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A company is looking for a Medical Records Technician (Coder-Outpatient and Inpatient).Key Responsibilities Assign codes to outpatient and inpatient services using various coding systems Review health record documentation to abstract necessary medical data Utilize computer systems to code, abstr

A company is looking for an Outpatient SDS Coder.

Key Responsibilities Abstract billing for outpatient evaluation and management codes, minor surgical procedures, and HCPCS codes from provider documentation Research coding/billing issues and recommend appropriate methods for physicians Analyze medical records to ensure appropriate coding and id

Job Title : Certified Medical Coders - Inpatient Location : Bronx, NY 10461 Duration : 3 Months Contract (with possible extension) Education : High School Diploma/GED, AHIMA, RHIA or RHIT and/or CCP, CCS. Shift Details : 8:00 AM-04:00 PM General Description: ·Medical coding in an acute care setting; must possess proficient computer skills (e.g., MS Word, Excel, ICD 9 CM, CPT 4, Encoder); knowledge of coding guidelines, payor guidelines, federal billing guidelines; knowledge of anatomy, physiology & disease processes; ability to research coding related issues; competence in coder training; must have CCS and knowledgeable with 3M/HDS coding application. ·Seeking certified coders with a strong inpatient coding background. ·Candidate should be able to work with minimal training. • Inpatient and ED experience., • Starts onsite for training, then transitions to remote work once duties are mastered. Education: High School Diploma/GED, AHIMA, RHIA or RHIT and/or CCP, CCS.

Certified Professional Coder / Bill Review Expert Responsibilities: • Review medical bills related to MVA injuries sustained for NJ and or NY covered insureds, • Conduct reviews of medical bills and supporting documentation to ensure proper codes assigned, • Assign proper codes as needed based on review outcome, • Use various resources, IE: eBooks, 3M software to support reviews, • Interpret fee schedule guidelines and apply those guidelines in daily reviews, • Document review outcomes for customer in a professional easy to understand manner, • Participate in conference calls as needed with customer and/or attorneys, • Assist with various special projects and other duties as assigned Qualifications and Experience: • 3-5 years of medical billing experience specifically NJ / NY PIP fee schedules, • Strong communicate skills, must be able to explain outcome of review, both written and verbally, • Extensive knowledge of coding /documentation requirements, • Thorough knowledge of CPT, HCPCs, ICD-10, • CPC/AAPC certification required, • Ability to multi-task, • Ability to meet critical timelines, • Computer experience, • Excel experience beyond beginner, • Independent worker, • Ability to manage time when working remotely, • Must be able to travel to Hamilton NJ office as needed, • Ability to effectively communicate with team

Job Title: Certified Medical Coders - Inpatient Location: Bronx, NY 10461 Schedule: 8:00 AM-4:00 PM Duration: 3 Months with a strong possibility of ongoing extension Pay Range: $35 - $40/Hour. Duties: • Medical coding in an acute care setting., • Must possess proficient computer skills (e.g., MS Word, Excel, ICD 9 CM, CPT 4, Encoder)., • knowledge of coding guidelines, payor guidelines., • Federal billing guidelines; knowledge of anatomy, physiology & disease processes., • Ability to research coding related issues., • Competence in coder training., • Must have CCS and be knowledgeable with 3M/HDS coding application., • Inpatient and ED experience. Skills: • Three years’ experience Knowledge of ICD10 Required Experience: • Experience with EPIC and 3M is required, • Candidate with both in/out-patient coding experience will be ideal., • CCS Certification is required. Education: • High School Diploma/GED, • AHIMA, RHIA or RHIT and/or CCP, CCS. “Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors”

Job Title : Remote Certified Medical Coder – Inpatient/Outpatient Location : Bronx, NY 10467 / Remote Duration : 3 Months Education : High School Diploma / GED required. Shift Details : Mon–Fri 8:00 AM to 4:00 PM General Description:

A company is looking for a Senior Inpatient Facility Certified Medical Coder. Key Responsibilities: Assign ICD-10-CM and ICD-10-PCS codes for inpatient services while adhering to coding guidelines Abstract additional data during the Chart Review process as needed Provide documentation feedback t

