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Job DescriptionPosition Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. We are seeking a registered nurse with experience in clinical validation to work within our coding department. Candidate should be highly motivated, with strong clinical and coding background. This individual must have excellent communication skills and an analytical mindset to achieve and maintain high-level performance in a fast-paced environment. This is a fulltime position (40 hours per week) Monday – Friday. You’ll enjoy the flexibility to telecommute from anywhere within the United States. Training will be conducted virtually from your home. If you are interested in this role with MedReview, please let us know. Here is what we are searching for: Responsibilities: • Perform clinical validation by ensuring diagnosis codes billed by the provider are supported within the medical record, • Must be able to interpret clinical guidelines/criteria and apply to clinical review, • Solid understanding of anatomy and physiology, diagnostic and surgical procedures developed from specialized training and extensive experience with ICD-10-PCS code assignments, • Demonstrates the ability to accurately interpret the medical record, • Writes clear, accurate and concise rationales in support of findings, • Maintains and manages case reviews with a high emphasis on quality, • Demonstrates the ability to work in a high – volume production environment, • Minimum of two years’ experience in clinical validation in a payment integrity setting required, • May consider nurses with inpatient claims auditing experience or case management experience., • Unrestricted Registered Nurse with active RN licensure required, • CCS (Certified Coding Specialist) or CIC (Certified Inpatient Coder) certification preferred, • CCDS or CDIP Certification preferred, • Knowledge of ICD-10 coding, • Basic Knowledge of DRG validation and coding, • High speed internet (100 Mbps per person recommended) with secured WIFI., • A dedicated workspace with minimal interruptions to protect PHI and HIPAA information., • Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents., • 401(k) with Employer Match - Join the team and we will invest in your future, • Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays., • Wellness - We care about your well-being. From Commuter Benefits to FSAs, we’ve got you covered. Powered by JazzHR aBDzJ1rwvQ

Job Description Revenue Cycle Manager Our client, a dedicated healthcare organization committed to community development, is hiring a Revenue Cycle Manager to lead their billing and reimbursement operations. This pivotal role ensures the financial health of the organization by streamlining revenue cycle processes, supervising billing staff, and ensuring compliance with industry standards and regulations. Responsibilities: • Supervise daily activities of the billing department and foster workflow enhancements through automation and standardization., • Conduct regular team meetings to ensure alignment with revenue cycle management (RCM) plans, programs, and deadlines., • Identify and address challenges in the revenue cycle to maximize collection efficiency and reimbursement., • Apply strong analytical skills to leverage data for performance monitoring, trend identification, and revenue integrity improvements, • Bring deep expertise in Revenue Cycle Management, including team leadership and operational oversight, • Develop and refine policies, procedures, and workflows for billing, coding, and collections., • Manage key performance indicators and departmental goals, providing status reports and analytics to senior leadership., • Develop and execute strategies to enhance revenue cycle performance and support sustainable growth, • Keep abreast of Medicare/Medicaid, third-party payers, and regulatory updates, integrating changes into internal systems and staff education., • Oversee coding accuracy, claim transmission, payment posting, and denials management, ensuring adherence to guidelines like ICD-10, CPT, and HCPCS., • Recruit, train, and evaluate billing personnel, fostering a high-performing team environment., • Bachelor’s degree and a minimum of 5 years of experience in healthcare finance or revenue cycle management, supervising claims and reimbursement processes., • In-depth knowledge of revenue cycle management, medical billing, coding, managed care products, and regulatory compliance;, • An active Certified Coder (CPC) is a must, • Strong understanding of healthcare administration, HIPAA, insurance practices, and payer credentialing., • Effective leadership, communication, and organizational skills; ability to manage staff and projects efficiently., • Proficiency in billing practice management systems, Microsoft Office Suite, and internet research skills., • Preferred Qualifications, • Familiarity with Pay-for-Performance (P4P) incentive programs, • Opportunity to lead a vital component of a community-focused healthcare organization., • Collaborative work environment with professional growth prospects. Salary: The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range Company DescriptionWe provide full-service Healthcare Recruitment solutions. We identify, attract, engage, and connect the best possible talent with quality healthcare professionals. We build teams, provide executive recruitment solutions and discover high-performance candidates on behalf of our client partners. Our strength lies in our proven recruitment strategies, leadership in the larger healthcare community (regional and national), and networking.We provide full-service Healthcare Recruitment solutions. We identify, attract, engage, and connect the best possible talent with quality healthcare professionals. We build teams, provide executive recruitment solutions and discover high-performance candidates on behalf of our client partners. Our strength lies in our proven recruitment strategies, leadership in the larger healthcare community (regional and national), and networking.

