physician coding 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

CHRISTUS Health

<div>Description 
Summary:
Selected by CHRISTUS Health Coding Leadership, to focus coding skills and expertise on designated Inpatient or Outpatient high dollar or specialty account types. Specialty Coder is responsible for maintaining current and high-quality ICD-10-CM, ICD-10-PCS and/or CPT coding for the Inpatient and or/ Outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. Specialty Coder will accurately abstract data into any and all appropriate CHRISTUS Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM and ICD-10-PCS Guidelines for Coding and Reporting and AMA CPT Guidelines.
Coder will work collaboratively with various CHRISTUS Health departments, including but not limited to the HIM and Clinical Documentation Specialists, to ensure accurate and complete physician documentation to support accurate billing and reduce denials. Coder will also assist in other areas of the department, as requested by leadership.
Coder will report directly to their Regional Coding Manager, with additional leadership from the Director of Coding Operations and System HIM Director.
Responsibilities: 
<ul><li>Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders.</li><li>
Assign codes for diagnoses, treatments, and procedures according to the ICD-10-CM/PCS Official Guidelines for Coding and Reporting through review of coding critical documentation, to generate appropriate MS/APR DRG.</li><li>
Abstracts required information from source documentation, to be entered into the appropriate CHRISTUS Health electronic medical record system.</li><li>
Validates admit orders and discharge dispositions.</li><li>
Works from assigned coding queue, completing and re-assigning accounts correctly.</li><li>
Manages accounts on ABS Hold, finalizing accounts when corrections have been made, in a timely manner.</li><li>
Meets or exceeds an accuracy rate of 95%.</li><li>
Meets or exceeds the designated CHRISTUS Health Productivity standard per chart type.</li><li>
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA).</li><li>
Assists in implementing solutions to reduce backend errors.</li><li>
Identifies and appropriately reports all hospital-acquired conditions (HAC).</li><li>
Expertly queries providers for missing or unclear documentation, by working with the HIM department and Clinical Documentation Improvement Specialists.</li><li>
Has strong written and verbal communication skills.</li><li>
Able to work independently in a remote setting, with little supervision.</li><li>
Participates in both internal and external audit discussions.</li><li>
All other work duties as assigned by the Manager.</li></ul>
Job Requirements: 
Education/Skills
<ul><li>High school Diploma or equivalent years of experience required.
</li><li>Completion of Accredited Baccalaureate Health Informatics or Health Information Management or an AHIMA approved Coding Certificate Program, preferred.
</li></ul>Experience
<ul><li>1 &ndash; 3 years of experience preferred.
</li></ul>Licenses, Registrations, or Certifications
<ul><li>None required.</li></ul>
Work Schedule: 
TBD
Work Type: 
Full Time 

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Specialty Coder Senior - Multi Specialty

CPA CLINICS

Billing Specialist - eSuperbill CreationLocation: Lahore, PakistanShift: Evening/Night (aligning with U.S. time zones)Role OverviewWe are a U.S.‑based medical practice (Urgent and Primary are) seeking a Medical Billing Specialist in Lahore to handle eSuperbill creation. This role focuses on converting finalized physician notes into billing claims for U.S. insurance reimbursement.Responsibilities- Review finalized physician notes.- Enter CPT and ICD‑10 codes into billing software (CureMD).- Generate accurate electronic superbills (eSuperbills) for insurance claim submission.- Ensure compliance with U.S. billing standards and minimize claim denials.- Coordinate with physicians/admin staff for missing documentation when needed.Requirements- Bachelor&rsquo;s degree preferred (preferred MBBS or equivalent).- Prior experience in U.S. medical billing strongly preferred.- Familiarity with EMR/EHR systems and billing software (CureMD).- Strong attention to detail and accuracy in coding.- Strong knowledge of ICD‑10, CPT, HCPCS coding systems and U.S. healthcare billing standards.- Good English communication skills (written and spoken).- Ability to work evening/night shifts..Job Type: Full-timePay: Rs90,000.00 - Rs140,000.00 per monthApplication Question(s):<ul><li>Are you proficient in ICD‑10, CPT, and HCPCS coding systems? Please give examples of coding work you&rsquo;ve handled.</li><li>Have you worked with CureMD EMR software before? If not, what EMR/EHR systems are you familiar with?</li><li>What are your salary requirement?</li><li>Are you able to work evening/night shifts aligned with U.S. time zones from our Lahore DHA office ?</li></ul>Education:<ul><li>Middle School (Preferred)</li></ul>Work Location: In person

