST.</div>
Responsibilities:
<ul><li>Understand and apply correct coding, regulatory and compliance guidelines, APCs, ICD10, CPT, E&amp;M, procedure codes and modifiers, and applies documentation guidelines.</li><li>
Maintains 95% coding accuracy while meeting department's productivity standards.</li><li>
Participate in staff discussions and provides valuable input to the team.</li></ul>
Qualifications:
<div><b>
Required:</b></div><ul><li>
High School Degree, GED, or equivalent combination of education and experience from which comparable knowledge and abilities can be acquired is necessary.</li><li>
RHIT, CCS, CPC, COC and/or CCS-P</li><li>
A minimum of 2 years experience in outpatient facility abstracting coding (ICD9,ICD10, HCPCS and CPT) and facility coding modifiers. Experience may be substituted for a Bachelor's degree in Health Informatics or Health Information Management along with required certification. Prior experience working with clinical professionals is preferred.</li><li>
Working knowledge of insurance plans, LCD/NCD&rsquo;s</li><li>
Ability to work with clinical professionals</li><li>
Medical records and EMR/EHR knowledge</li><li>
Medical terminology, Anatomy and Physiology</li></ul><div><b>
Preferred:</b></div><ul><li>
Bachelor&rsquo;s degree</li><li>
Prior oncology or transplant coding, prior training experience with clinicians, E &amp; M, surgical and infusion coding, ICD10 training and/or dual/double coding experience, EPIC HB, 3M encoder ORCA and Mindscape experience.</li><li>
Prior oncology or Transplant coding</li><li>
Prior training experience with clinicians</li><li>
E &amp; M, Surgical and Infusion coding</li><li>
ICD10 training and/or Dual/Double coding experience</li><li>
EPIC HB, 3M encoder ORCA and Mindscape experience</li></ul><p></p><div>
The hourly pay range for this position is from $29.77 to $42.39 and pay offered will be based on experience and qualifications.
<br>
<br>
Although Fred Hutch is not sponsoring most H-1B visas at this time, candidates who already hold an H-1B sponsored by another organization and are currently in the U.S. may be eligible for this position.</div><div></div><div><br>
This position is a full time remote position. The hours of this position is Monday through Friday 8:00 am to 5:00 pm PST.<br>
<br>
Fred Hutchinson Cancer Center offers employees a comprehensive benefits package designed to enhance health, well-being, and financial security. Benefits include medical/vision, dental, flexible spending accounts, life, disability, retirement, family life support, employee assistance program, onsite health clinic, tuition reimbursement, paid vacation (12-22 days per year), paid sick leave (12-25 days per year), paid holidays (13 days per year), paid parental leave (up to 4 weeks).</div>
Additional Information: We are proud to be an Equal Employment Opportunity (EEO) and Vietnam Era Veterans Readjustment Assistance Act (VEVRAA) Employer. We do not discriminate on the basis of race, color, religion, creed, ancestry, national origin, sex, age, disability (physical or mental), marital or veteran status, genetic information, sexual orientation, gender identity, political ideology, or membership in any other legally protected class. We desire priority referrals of protected veterans. If due to a disability you need assistance/and or a reasonable accommodation during the application or recruiting process, please send a request to Human Resources at hrops@fredhutch.org or by calling 206-667-4700.</div>

