Certified professional coder jobs in Hoboken, New JerseyCrear alertas

Job DescriptionThis position is responsible for the accurate and timely billing of ambulance transports while maintaining quality and productivity standards. This position is expected to determine diagnosis and levels of service, based on information provided on the Patient Care Report (PCR) and to accurately bill using the appropriate codes.As a Medical Billing Specialist you will: • Review as a second verification basic information for the patient, including name, address, date of birth, social security number, insurance information, ranking of insurance related to call; update as necessary., • Verify receipt of and update PCS information (if non-emergency and/or schedule trips) or payor's pre-authorization of services for the trip., • Verifies and updates service details, including pick-up and drop-off addresses, date and time, call type, response priority and transport priority., • Verifies the medical details and determine the appropriate service code, ICD-10 or condition codes for the patient's complaint(s)., • Verifies and updates the correct amount to charge for the services rendered, and the procedures administered., • Determines the correct procedure codes and modifiers you must use for the charges, as required by the payor being billed., • Reports any additional information needed., • Generate a claim for the trip on paper or in the correct electronic submission format-that includes all the necessary details, modifiers, indicators, condition codes, and documentation, and send to the primary payor(s)., • Assure HIPAA compliance with regards to billing practices., • Keeps track of all trips and claims., • Ensures ePCR's received is equal to the total trips for that day., • Maintains knowledge of all coding regulations, particularly as it relates to assigned state or payor., • Maintains files for all trips and medical documentation., • Continuously cross-trains in other function areas and supports office logisticsQualifications:, • Minimum of 1-year medical billing experience with an ambulance company (or similar practice or clinic)., • Ambulance/Medical billing certification or diploma preferred, • Certified Ambulance Coder (CAC) or Certified Professional Coder (CPC), • Excellent organizational skills and the ability to multi-task in a fast-paced environment, • Analytical - collects and researches data; uses intuition and experience to complement dataSkills:, • Excellent organizational skills and the ability to multi-task in a fast-paced environment., • Analytical - collects and researches data; uses intuition and experience to complement data., • Thorough knowledge of ambulance transport documentation., • Extensive knowledge of ICD-10 and Condition Codes., • Ability to collect for healthcare claims from Medicare/Medicaid, commercial insurance, contracted facilities, and individuals., • Understands Medicare and Medicaid regulations and guidelines., • Familiarity with Medicare, Medicaid, Coding, Private Pay, and insurance preferred., • Familiarity with medical terminology., • Ability to interpret EOB (Explanation of Benefits)., • Familiarity with Microsoft Office Suite (Excel, Word).Benefits:, • 401K, • Medical Insurance, • Dental, • Vision, • PTOWork Location:, • 43 River Road, Nutley, NJ, 07710 (Metro Ambulance Office)

Job DescriptionDescription: We are seeking a detail-oriented and experienced Billing and Coding Specialist to join our healthcare team. This role is vital in ensuring accurate and timely processing of medical claims, supporting our commitment to efficient patient care and revenue cycle management. If you have a strong understanding of medical billing and coding procedures, we invite you to become a key part of our organization’s success. Key Responsibilities: • Review and accurately code medical diagnoses, procedures, and services using ICD-10, CPT, and HCPCS coding systems., • Prepare and submit insurance claims in a timely manner, ensuring compliance with payer requirements., • Verify patient insurance coverage and obtain necessary authorizations., • Follow up on unpaid or denied claims to facilitate prompt resolution., • Maintain detailed and organized records of billing and coding activities., • Stay updated on changes in coding regulations and insurance policies., • Collaborate with healthcare providers and administrative staff to resolve billing issues., • Ensure compliance with all relevant healthcare laws and regulations. Benefits Available: • Multiple medical and prescription coverage options, • Dental and vision care plans, • Health Savings Accounts (HSAs), where applicable, • Flexible Spending Accounts (FSAs), • Voluntary critical illness, cancer, and accident insurance, • Voluntary hospital indemnity coverage, • Voluntary short-term and long-term disability insurance, • Voluntary term life insurance and AD&D (Accidental Death & Dismemberment), • 401(k) retirement savings plan, • Paid time off (PTO), • Commuter benefits, • Proven experience in medical billing and coding, preferably in a healthcare setting., • Certification such as Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is preferred., • Strong knowledge of ICD-10, CPT, HCPCS coding systems, and medical terminology., • Familiarity with electronic health records (EHR) and billing software., • Excellent attention to detail and organizational skills., • Ability to work independently and as part of a team., • Strong communication skills and problem-solving abilities., • Knowledge of healthcare regulations and compliance standards.