Billing Specialist - eSuperbill Creation

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

The Garden of Eve

Job Title:Junior Medical CoderWho We Are7 KINGS CODE is US based Software solutions company. We support our partners and clients globally in USA, CANADA, EUROPE, INDIA, PAKISTAN &amp; MIDDLE EAST.Education &amp; Experience Required:<ul><li>Medical Billing Coding Specialist</li><li>1 year experience as a Coder in US healthcare industry.</li></ul>Skills Required:Outpatient CodingPain ManagementFamily Nurse Practitioner (FNP) CodingLab &amp; PathologyWound Care ClinicsPrimary Care Physician CodingIf you have strong knowledge of ICD-10-CM, CPT, and HCPCS and are ready to grow your career in the US Healthcare domain, we&rsquo;d love to hear from you.Send your CV to hr@7kingscode.comJob Type: Full-timeAbility to commute/relocate:<ul><li>Lahore: Reliably commute or planning to relocate before starting work (Required)</li></ul>Education:<ul><li>Bachelor's (Required)</li></ul>Experience:<ul><li>Medical Coder: 1 year (Required)</li></ul>Work Location: In person

Junior Medical Coder

Texas Children's Hospital

<div>We&rsquo;re searching for a Coding Quality Assurance Specialist I - someone who works well in a fast-paced setting. In this position, you will assign and audit the accuracy of the ICD-10-CM and CPT codes to ambulatory, emergency center, observation, and day surgery records for purposes of billing, research, and providing information to government and regulatory agencies. The position also ascertains the accuracy of the physicians' E/M and procedure coding, completes the auditing reporting tool, and provides this feedback to the education team and/or provider.
Think you&rsquo;ve got what it takes?
Job Duties &amp; Responsibilities
Assigns ICD-10-CM and CPT codes.
Reviews documentation in records to appropriately assign ICD-10-CM, PCS, and CPT codes.
Communicates with and provides feedback to the education team and/or provider.
Utilizes the encoder or coding books to correctly assign all appropriate ICD-10-CM, ICD-10-PCS, and CPT codes for diagnosis and procedures.
Sequences diagnosis and procedures to generate appropriate DRGs for billing in accordance with the Coding Guidelines based on the type of coding.
Queries physicians to obtain clarification or missing elements in the record preventing correct coding.
Utilizes available resources for assignment of codes as necessary (e.g., Diagnostic Imaging system, Lab system, Emergency Center system, Cardiac Cath system, Epic, and coding reference books).
Inputs codes into the Epic computer system utilizing the Encoder.
Completes abstracts if appropriate.
Identifies problem accounts.
Assists in correction of problem accounts.
Participates in education and maintains certification.
Maintains concurrent coding for all records.
Skills &amp; Requirements
Required H.S. Diploma or GED
Required Certifications
LCCA - Certified Coding Associate
CCS - Cert-Cert Coding Specialist
CCS-P - Cert-CCS-P Physician Based
CIPC - Certified Inpatient Coder
COC - Certified Outpatient Coder
COC-A - Cert Outpat Coder - Apprentice
CPC - Cert-Cert Professional Coder
CPC-A - Cert Prof Coder - Apprentice
CRC - Cert Risk Adjustment Coder
RHIA - Cert-Reg Health Infm. Admins
RHIT - Cert-Reg Health Infm. TECH
Required 1 years&rsquo; experience as a coder</div>