Job Description ENGLEWOOD ORTHOPEDIC ASSOCIATES JOB DESCRIPTION Department: Billing Title: Medical Biller Location: Englewood Cliffs Supervision Received: Reports to Team Lead Englewood Orthopedic Associates is currently recruiting a Full-Time Medical Biller Individuals must be experienced in medical billing, and initiate & monitor prior authorizations. Candidate Qualifications and Position Responsibilities: • The Medical Billing Specialist applying must have 2 or more solid years of medical billing and authorization experience., • Performs ongoing prospective coding and documentation chart reviews for physician services to ensure that the coding supports the services billed., • The candidate should have excellent oral and writing skills., • Proven experience in insurance verification and obtaining authorizations for office and hospital procedures, • Preparing, reviewing, and submitting claims, • Researching and appealing denied claims, • Ability to multi-task, efficient, while providing high standards of customer service., • Provide account and billing information to patients, explain to patients the reason for their balance., • Other duties as assigned., • Preferred Orthopedic experience but not required, • Preferred Certified Professional Coder (CPC) Typical Physical Demand: Involves sitting for prolonged periods of time. Englewood Orthopedic Associates is an Equal Opportunity Employer. Job Type: Full-time Benefits: • 401(k), • Dental insurance, • Flexible spending account, • Health insurance, • Life insurance, • Paid time off, • Vision insurance Schedule: • 8 hour shift, • Monday to Friday Ability to Commute: • Englewood Cliffs, NJ 07632 (Required)

Job Description We are currently looking for candidates with experience specializing in the following area: Orthopedic Hand/Upper Extremity and Lower Extremity Surgery Responsibilities: · Review and accurately code cases to maximize reimbursement in a timely manner. • Review and accurately code E/M visits and office procedures., • Able to work independently and research coding scenarios., • Coder is responsible for meeting our daily production goal and our quality goal of averaging 95% accuracy rate on a consistent basis., • Attend conference calls as necessary to provide information and/or feedback., • Communicate with leadership on coding or documentation issues/trends., • Stay current on all coding guidelines (to include orthopedic-specific guidelines) and maintain credentials as necessary., • Participate in coding department and education meetings., • Flexible to expand coding skill set into other specialties altogether., • Maintain confidentiality and protect sensitive information., • High School diploma required. Associates or BS degree preferred., • Successful completion of at least one AHIMA or AAPC certified program with the achievement of the correlating professional credential (CCS, CPC, etc.); active and in good standing. A CPC or CCS-P certification is required. CPC-A is not accepted., • Minimum of 3 years physician coding experience (recent hands-on production) in Expertise in professional general surgery coding & procedural coding in at least one of the following areas: Neurosurgery, General Surgery (SDS), Plastics, Podiatry required with the specialty of Orthopedics, specifically for hand/upper extremity and lower extremity surgical coding, including E/M leveling and office procedures (joint injections, fracture care)., • Must have proficient knowledge of anatomy and physiology, medical terminology, CPT, ICD-10 coding, modifiers, disease processes, surgical techniques, and Medicare and Medicaid billing policies for professional services., • Additional skills required: Proficiency with Microsoft Word, Excel, PowerPoint, Windows, and electronic healthcare record information and billing systems. Company DescriptionM&D Capital maintains an exciting and energetic culture with opportunity for personal and professional growth and advancement. We work closely with all our staff in order to enhance their skills and grow the scope of their responsibilities, through training and support from every member of our company up to and including those at the executive level. If you meet the qualifications below, we invite you to join our team.M&D Capital maintains an exciting and energetic culture with opportunity for personal and professional growth and advancement. We work closely with all our staff in order to enhance their skills and grow the scope of their responsibilities, through training and support from every member of our company up to and including those at the executive level. If you meet the qualifications below, we invite you to join our team.