A company is looking for a Risk Adjustment Medical Record Coder to support accurate coding practices in a remote setting. Key Responsibilities Maintain compliance with CMS risk adjustment diagnosis coding guidelines Perform comprehensive first-pass reviews of medical records and physician assessm

Remote Certified Medical Coder – Inpatient (Remote after Training) Pay: 35–40 per hour (W2) Contract Length: 13 weeks Schedule: 40hr/week, Monday to Friday, 8:00 AM to 4:00 PM We’re looking for an experienced inpatient coder who can step into a fast-paced acute care environment with confidence. The role starts with one to two weeks of onsite training in New York, then shifts fully remote once you’re up to speed. What you’ll do • Review and code inpatient and ED encounters, • Apply ICD-10, CPT, and federal and payor guidelines accurately, • Work within 3M/HDS and EPIC, • Research complex coding questions and support coder training when needed, • Maintain consistent productivity and quality standards What you bring • Three or more years of inpatient and ED coding experience, • Strong knowledge of ICD-10 and CPT, • CCS or CPC required; RHIA/RHIT or additional AHIMA credentials are a plus, • Comfortable working independently with limited oversight, • Solid computer skills, including Word, Excel, and encoder tools, • Ability to learn quickly during onsite onboarding Work setup • Onsite in New York for initial training, • Fully remote afterward If you’re a certified coder who’s ready to jump in with minimal ramp-up time, we’d love to connect. Apply now while the role is still open.

A company is looking for a Medical Coder I.

A company is looking for a Coder Certified (Remote) - Surgery. Key Responsibilities Review medical record documentation to select appropriate diagnoses and procedures for billing Code evaluation and management to appropriate CPT and ICD-9 codes Assist coders and meet with physicians to ensure pr

Current Registered Health Information Technologies (RHIT) or Certified Professional Coder designation from the American Academy of Professional Coders or a Certified Coding Specialist, P from the American Health Information Management (AHIMA).

West Orange, New Jersey, PM&R Opening - Part-Time or Full-Time Clinical Role:Do you know someone that might be a good fit for this position? Please ask about our generous referral fees!Seeking a board certified or eligible physiatristOpportunity to work part-time or full-timeWork out of an inpatient rehab facilityBrand new market for this groupExpect to see 18-22 patients per dayCall: TBDGroup has a compliance programAllow RecruitWell to set a up a phone call with you and the client to discuss more!Organization Information:Nationwide physiatry groupGroup employs 100+ physicians nationwidePhysicians are typically employed as W2If you do part-time, you'd be a 1099 directly through the hiring entityEmployed providers get full benefitsMedical, dental, and vision insuranceMalpractice insurance with a tailFull-time staff physicians make a guaranteed $180,000 per year - directors make a guaranteed $200kOnce you meet the company's bonus structure, you get 70% of the billingsOn average, their full-time physicians make $230,000 up to $425,000+ with production bonus and salaryGroup uses an app called MD Coder - it allows you to put your charges in with ease, provides you with billing codes, and ensures that all are meeting compliance standardsRecruitWell's Core Values:Open communicationSense of urgencyTeamworkAccountabilityDriven to winHigher consciousness

Certified Coding Specialist (CCS) by AHIMA, Certified Professional Coder (CPC) by the American Academy of Professional Coders (AAPC) or Certified Medical Billing Specialist (CMBS) by the Medical Association of Billers (MAB); or. Residents of Queens can count on the delivery of quality medical care r

Remote Certified Medical Coder Inpatient (Remote after Training). Were looking for an experienced inpatient coder who can step into a fast-paced acute care environment with confidence. Research complex coding questions and support coder training when needed.