Coding Quality Assur Spec I

Banner Health

<div>Department Name:
Coding Ambulatory
Work Shift:
Day
Job Category:
Revenue Cycle
Estimated Pay Range:
$25.54 - $38.30 / hour Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.
Innovation and highly trained staff. Banner Health recently earned Great Place To Work&reg; Certification&trade;. This recognition reflects our investment in workplace excellence and the happiness, satisfaction, wellbeing and fulfilment of our team members. Find out how we&rsquo;re constantly improving to make Banner Health the best place to work and receive care.
We are looking for a motivated, experienced Profee Coder | Physician Practice Complex Coder with 3+ years of Cardiology Complex Coding experience (ideally Surgical Cardiology) to join our talented team. This position does require Certified Professional Coder (CPC) in active status (this position requires more than an apprentice CPC-A) with recent/consistent coding work history of 3 years or more.
Location: REMOTE, Banner provides equipment
Schedule: Full time; Flexible scheduling after training completed
Ideal Candidates:<ul><li>
3 years recent experience in Surgical Cardiology Profee EM coding (clearly reflected in your attached resume);</li><li>
Specialty Cardiology coding experience preferred;</li><li>
Must be currently certified through AAPC or Ahima, as defined in minimum qualifications below. Please upload a copy or provide certification number in your questionnaire. Please note, this is a COMPLEX role, requiring more than a CPC-A level certification.</li></ul>
 ** Don't quite meet the above requirements? Check out some of our other Coder positions!
This is a fully remote position and available if you live in the following states only: AK, AL, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA, MI, MN, MO, MS, NC, NH, ND, NE, NM, NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA, WA, WI, WV &amp; WY. The hours are flexible with the ability to work your 8-hour shift between 4am-7pm (Monday-Friday).
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
POSITION SUMMARY
This position evaluates medical records, provides clinical and surgical abstraction for full range of complex and/or multispecialty surgical, procedural and E&amp;M professional services in accordance with nationally recognized coding guidelines. Utilize coding knowledge and expertise to support department projects, validation edits and/or revisions.
CORE FUNCTIONS
1. Analyzes medical information from medical records. Accurately codes diagnostic and procedural information in accordance with national coding guidelines and appropriate reimbursement requirements. Consults with medical providers to clarify missing or inadequate record information and to determine appropriate diagnostic and procedure codes. Provides thorough, timely and accurate coding in accordance to department specific productivity and quality standards. Codes ICD CM and CPT4 for accurate APC assignment. Addresses National Correct Coding Initiative (NCCI) edits as appropriate. Reconciliation of charges as required. 
2. Abstracts clinical diagnoses, procedure codes and documents other pertinent information obtained from the medical record into the electronic medical records. Seeks out missing information and creates complete records, including items such as disease and procedure codes, discharge disposition, date of surgery, attending physician, consulting physicians, surgeons and anesthesiologists, and appropriate signatures/authorizations. Refers inconsistent patient treatment information/documentation to coding quality analysts, supervisor or individual department for clarification/additional information for accurate code assignment. 
 
3. Provides quality assurance for medical records. For all assigned records and/or areas assures compliance with coding rules and regulations according to regulatory agencies for state Medicaid plans, Center for Medicare Services (CMS), Office of the Inspector General (OIG) and the Health Care Financing Administration (HCFA), as well as company and applicable professional standards. 
 
4. As assigned, compiles daily and monthly reports; tabulates data from medical records for research or analysis purposes.
5. Able to identify validation edits and revision issues to ensure compliant coding.
6. Recognizes and distinguishes complex diagnoses and procedures and has attention to detail to make needed corrections and ensure accurate coding, reimbursement, and compliance.
7. Works independently under regular supervision. Uses specialized knowledge for accurate assignment of ICD/CPT codes according to national guidelines. May seek guidance for correct interpretation of coding guidelines and LCDs (Local Coverage Determinations).
MINIMUM QUALIFICATIONS 
 
High school diploma/GED or equivalent working knowledge and specialized formal training equivalent to the two year certification course in medical record keeping principles and practices, anatomy, physiology, pathology, medical terminology, standard nomenclature, and classification of diagnoses and operations, or an Associate&rsquo;s degree in a related health care field.
Requires at least one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Certified Coding Specialist &ndash; Physician (CCS-P), Registered Health Information Administrator (RHIA), or Registered Health Information Technician (RHIT), in an active status with the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC). Certification may also include a general area of specialty.
Requires three or more years of complex professional coding experience within specialty.
Must demonstrate a level of knowledge and understanding of ICD and CPT coding principles as recommended by the American Health Information Management Association coding competencies, and as normally demonstrated by certification by the American Academy of Professional Coders. 
Must be able to work effectively and efficiently in a remote setting, utilizing common office programs, coding software and abstracting systems. 
PREFERRED QUALIFICATIONS
Specialty Certification. Radiology Certified Coder (RCC) if employed in the Imaging space. 
Experience in a large, multi-system physician practice preferred.
Additional related education and/or experience preferred.
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Profee Complex Coder Surgical Cardiology

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