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! 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, • 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 Hi, we're Oscar. We're hiring a Senior Specialist to join our Risk Adjustment 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, Risk Adjustment for Medicare Advantage (MA) and Affordable Care Act (ACA) lines of business will work closely with management to meet communicated individual and departmental goals, deadlines set forth by Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS), and be active and engaged in establishing Risk Adjustment processes. You will report to the Associate Director, Risk Adjustment. 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: $72,800 - $95,550 a year. The base pay for this role in all other locations is: $65,520 - $85,995 a year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities • Responsible for daily operations pertaining to Risk Adjustment including but not limited to: medical record reviews to report ICD-10-CM diagnosis codes for ACA and MA lines of business, potential CMS audits and medical record retrieval efforts., • Maintain compliance with national standards and coding practices set by the ICD-10-CM coding guidelines for accuracy, as well as compliance with Risk adjustment production standards., • Participate in CMS audits of Risk Adjustment activities, including but not limited to Risk Adjustment Data Validation audits., • Develop relationships with key individuals to foster an increased understanding of the Risk Adjustment process., • Support in the identification of document improvement opportunities for provider education in both MA and ACA line of business., • Identify process improvements to enhance medical encounter review efficiency., • Compliance with all applicable laws and regulations, • Other duties as assignedQualifications, • Bachelor's degree in a relevant field of study or commensurate work experience., • Certified professional coder (CPC), • 2+ year(s) retrospective risk adjustment coding experience.Bonus points, • Certified Risk Adjustment Coder (CRC) or similar certification, • Experience coding in a variety of different Electronic Medical Record (EMR) systems.Travel 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. 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. Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar. 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 Notice to Job Applicants.

Job Description We are currently looking for candidates with experience specializing in the following area: Neurosurgery/Spine Responsibilities: • Review and accurately code cases to maximize reimbursement in a timely manner., • Review and accurately code E/M visits and office procedures., • Able to work independently and research coding scenarios., • Coder is responsible for meeting our daily production goal and our quality goal of averaging 95% accuracy rate on a consistent basis., • Attend conference calls as necessary to provide information and/or feedback., • Communicate with leadership on coding or documentation issues/trends., • Stay current on all coding guidelines (to include orthopedic-specific guidelines) and maintain credentials as necessary., • Participate in coding department and education meetings., • Flexible to expand coding skill set into other specialties altogether., • Maintain confidentiality and protect sensitive information., • High School diploma required. Associates or BS degree preferred.