Job DescriptionJob Title: Certified Medical Coder Location: Bronx, NY 10461 Position Type: Contract Assignment Duration: 9 Weeks Schedule: Monday–Friday | 8:00 AM – 4:00 PM Position Summary A leading acute care healthcare organization in Bronx, New York is seeking an experienced Certified Medical Coder to support outpatient and Emergency Department coding operations. The ideal candidate will work independently with minimal onboarding and demonstrate strong knowledge of outpatient coding guidelines, compliance standards, and acute care workflows. Key Responsibilities * Perform outpatient and Emergency Department medical coding in an acute care setting * Assign accurate ICD-10-CM, CPT, and HCPCS codes * Ensure compliance with federal billing, payer, and coding regulations * Utilize EPIC EMR and 3M/HDS encoder systems * Review clinical documentation for accuracy, completeness, and coding compliance * Research, resolve, and correct coding discrepancies and denials * Support coding quality initiatives and education efforts as needed * Maintain productivity and accuracy standards with minimal supervision Required Experience & Skills * 4+ years of outpatient medical coding experience (required) * Emergency Department (ED) coding experience (required) * Strong knowledge of ICD-10-CM and CPT coding guidelines * Hands-on experience with EPIC and 3M coding systems (required) * Proficiency in Microsoft Word and Excel * Ability to work independently with limited training and oversight Required Certifications (Active) Candidates must hold one of the following certifications: * CCS – Certified Coding Specialist * CPC – Certified Professional Coder * RHIA or RHIT (AHIMA-issued) Education * High School Diploma or GED (required) For more details reach at or Call / Text at 516-862-1203. About Navitas Healthcare, LLC: It is a certified WBENC and one of the fastest-growing healthcare staffing firms in the US providing Medical, Clinical and Non-Clinical services to numerous hospitals. We offer the most competitive pay for every position we cater. We understand this is a partnership. You will not be blindsided and your salary will be discussed upfront.

Job Description Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in 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! *Preferred: PRN SDS and Observation Outpatient coder with at least 3 years experience. 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 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 Certified Coder – Neurology Department (Contract) We are seeking a detail-oriented Certified Coder to join a busy Neurology Department on a contract basis. Responsibilities: • Perform coding for hospital and professional services in compliance with CMS and payer guidelines., • Review and resolve coding edits, including medical necessity, bundled/unbundled services, and non-covered services., • Research policies and procedures to resolve billing and coding discrepancies., • Certified Coder (CCS, CPC, or equivalent)., • Strong understanding of coding regulations and medical necessity guidelines., • Monday–Friday, 8:30 AM-5 PM, • This role is onsite. Must be able to commute to the location daily.