We are seeking a highly qualified candidate for a Clinical Certified Coder role within our client's Special Investigations Unit. The Clinical Coder will support the organization in the detection, prevention and investigation of suspected fraud, waste, and abuse. AAPC Coding certification required -

Job Description Do Not Apply If You Have No Plastic Surgery Experience. We are seeking an experienced Billing Manager who is detail-oriented, proactive, and highly organized to lead our billing operations. Qualifications • Minimum 3–5 years of medical billing experience in plastic surgery., • Certified Professional Coder or similar certification is required, • Strong understanding of cosmetic vs. reconstructive billing workflows, • Proficiency in insurance verification, coding, prior authorizations, and appeals, • Experience with EHR/PM systems and electronic claims submission, • Proficiency in Microsoft Office (particularly Word and Excel) is required, • Experience with Nextech and Epic is preferred Oversee the full revenue cycle, including coding, charge posting, payments, adjustments, and A/R follow-up. * Verify insurance eligibility, run prior authorizations, and initiate predeterminations for surgical procedures. * Prepare and submit accurate claims, appeals, HCFA forms, and supporting documentation. * Manage patient and insurance payment posting, refunds, recoupments, and collections activity. * Generate Good Faith Estimates and create internal financial agreements for cosmetic patients. * Handle the Federal IDR process, No Surprises Act compliance, and communication with attorneys on billing disputes. * Provide patients with itemized statements, medical records, and billing-related assistance. * Maintain provider enrollment, credentialing, and payer updates for the practice. * Educate staff on billing workflows, policies, and documentation requirements. * Ensure compliance, accuracy, and timeliness across all billing operations in a high-volume plastic surgery practice. Benefits • Competitive salary (DOE), • Health, dental, and vision benefits, • PTO and paid holidays, • Supportive, team-oriented environment

Job Description Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an ProFee Audit Specialist you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! * For this position, we are seeking an auditor with a broad range of experience across multiple specialties, with strong expertise in neurosurgery and orthopedics. Experience in Interventional Radiology and HCC is a plus.* You Will: • Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment., • Review non-CC/MCC records to assess proper coding or identify the need for additional documentation. Scrutinizes all HCPCS and CPT codes influencing APC assignment., • Provide coder education through the auditing process., • Prepare preliminary results for review by the facility or CCS HIM director., • Review disagreements on APC/DRG changes with the appropriate manager., • Prepare the final reports for the coding audit and actively participates in the resolution of audit findings., • Provide coder education via email and/or conference calls, utilizing the audit spreadsheet findings and comments., • Attend coding workshops as necessary., • Stay current with regulatory changes., • Organize and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution., • Demonstrate versatility and exceptional work across a wide range of coded services., • Meet with client facility representatives to discuss issues and trends identified in audits., • Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation., • Communicate effectively with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Function in a professional, efficient, and positive manner., • Adhere to the American Health Information Management Association's code of ethics., • Maintain a customer-service focus and exhibits professionalism, flexibility, dependability, a desire to learn, commitment to excellence, and commitment to the profession., • Conduct audits on external coding staff as needed and provides reports to the manager as directed., • Handle a high complexity of work functions and decision-making., • 3-5 years experience auditing, • Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS, • Preferred: CCS, RHIT, or RHIA credentials., • Recent experience in academic/level 1 trauma centers, • Experience coding and auditing inpatient and outpatient records for various facilities, • Track record of acceptable productivity standards, • Maintain 95% accuracy rate for APC assignment and 95% productivity rate, • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays, • Free CEUs every year, • Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable, • Equipment: monitor, laptop, mouse, headset, and keyboard, • Comprehensive training led by a credentialed professional coding manager This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.