Job Description Job Title: Medical Risk Adjustment Coder Job Summary WE HAVE AN IMMEDIATE OPENING FOR A MEDICAL CODER with RISK ADJUSTMENT EXPERIENCE FOR A HYBRID ROLE IN MIDTOWN MANHATTAN. The Medical Risk Adjustment Coder is responsible for reviewing and abstracting diagnosis codes from medical records to ensure accurate and complete capture of patient risk profiles. This role supports risk adjustment programs (e.g., Medicare Advantage, ACA, Medicaid) by identifying and coding Hierarchical Condition Categories (HCCs) in compliance with official coding guidelines, payer requirements, and CMS regulations. Key Responsibilities • Review medical records to identify, abstract, and assign accurate ICD-10-CM diagnosis codes for risk adjustment, • Ensure coding is in compliance with CMS, HHS, and official coding guidelines (ICD-10-CM, HCC, and MEAT criteria), • Validate documentation supports submitted diagnosis codes for risk adjustment models (HCC, CDPS, etc.), • Collaborate with providers and clinical teams to clarify documentation and support accurate coding, • Meet or exceed productivity and accuracy benchmarks as set by the organization, • Maintain current knowledge of coding guidelines, risk adjustment models, and payer policies, • Certified Professional Coder (CPC), Certified Risk Adjustment Coder (CRC), or equivalent (e.g., CCS, CCS-P), • 2+ years of ICD-10-CM coding experience, preferably in risk adjustment or outpatient setting, • Strong understanding of risk adjustment methodologies (e.g., CMS-HCC, HHS-HCC, CDPS), • Proficiency in EHR and coding software systems, • Strong attention to detail and analytical skills, • Ability to work independently and meet deadlines in a production-based environment

Job Description Medical Coder: OBGYN and Urology M&D Capital is a leading third-party Medical Billing and Revenue Cycle Management company serving clients across the United States. We operate offices across multiple states, along with a growing international team. We specialize in out-of-network surgical claims, and partner directly with our clients to ensure the maximum reimbursement for their services. Our rapidly growing organization provides employees with generous opportunities for professional growth and advancement. We’re looking for talented, dedicated employees who are eager to grow and contribute to our success. If you meet the qualifications below, we encourage you to apply. Key Responsibilities -Surgical procedures performed by OB/GYN physicians such as hysterectomy, biopsies, colpopexy, etc. -Endometriosis • Review and accurately code E/M visits and office procedures., • Able to work independently and research coding scenarios., • Coder is responsible for meeting our daily production goal and our quality goal of averaging 95% accuracy rate on a consistent basis., • Attend conference calls as necessary to provide information and/or feedback., • Communicate with leadership on coding or documentation issues/trends., • Stay current on all coding guidelines (to include orthopedic-specific guidelines) and maintain credentials as necessary., • Participate in coding department and education meetings., • Flexible to expand coding skill set into other specialties altogether., • Maintain confidentiality and protect sensitive information., • Other duties as assigned by leadership. Education/Experience Requirements • High School diploma required. Associates or BS degree preferred. Benefits M&D Capital offers our employees a comprehensive benefits package, including health, dental, vision, employee assistance plan, paid family leave, short-term disability and life insurance. We also provide a 401(k) plan with employer match, flexible spending accounts, employee discount program and an employee referral program. Company DescriptionM&D Capital maintains an exciting and energetic culture with opportunity for personal and professional growth and advancement. We work closely with all our staff in order to enhance their skills and grow the scope of their responsibilities, through training and support from every member of our company up to and including those at the executive level. If you meet the qualifications below, we invite you to join our team.M&D Capital maintains an exciting and energetic culture with opportunity for personal and professional growth and advancement. We work closely with all our staff in order to enhance their skills and grow the scope of their responsibilities, through training and support from every member of our company up to and including those at the executive level. If you meet the qualifications below, we invite you to join our team.