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. What We're Looking For: We are growing and seeking a full-time coder to support increasing client volumes and make an immediate impact. This is a great opportunity for a detail-oriented professional who thrives in a structured, performance-driven coding environment. The Provider Practice Coding Consultant role is an opportunity to make a significant impact in the field of medical coding. You will provide essential consulting services and educational support, guiding healthcare professionals on improved coding practices. Collaborating closely with key stakeholders such as clients and healthcare leaders, you'll meet and exceed customer expectations through identifying and proposing solutions, and being a responsible and reliable teammate. This role offers a unique opportunity to play a pivotal role in elevating coding quality, ensuring compliance, and optimizing service outcomes in both hospitals and alternative care settings. What You Will Do: • Review medical records and assign precise codes to ensure accurate coding aligned with client needs (CPT, ICD-10-CM, ICD-10 procedures, ICD-10-CM and ICD-10 PCS, HCPCS)., • Conduct data quality reviews of records to assess compliance with official coding and documentation guidelines., • Communicate professionally with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Demonstrate strong written and verbal communication skills, • Identify documentation improvement opportunities and coding issues, • Use VPN access to ensure productive and flexible task completion, • Uphold Datavant and HIM Division policies, promoting a culture of compliance and operational efficiency., • Track continuing education credits, maintaining a high standard of professional expertise., • Attend mandatory sponsored in-service and educational meetings, ensuring alignment with industry best practices for continual improvement., • 1+ year of hands-on experience with HCC coding, • Annual Wellness Visit (AWV) coding experience, • Strong knowledge of CPT II codes, • Ability to navigate and adhere to process-driven workflows, • Proven track record of meeting productivity and quality benchmarks, • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC)., • Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills., • Experience in computerized encoding and abstracting software., • Full Benefits including a 401k Savings Plan, • Access to 20-24 free CEUs per year, provided by Datavant, to support your continuous professional development, • Compensation for AAPC/AHIMA dues, • Company-provided equipment including computer, monitor, mouse, etc, • 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 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: $65,412 - $85,853 per year. The base pay for this role in all other locations is: $58,870 - $77,267 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 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! Preferred: In need for a FT IP auditing specialist. Auditing specialist will be responsible for reviewing and validating DRGs specific to Medicare and Medicare Managed Care. Interest in coding IP charts in the event the contract ends. Must be able to work 40 hours/week M-F. Systems: Cerner PowerChart, 3M360. 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+ years experience coding and 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, • Experience with various software including EMR, Encoder and Auditing software Perks: • 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, • Exceptional service-style management and mentorship (we're in this together!) We are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. 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. Our compensation philosophy is to be externally competitive, internally fair, and not win or lose on compensation. Salary ranges for this position are developed with the support of benchmarks (competitive San Francisco rates for US-based roles) and industry best practices. We're building a high-growth, high-autonomy culture. We rely less on job titles and more on cultivating an environment where anyone can contribute, the best ideas win, and personal growth is driven by expanding impact. This means we default to simple job titles (e.g., Software Engineer) rather than complex ones (e.g., Senior Software Engineer). The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on level, responsibilities, skills, and experience for a specific job. The estimated pay range for this role is $40 - $45 per 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:$35—$45 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 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 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.