Job Description Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. As an Inpatient Auditing Specialist you will be instrumental in addressing consulting and educational needs related to coding quality, compliance assessments, external payer reviews, coding education, interim coding management, and coding workflow operations reviews. In this role, you will offer meaningful information tailored to exceed customer expectations, actively identifying and presenting solutions for customer issues. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! * Inpatient auditor with 3-5 years of experience at a Trauma Level 1 facility. SMART software experience strongly encouraged to apply* You Will: • Conduct inpatient coding audits on medical records, utilizing ICD-10-CM, CPT, and appropriate coding references for accurate DRG and APC assignment., • Review non-CC/MCC records to assess proper coding or identify the need for additional documentation. Scrutinizes all HCPCS and CPT codes influencing APC assignment., • Provide coder education through the auditing process., • Prepare preliminary results for review by the facility or CCS HIM director., • Review disagreements on APC/DRG changes with the appropriate manager., • Prepare the final reports for the coding audit and actively participates in the resolution of audit findings., • Provide coder education via email and/or conference calls, utilizing the audit spreadsheet findings and comments., • Attend coding workshops as necessary., • Stay current with regulatory changes., • Organize and prioritize multiple cases concurrently to ensure departmental workflow and prompt case resolution., • Demonstrate versatility and exceptional work across a wide range of coded services., • Meet with client facility representatives to discuss issues and trends identified in audits., • Develop and implement education for physicians, nursing, and other clinical staff to enhance documentation., • Communicate effectively with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Function in a professional, efficient, and positive manner., • Adhere to the American Health Information Management Association's code of ethics., • Maintain a customer-service focus and exhibits professionalism, flexibility, dependability, a desire to learn, commitment to excellence, and commitment to the profession., • Conduct audits on external coding staff as needed and provides reports to the manager as directed., • Handle a high complexity of work functions and decision-making. What you will bring to the table: • 3-5 years experience auditing, • Associate or Bachelor's degree from an AHIMA-certified HIM or Nursing Program, or completion of a certificate program from AAPC with a preference for CCS, • Preferred: CCS, RHIT, or RHIA credentials., • Recent experience in academic/level 1 trauma centers, • Experience coding and auditing inpatient and outpatient records for various facilities, • Track record of acceptable productivity standards, • Maintain 95% accuracy rate for APC assignment and 95% productivity rate, • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays, • Free CEUs every year, • Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable, • Equipment: monitor, laptop, mouse, headset, and keyboard, • Comprehensive training led by a credentialed professional coding manager This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.

Job Description Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace! * What You Will Do: • Review medical records and assign accurate codes for diagnoses and procedures., • Assign and sequence codes accurately based on medical record documentation., • Assign the appropriate discharge disposition., • Abstract and enter the coded data for hospital statistical and reporting requirements., • Communicate documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution., • Maintain a 95% coding accuracy rate and a 95% accuracy rate for APC assignment and meet site-designated productivity standards., • Be responsible for tracking continuing education credits to maintain professional credentials., • Attend Datavant Health sponsored education meetings/in-services., • Demonstrate initiative and judgment in the performance of job responsibilities., • Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Function in a professional, efficient, and positive manner., • Adhere to the American Health Information Management Association's code of ethics., • Be customer-service focused and exhibit professionalism, flexibility, dependability, and a desire to learn., • Handle a high complexity of work function and decision-making., • Possess strong organizational and teamwork skills. What You Need to Succeed: • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC)., • 2+ years of coding experience in a hospital and/or coding consulting role., • Proficiency with most or all of these coding specialties (Same Day Surgery, Observation, Injections/Infusions), • Proficiency with most or all of these coding specialties (Ancillary, Emergency Department, Injections/Infusions, E/M leveling), • Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills., • Experience in computerized encoding and abstracting software., • Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually, • Experience in computerized encoding and abstracting software What We Offer: • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays, • Benefits for PRN employees: 401k savings plan w/match, • Free CEUs every year, • Stipend provided to assist with education and professional dues (AHIMA/AAPC), • Equipment: monitor, laptop, mouse, headset, and keyboard, • Comprehensive training led by a credentialed professional coding manager, • Exceptional service-style management and mentorship (we're in this together!) Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $20 - $35 an Hour Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is:$20—$35 USD To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion. This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here. Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay. At the end of this application, you will find a set of voluntary demographic questions. If you choose to respond, your answers will be anonymous and will help us identify areas for improvement in our recruitment process. (We can only see aggregate responses, not individual ones. In fact, we aren't even able to see whether you've responded.) Responding is entirely optional and will not affect your application or hiring process in any way. Datavant is committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need an accommodation while seeking employment, please request it here, by selecting the 'Interview Accommodation Request' category. You will need your requisition ID when submitting your request, you can find instructions for locating it here. Requests for reasonable accommodations will be reviewed on a case-by-case basis. For more information about how we collect and use your data, please review our Privacy Policy.