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! Preferred: SDS/OBV coder for highly complex ambulatory surgery procedures. Must have a CCS. Experience in EPIC/3M360 preferred. Attention to detail critical as looking for total quality. 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., • Be willing and able to travel when necessary if applicable. Preferred: SDS/OBV coder for highly complex ambulatory surgery procedures. Must have a CCS. Experience in EPIC/3M360 preferred. Attention to detail critical as looking for total quality. • Excellent written and verbal communication skills, • 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., • Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually, • Proficiency with most or all of these coding specialties (Emergency Department, Same Day Surgery, Ancillary, Observation, Injections/Infusions, E/M leveling), • Must be able to communicate effectively in the English language., • 2+ years of coding experience in a hospital and/or coding consulting role., • Experience in computerized encoding and abstracting software, • 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 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 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! Preferred: SDS/OBV Coder. EPIC and 3M360 experience a plus. Observation coding requires I&I experience. SDS includes but not limited to Interventional radiology, transplant surveillance, gynecology, ophthalmology, ortho, ENT, EGD and colonoscopies, urology, pacemaker/AICD, Trauma, plastic surgery.* 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., • Be willing and able to travel when necessary if applicable. Preferred: SDS/OBV Coder. EPIC and 3M360 experience a plus. Observation coding requires I&I experience. SDS includes but not limited to Interventional radiology, transplant surveillance, gynecology, ophthalmology, ortho, ENT, EGD and colonoscopies, urology, pacemaker/AICD, Trauma, plastic surgery.* • Excellent written and verbal communication skills, • 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., • Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually, • Proficiency with most or all of these coding specialties (Emergency Department, Same Day Surgery, Ancillary, Observation, Injections/Infusions, E/M leveling), • Must be able to communicate effectively in the English language., • 2+ years of coding experience in a hospital and/or coding consulting role., • Experience in computerized encoding and abstracting software, • 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 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 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, • 3 recent years of HCC / Risk Adjustment and/or inpatient coding are highly preferred, • 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. 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: A STRONG Observation coder. Must have hospital observation coding experience and surgery coding experience. MUST have heavy injection and infusion coding experience and needs to have Academic/Trauma Level 1 facility coding experience. Systems are Cerner/3M.* 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., • Be willing and able to travel when necessary if applicable. Preferred: A STRONG Observation coder. Must have hospital observation coding experience and surgery coding experience. MUST have heavy injection and infusion coding experience and needs to have Academic/Trauma Level 1 facility coding experience. Systems are Cerner/3M. • Excellent written and verbal communication skills, • 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., • Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually, • Proficiency with most or all of these coding specialties (Emergency Department, Same Day Surgery, Ancillary, Observation, Injections/Infusions, E/M leveling), • Must be able to communicate effectively in the English language., • 2+ years of coding experience in a hospital and/or coding consulting role., • Experience in computerized encoding and abstracting software, • 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 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 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 Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in