CitiMed is a unique medical facility that provides exclusive healthcare amenities to our community. The range of medical and rehabilitative services offered has been specifically selected to treat traumatic injury patients. We provide a variety of health services including diagnostic and rehabilitation. Our vision directs the evolution of our practice, as we strive to improve our services to the community. All CitiMed offices are multilingual and staffed with individuals to make any experience pleasant. You can learn more about us at . CitiMed is growing rapidly, and we are looking for many qualifying individuals to be a part of our team! With the support and hard work of all our employees, CitiMed continues to make its way down a successful road. CitiMed maintains a work culture that allows our team members to feel supported and confident in their work. We offer many learning opportunities with room for professional growth. If the responsibilities interest you and believe you have met the requirements, we strongly encourage you to apply! Job Description: We are seeking a highly skilled and detail-oriented Certified Medical Coder with expertise in Pain Management and Orthopedic coding to join our dynamic team. The ideal candidate will possess a strong understanding of coding guidelines and regulations, ensuring accurate coding for optimal reimbursement and compliance. Key Responsibilities: • Accurate Coding: Assign appropriate ICD-10, CPT, and HCPCS codes for pain management and orthopedic services, including surgical procedures, injections, and diagnostic tests., • Documentation Review: Analyze medical records, operative reports, and provide documentation to ensure completeness and accuracy of coding., • Compliance: Ensure coding practices adhere to federal, state, and payer-specific regulations, including NCCI edits and LCD/NCD guidelines., • Denial Management: Collaborate with billing and clinical staff to address coding-related denials and implement corrective actions., • Education & Training: Provide feedback and education to providers and staff with documentation requirements and coding updates., • Quality Assurance: Participate in internal audits and quality improvement initiatives to maintain high coding accuracy standards., • Data Analysis: Utilize coding data to identify trends, opportunities for revenue enhancement, and areas for process improvement. Qualifications • Certification: Active AAPC certification (CPC, COSC, or CANPC) or AHIMA equivalent (CCS, CCS-P)., • Experience: Minimum of 3 years of coding experience in pain management and orthopedic specialties., • Knowledge: Proficient in ICD-10-CM, CPT, HCPCS Level II coding systems, and medical terminology related to musculoskeletal and pain management services., • Technical Skills: Experience with EHR systems and coding software (e.g., EncoderPro, 3M)., • Analytical Skills: Strong attention to detail and ability to interpret complex medical documentation., • Communication: Excellent verbal and written communication skills for effective collaboration with healthcare providers and staff. Preferred Qualifications: • Advanced Certification: COSC (Certified Orthopedic Surgery Coder) or CANPC (Certified Anesthesia and Pain Management Coder)., • Audit Experience: Familiarity with conducting coding audits and implementing compliance strategies., • Regulatory Knowledge: Understanding of CMS guidelines, HIPAA regulations, and payer-specific policies.

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers. Researching state and payer regulations to identify areas of risk in a variety of healthcare settings and specialties, coordinating with various team members to ensure clear expectations are communicated and deadlines are met. Qualifications: CPC/CCS-P with a minimum of 5 years of experience in healthcare coding/auditing (E&M, CPT, HCPCS and ICD-10), with knowledge of professional billing, coding, and documentation practices performed by physicians and other qualified healthcare providers in inpatient and outpatient settings. Proficiency in evaluating how well clinical documentation supports medical necessity and the E/M, CPT, and HCPCS codes that were billed, across a wide range of services. The focus will be in the primary care sector (fee-for-service and risk-based), though experience in specialties such as dermatology, vascular, podiatry, wound care, home health, and personal care is preferred. Behavioral health experience is also a plus. Proven ability to identify billing and coding issues including use of modifiers, bundling issues, CCI edits, therapeutic and diagnostic procedures, supplies, materials, injections, drugs, and units of service etc. Solid understanding of both federal and state coding and documentation laws and regulations, applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity. Identify and access risk of repayment or recoupment in the event of payor scrutiny. Familiarity with both UB-04 and CMS 1500 claims data, as well as understanding of payor remittances. Knowledge of anatomy, physiology, and medical terminology necessary to appropriately review assignment and documentation of diagnosis codes. Solid working knowledge of various EHR/EMR systems; experience accessing these remotely. Strong organizational skills and task management Highly organized with a high level of attention to detail Ability to work in a fast paced and rapidly changing environment. Skilled at multi-tasking with the ability to handle several different priorities simultaneously. Strong communication skills with experience in articulating audit findings and interpretation of coding regulations Experience with HIPAA, data privacy, and/or data security processes. Experience working with regulators governing (public or private) health insurance carriers. A minimum of AAPC or AHIMA certification required, that could include: · Certified Professional Coder (CPC) · Certified Outpatient Coder (COC™) · Certified Professional Medical Auditor (CPMA) · Certified Risk Adjustment Coder (CRC™) · Certified Coding Specialist (CCS) · Certified Coding Specialist – Physician based (CCS-P) For consideration, please email resume and cover letter as attachments with salary expectations to with the subject title “Certified Coding Auditor - Behavioral Health.” Marwood offers a comprehensive compensation package with full benefits. We offer a competitive wage, a collaborative work environment and an opportunity to participate in a full benefit package, including, Medical, Dental, Vision, Life, AD&D, Voluntary Life and LTD, Spouse and Dependent Life, 401k Retirement plan with a company match, Commuter, FSA/DCFSA. We offer paid days off, and paid holidays. Marwood prides itself on providing employees with a good work-life balance. There is no travel expected with this position. The position is based in our New York location. Currently working a hybrid schedule. Remote option will be considered. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class.