Job Description Hi, we're Oscar. We're hiring a SIU Coding Auditor to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a focus on serving our members. We started Oscar in 2012 to create the kind of health insurance company we would want for ourselves—one that behaves like a doctor in the family. About the role The Senior Specialist works in the Special Investigation Unit to support in assessing trends and patterns in FWA across the healthcare industry using deep coding knowledge to prevent and recoup inappropriately paid claims. The Specialist Investigation Unit runs and coordinates activities across Oscar to reduce the incidence and impact of fraud, waste, and/or abuse ("FWA") on all our operations. You will report to the Manager, SIU Coding Audit. Work Location: Oscar is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. If you live within commutable distance to our New York City office (in Hudson Square), our Tempe office (off the 101 at University Dr), or our Los Angeles office (in Marina Del Rey), you will be expected to come into the office at least two days each week. Otherwise, this is a remote / work-from-home role. You must reside in one of the following states: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, or Washington, D.C. Note, this list of states is subject to change. #LI-Remote Pay Transparency: The base pay for this role in the states of California, Connecticut, New Jersey, New York, and Washington is: $63,200 - $82,950 per year. The base pay for this role in all other locations is: $56,880 - $74,655 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities • Develop a depth of expertise on CPT, HCPCS, and ICD-10 Coding guidelines and other insurance billing submission requirements., • Perform complex audits of assigned medical records and claims on both a prepayment and post payment basis to determine accuracy of claims submitted to Oscar., • Document findings including reference to sources used to support decision making and in a way that can be easily understood by non clinicians or coders., • Create audit report findings, tools, and reference guide that can be used by other team members to communicate findings or more effectively perform similar reviews., • Help draft written communications to providers to convey audit findings., • Participate in educational calls with providers., • Help train new team members., • Develop and document processes to improve the effectiveness of the team., • Compliance with all applicable laws and regulations, • Other duties as assignedQualifications, • 2+ years of coding or auditing experience across multiple specialties is required, • Bachelor's degree or 4+ years of work experience, • Certified Professional Coder (CPC), Certified Inpatient Coder (CIC), Certified Outpatient Coder (COC) designation or similar certification, • Experience working in production-based environment, • Experience of both outpatient and inpatient auditingBonus Points, • Certified Professional Medical Auditor (CPMA), • Additional certification applicable to this work such as Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), other coding certifications or similar, • Knowledge of applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity, • Demonstrated experience translating technical jargon to non-technical end users., • Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting., • Experience with HIPAA, data privacy, and/or data security processes At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care -- an experience made whole by our unique backgrounds and perspectives. Pay Transparency: Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements. Artificial Intelligence (AI): Our AI Guidelines outline the acceptable use of artificial intelligence for candidates and detail how we use AI to support our recruiting efforts. Reasonable Accommodation: Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team () to make the need for an accommodation known. California Residents: For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Privacy Policy.