Coding Specialist

Fred Hutch

<div>
 <strong>
  Overview
  <br/>
  <br/>
 </strong>
 Fred Hutchinson Cancer Center is an independent, nonprofit organization providing adult cancer treatment and groundbreaking research focused on cancer and infectious diseases. Based in Seattle, Fred Hutch is the only National Cancer Institute-designated cancer center in Washington.
 <br/>
 <br/>
 With a track record of global leadership in bone marrow transplantation, HIV/AIDS prevention, immunotherapy and COVID-19 vaccines, Fred Hutch has earned a reputation as one of the world&rsquo;s leading cancer, infectious disease and biomedical research centers. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services, and network affiliations with hospitals in five states. Together, our fully integrated research and clinical care teams seek to discover new cures to the world&rsquo;s deadliest diseases and make life beyond cancer a reality.
 <br/>
 <br/>
 At Fred Hutch we value collaboration, compassion, determination, excellence, innovation, integrity and respect. Our mission is directly tied to the humanity, dignity and inherent value of each employee, patient, community member and supporter. Our commitment to learning across our differences and similarities make us stronger. We seek employees who bring different and innovative ways of seeing the world and solving problems.
 <br/>
 <br/>
 The Coding Specialist complies with the Official Coding Guidelines in ICD-10-CM and CPT coding conventions to assign for diagnoses and procedure codes for Fred Hutch&rsquo;s outpatient facility services. Clinical judgment and high level analytical skills are utilized to code and abstract the legal medical record to support appropriate reimbursement, physician documentation improvement, clinical effectiveness, outcome studies, and research to meet regulatory accreditation requirements for state and federal reporting and other external reporting purposes. This position offers a combination of remote and on-site coding.
 <br/>
 <br/>
 This position is a full time remote position. The hours of this position is Monday through Friday 8:00 am to 5:00 pm PST.
 <br/>
 <br/>
 <strong>
  Responsibilities
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Understand and apply correct coding, regulatory and compliance guidelines, APCs, ICD10, CPT, E&amp;M, procedure codes and modifiers, and applies documentation guidelines.
  </li>
  <li>
   Maintains 95% coding accuracy while meeting department's productivity standards.
  </li>
  <li>
   Participate in staff discussions and provides valuable input to the team.
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Required
  <br/>
  <br/>
 </strong>
 <strong>
  Qualifications
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   High School Degree, GED, or equivalent combination of education and experience from which comparable knowledge and abilities can be acquired is necessary.
  </li>
  <li>
   RHIT, CCS, CPC, COC and/or CCS-P
  </li>
  <li>
   A minimum of 2 years experience in outpatient facility abstracting coding (ICD9,ICD10, HCPCS and CPT) and facility coding modifiers. Experience may be substituted for a Bachelor's degree in Health Informatics or Health Information Management along with required certification. Prior experience working with clinical professionals is preferred.
  </li>
  <li>
   Working knowledge of insurance plans, LCD/NCD&rsquo;s
  </li>
  <li>
   Ability to work with clinical professionals
  </li>
  <li>
   Medical records and EMR/EHR knowledge
  </li>
  <li>
   Medical terminology, Anatomy and Physiology
   <br/>
   <br/>
  </li>
 </ul>
 <strong>
  Preferred
  <br/>
  <br/>
 </strong>
 <ul>
  <li>
   Bachelor&rsquo;s degree
  </li>
  <li>
   Prior oncology or transplant coding, prior training experience with clinicians, E &amp; M, surgical and infusion coding, ICD10 training and/or dual/double coding experience, EPIC HB, 3M encoder ORCA and Mindscape experience.
  </li>
  <li>
   Prior oncology or Transplant coding
  </li>
  <li>
   Prior training experience with clinicians
  </li>
  <li>
   E &amp; M, Surgical and Infusion coding
  </li>
  <li>
   ICD10 training and/or Dual/Double coding experience
  </li>
  <li>
   EPIC HB, 3M encoder ORCA and Mindscape experience
   <br/>
   <br/>
  </li>
 </ul>
 The hourly pay range for this position is from $29.77 to $42.39 and pay offered will be based on experience and qualifications.
 <br/>
 <br/>
 Although Fred Hutch is not sponsoring most H-1B visas at this time, candidates who already hold an H-1B sponsored by another organization and are currently in the U.S. may be eligible for this position.
 <br/>
 <br/>
 This position is a full time remote position. The hours of this position is Monday through Friday 8:00 am to 5:00 pm PST.
 <br/>
 <br/>
 Fred Hutchinson Cancer Center offers employees a comprehensive benefits package designed to enhance health, well-being, and financial security. Benefits include medical/vision, dental, flexible spending accounts, life, disability, retirement, family life support, employee assistance program, onsite health clinic, tuition reimbursement, paid vacation (12-22 days per year), paid sick leave (12-25 days per year), paid holidays (13 days per year), paid parental leave (up to 4 weeks).
 <br/>
 <br/>
 <strong>
  Additional Information
  <br/>
  <br/>
 </strong>
 We are proud to be an Equal Employment Opportunity (EEO) and Vietnam Era Veterans Readjustment Assistance Act (VEVRAA) Employer. We do not discriminate on the basis of race, color, religion, creed, ancestry, national origin, sex, age, disability (physical or mental), marital or veteran status, genetic information, sexual orientation, gender identity, political ideology, or membership in any other legally protected class. We desire priority referrals of protected veterans. If due to a disability you need assistance/and or a reasonable accommodation during the application or recruiting process, please send a request to Human Resources at hrops@fredhutch.org or by calling 206-667-4700.
</div>


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