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers. Researching state and payer regulations to identify areas of risk in a variety of healthcare settings and specialties, coordinating with various team members to ensure clear expectations are communicated and deadlines are met. Qualifications: CPC with a minimum of 5 years of experience in healthcare coding/auditing (E&M, CPT, HCPCS, and ICD-10), with knowledge of professional billing, coding, and documentation practices performed by physicians and other qualified healthcare providers in inpatient and outpatient settings. Proficiency in evaluating how well clinical documentation supports medical necessity and the E/M, CPT, and HCPCS codes that were billed, across a wide range of services. The focus will be in the behavioral health sector, including mental health (psychiatry/therapy), substance use disorder (IOP, PHP, detox, and residential treatment), I/DD, opioid treatment programs, and ABA therapy. Inpatient psych experience preferred. Proven ability to identify billing and coding issues including use of modifiers, bundling issues, CCI edits, therapeutic and diagnostic procedures, supplies, materials, injections, drugs, and units of service etc. Solid understanding of both federal and state coding and documentation laws and regulations, applicable fraud statutes, and regulations, and of federal guidelines on recoupments and other anti-FWA activity. Identify and access risk of repayment or recoupment in the event of payor scrutiny. Familiarity with both UB-04 and CMS 1500 claims data, as well as understanding of payor remittances. Knowledge of anatomy, physiology, and medical terminology necessary to appropriately review assignment and documentation of diagnosis codes. Solid working knowledge of various EHR/EMR systems; experience accessing these remotely. Strong organizational skills and task management Highly organized with a high level of attention to detail Ability to work in a fast paced and rapidly changing environment. Skilled at multi-tasking with the ability to manage several different priorities simultaneously. Strong communication skills with experience in articulating audit findings and interpretation of coding regulations Experience with HIPAA, data privacy, and/or data security processes. Experience working with regulators governing (public or private) health insurance carriers. Certifications that are applicable to this work include: • Certified Outpatient Coder (COC™), • Certified Professional Medical Auditor (CPMA), • Certified Risk Adjustment Coder (CRC™), • Certified Coding Specialist (CCS), • Certified Coding Specialist – Physician based (CCS-P) For consideration, please email resume and cover letter as attachments with salary expectations to with the subject title “Certified Coding Auditor - Behavioral Health.” Marwood offers a comprehensive compensation package with full benefits. We offer a competitive wage, a collaborative work environment and an opportunity to participate in a full benefit package, including, Medical, Dental, Vision, Life, AD&D, Voluntary Life and LTD, Spouse and Dependent Life, 401k Retirement plan with a company match, Commuter, FSA/DCFSA. We offer paid days off, and paid holidays. Marwood prides itself on providing employees with a good work-life balance. There is no travel expected with this position. The position is based in our New York location. Currently working a hybrid schedule. Remote option will be considered. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class.

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 and 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

The Certified Professional Coder (CPC) is responsible for accurate coding of medical records and claims within the Clinical Revenue Office's Accounts Receivable department.

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. May organize, file and retrieve medical records. Two (2) years of satis

TekSystems is currently hiring for a Medical Coder that can sit anywhere in the US as it is FULLY REMOTE, this position does work on EST time zone hours!*. These Coders will be taking the work from the Client Coordinators. Certified Professional Coder or CPC (Can look at but not guaranteed Certified

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 out