Job Description Position: Risk Adjustment Coder Location: Remote (Must reside in NY/NJ/CT) Schedule: Monday - Friday 9am-5pm Compensation: $77,506.87 - 87,195.23 annual salary CPC, CCS, RHIT or RHIA and CRC are required Join VillageCare as a Full Time Risk Adjustment Coder and embrace the opportunity to work remotely while making a significant impact in the Health Care sector. This role offers the flexibility of a work-from-home environment, allowing you to balance your professional and personal commitments without the daily commute. You'll be part of a dynamic team that thrives on innovation, problem-solving, and a customer-centric approach, all while contributing to the excellence and integrity that VillageCare stands for. With a competitive salary up to $77,506.87 - $87,195.23, this is not just a job but a chance to build your career in a forward-thinking organization dedicated to healthcare improvement. As a team member you'll be able to enjoy benefits such as PTO package, 10 Paid Holidays, Personal and Sick time, Medical/Dental/Vision, HRA/FSA, Education Reimbursement, Retirement Savings 403(b), Life and Disability, Commuter Benefits, Paid Family Leave, and Additional Employee Discounts. Seize the opportunity to grow in a high-performance culture that values your contributions. Apply today and help shape a healthier future! A little about us VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. What's your day like? As a Full Time Risk Adjustment Coder at VillageCare in New York, NY, you will perform critical code abstraction of medical records, ensuring accurate assignment of ICD-9-CM, ICD-10-CM, CPT, and HCPCS codes supported by clinical documentation. Your role involves a comprehensive review of medical records, validating that documentation meets CMS requirements, including provider signatures and relevant dates. You will identify improvement opportunities in documentation and coding processes and participate in quality initiatives that enhance overall outcomes. By maintaining current knowledge of coding standards and regulations, you will support the Medicare Risk Adjustment team in educating providers on compliance and consistency. Your contributions will include reporting findings from audits, assisting in analysis, and maintaining a minimum accuracy of 95% on coding quality audits while meeting productivity requirements. This is an exciting opportunity to make a meaningful impact in healthcare while advancing your coding expertise. Requirements for this Risk Adjustment Coder job To thrive as a Full Time Risk Adjustment Coder at VillageCare, candidates must possess a robust understanding of clinical terminology, disease processes, anatomy and physiology, as well as pharmacology. A strong foundation in claims processing procedures, state and federal regulations, and Medicare Coordination of Benefits applications is essential. Ideal candidates will have at least three recent years of experience in HCC/Risk Adjustment and/or inpatient coding, complemented by relevant certifications such as CPC, CRC, RHIT, or RHIA from AAPC or AHIMA. Additionally, successful candidates will exhibit exceptional attention to detail, basic computer skills, and the ability to maintain a productive home office environment with high-speed internet. Residing in New York, New Jersey, or Connecticut is also a prerequisite to ensure alignment with local regulations and standards. Strong problem-solving skills and a commitment to coding excellence are crucial for contributing to the organization's mission in improving healthcare quality. Knowledge and skills required for the position are: • Strong knowledge of clinical terminology, disease processes, anatomy/physiology and pharmacology, • Have high speed internet at their house and a distraction free home office, • Must be detail oriented and have basic computer skills, • Strong knowledge of claims processing procedures and systems, • State, Federal and Medicare Regulations and Coordination of Benefits applications required, • Must reside in NY, NJ or CT, • 5 recent years of HCC / Risk Adjustment and/or inpatient coding are required, • Certified through AAPC or AHIMA(CPC, CRC, RHIT or RHIA), • CPC, CCS, RHIT or RHIA and CRC are requiredConnect with our team today! VillageCare is an Equal Opportunity Employer. Job Posted by ApplicantPro

Job Description Job Title: Certified Medical Coder – Outpatient & Emergency Department (ED) Location: Remote - Bronx, NY 10461 1–2 weeks of onsite training at the start Schedule: Monday – Friday, 8:00 AM – 4:00 PM (40 hours per week) Pay Rate: $35 – $38 per hour Duration: 3 months (with possible extension) Position Overview: We are seeking an experienced and detail-oriented Certified Medical Coder to join our team in an acute care setting. The ideal candidate will possess strong outpatient and emergency department (ED) coding experience, advanced knowledge of ICD-9-CM, CPT-4, and HCPCS coding systems, and hands-on experience using EPIC and 3M/HDS applications. This position requires strict adherence to federal billing and coding guidelines to ensure accurate and compliant claim submission. Required Qualifications: • Certification: Certified Coding Specialist (CCS) – Required, • Education: High School Diploma/GED required; AHIMA credentials (RHIA, RHIT, or CCS-P) preferred, • Experience:, • Minimum 2–3 years of coding experience in an acute care setting, • Strong background in Outpatient and ED coding, • Experience with both Inpatient and Outpatient coding highly preferred, • Proficiency with EPIC and 3M/HDS systems – Required, • Technical Skills: Proficient in MS Word, Excel, and Encoder software., • Knowledge Base: Strong understanding of anatomy, physiology, disease processes, and medical terminology., • Ability to research and resolve complex coding issues independently. Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors Company DescriptionPride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

Collaborates with Accounts Receivable staff to resolve denied or rejected claims related to coding issues. The Certified Professional Coder (CPC) is responsible for accurate coding of medical records and claims within the Clinical Revenue Office's Accounts Receivable department. Updates patient acco