translating clinical documentation into precise codes that reflect the complexity and severity of a patient's health stats, You will: • Provide education through detailed feedback within audits., • Provide coders' on-going education for any identified missed/incorrect ICD-10 codes or incorrect/missing/inappropriate client-based notes., • Maintain communication with both Coders as well as management on errors, trends, educational opportunities, etc., • Minimum 3 years of HCC coding experience, • Minimum 2 years of HCC Auditing experience, • High school diploma or GED equivalent, • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC)., • Proficient in ICD-10 coding., • Experienced in HCC coding across Medicare, commercial, and Medicaid sectors., • In-depth knowledge of medical terminology, abbreviations, pharmacology, and disease processes., • Ability to excel in a fast-paced production environment while upholding high-quality standards., • Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills., • Comprehensive health, dental, and vision insurance, • Paid time off (PTO) plan, • Retirement savings plan, • Flexible work arrangements, • Opportunities for career growth and development 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 DescriptionPosition Summary At MedReview, our mission is to bring accuracy, accountability, and clinical excellence to healthcare. As such, we are a leading authority in payment integrity solutions including DRG Validation, Cost Outlier and Readmission reviews. Under the direction of the DRG Operations Department leaders, the DRG Reviewer will conduct reviews of inpatient claims for both coding accuracy as well as perform screening referrals for clinical support of coded diagnoses. Responsibilities: • Analyze and review inpatient claims following the Official Coding and Reporting Guidelines to validate the reported ICD-10-CM/PCS codes to ensure proper DRG assignment for accurate billing., • Demonstrates the ability to perform a comprehensive initial review as outlined in the standard operating procedures and departmental guides., • Collaborates with physician reviewers, as needed., • Ability to prioritize and organize workload and complete tasks independently., • Required attendance of all departmental team meetings and/or training., • Report productivity daily utilizing department productivity report., • Meet/exceed daily productivity expectations., • Maintains 95% accuracy in claim reviews., • Required to work a 7.5-hour workday within the company’s core hours., • Coding Certification required (at least one of the following is required and must be maintained as a condition of employment)., • Certified Coding Specialist (CCS), • Certified Inpatient Coder (CIC), • Registered Heath Information Technician (RHIT), • College level courses in medical terminology, anatomy, pathophysiology, pharmacology, and medical coding courses., • At least 3 years’ experience in MS-DRG and APR-DRG validation in acute care inpatient coding, auditing. Payment integrity DRG validation is a plus., • Adherence to the Official Coding and Reporting guidelines, AHA Coding Clinic determinations, and CMS and other regulatory compliance guidelines and mandates., • Requires working knowledge of applicable industry-based standards., • Proficiency in Outlook, Word, Excel, and other applications., • Excellent written and verbal communication skills., • Maintain professional credentialed status with approved continuing education programs, • Ability to work independently and can multi-task or transition to different tasks easily. Remote Work Requirements: • High speed internet (100 Mbps per person recommended) with secured WIFI., • A dedicated workspace with minimal interruptions to protect PHI and HIPAA information., • Healthcare that fits your needs - We offer excellent medical, dental, and vision plan options that provide coverage to employees and dependents., • 401(k) with Employer Match - Join the team and we will invest in your future, • Generous Paid Time Off - Accrued PTO starting day one, plus additional days off when you’re not feeling well, to observe holidays., • Wellness - We care about your well-being. From Commuter Benefits to FSAs we’ve got you covered. IsCqOBvtBa

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. 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. Artificial Intelligence (AI) Guidelines: Please see our AI Guidelines for the acceptable use of artificial intelligence during the interview process at Oscar. 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 Notice to Job Applicants.

Job Description Professional Coder General Surgery (2) This is a full-time, remote position that offers a flexible schedule. We are currently looking for candidates with experience specializing in the following area: General Surgery. Responsibilities: • Review and accurately code cases to maximize reimbursement in a timely manner., • Review and accurately code E/M visits and office procedures., • Able to work independently and research coding scenarios., • Coder is responsible for meeting our daily production goal and our quality goal of averaging 95% accuracy rate on a consistent basis., • Attend conference calls as necessary to provide information and/or feedback., • Communicate with leadership on coding or documentation issues/trends., • Stay current on all coding guidelines (to include orthopedic-specific guidelines) and maintain credentials as necessary., • Participate in coding department and education meetings., • Flexible to expand coding skill set into other specialties altogether., • Maintain confidentiality and protect sensitive information., • High School diploma required. Associates or BS degree preferred.

Job Description WHO WE’RE LOOKING FOR Spectrum Vision Partners (“SVP”) and OCLI Vision (“OCLI”) work together to provide world class eye care to our patients to improve lives. SVP, the management services team, supports OCLI vision, one of the largest multi-specialty ophthalmology networks in the U.S. Our unique model and collaborative culture differentiate us in the marketplace and in our service to our patients. We build our culture one hire at a time. We want to build a great team that helps us focus on delivering exceptional eye care: the kind of team people want to be a part of, and the kind of team our patients can’t live without. We want to learn more about you and the kind of team culture you can help us create. We’re interested in your relevant skills and what you can do. We’re even more interested in your positive attitude and flexible mindset! THE OPPORTUNITY AT HAND The Manager, Compliance Audit oversees, monitors, audits and conducts education activity for clinical services related to billing activity across the enterprise in accordance with the Compliance Program. You’ll ensure accurate and complete documentation, real-time monitoring, regulatory based education, and corrective action plans. You’ll ensure ongoing compliance with federal and state regulations and provide guidance and tools to assist departments in developing monitoring programs. You’ll serve as a front-line resource to our clinics and be their role model for ethical behavior and will promote an awareness and understanding of the corporate compliance program. OUR EXPECTATIONS OF YOU Identify trends in revenue cycle activities, including payments, denials, billing, coding and/or documentation errors and recommend action plans to address deficiencies Conduct prospective and retrospective compliance documentation audits. Designs tools and methodologies for conducting audits. Tracks and trend result of audits. Track and analyze physician coding patterns and documentation. Prepares and presents reports on audit results, and maintains adequate documentation related to such and maintains integrity of the documentation whether in paper or electronic format Prepare written reports summarizing billing compliance investigations/inquiries, for review, and approval Develop, prepare and present reports related to billing trends, corrective actions, and compliance metrics Perform routine and special compliance audit and monitoring as deemed necessary, including but not limited to, the management sanction/exclusion screening, OMIG, CMS, and OIG compliance, and payer compliance Participate in the development and implementation of the annual compliance risk assessment and work plan as it relates to coding, billing, documentation initiatives Manage Specialist, Billing Compliance Audit Reviews the implementation of corrective action plans. Identifies trends in billing, coding and documentation errors and recommends corrective action plans. Monitors implementation and effectiveness of corrective action plans Develops compliance policies and procedures related to billing, workflows and training materials, and orients and trains employees and providers on such Stays abreast of industry developments pertaining to billing compliance, including OIG, OMIG, CMS WHAT YOU’LL NEED TO SUCCEED Bachelor's Degree or equivalent combination of education and related experience (10 years) Must have 5+ years of experience in medical coding and 3+ years of auditing experience Must have at least 2 years of experience in compliance department Must have at least 2+ years of experience managing staff Must be detail oriented and skilled at Microsoft Office Suite of products Ability to prioritize and plan work independently with strong project management skills Knowledge of Fraud Waste and Abuse Laws Proficiency in auditing providers and auditors and conducting education feedback sessions. Proficiency in identifying regulatory source for documentation guidance. Must be analytical, trustworthy, and be a strong team player Certified Professional Coder Certificate (CPC) required Certifications in healthcare compliance and/or health care privacy, preferred WHO WE ARE Our globally recognized healthcare team is comprised of some of the top minds in ocular medicine. Our senior management team has a combined 200 years of eye industry experience collaborating with some of the most recognized practices in the nation. While our providers have the expertise to diagnose and treat complex ocular, oculoplastic, and retinal conditions, we’re also uniquely qualified to provide care for our patients from childhood though adulthood. We build relationships with our patients that last a lifetime With nearly 1,400 employees, we support over 50 clinic locations, five state-licensed ambulatory surgery centers, and over 110 surgeons, doctors, and other medical professionals. Our brands include OCLI Vision, Island Eye Surgi-center, New Vision Cataract Center, AIO, and others. At Spectrum Vision Partners we know that cultivating diversity and fostering an inclusive work environment is critical to our impact and success. We create an environment where no individual is advantaged or disadvantaged because of their background. We offer equal opportunity employment regardless of race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability status, age, marital status, or protected veteran status. With a commitment to maintaining a bias-free environment in which harassment is prohibited, we respect cultural diversity and comply with the laws of the places in which we operate. We expect our business partners, suppliers, clients, and all of our team members to uphold these commitments.

AAPC Coding certification - Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA) or Certified Coding Specialist (CCS) - Required. Collaborate with other SIU team members to evaluate suspected cases of fraudulent activities, such as over-utilization of services, upcoding,

Certified Coder - Neurology Associates of Stony Brook, UFPC. Certified Professional Coder (CPC) Certification.

The College actively seeks applications from women, veterans, individuals with disability, members of underrepresented groups, or anyone that would enrich the diversity of the College. Since we opened our doors to our first class of students in 1971, the College has grown to become one of the leadin

We are highly regarded NYC Outpatient Healthcare Organziation with Locations Throughout the City. Certified Professional Coder (CPC). Amazing NYC Outpatient Healthcare Organization is Looking to Hire a Manager of Medical Coding and Billing!.

Current certification in any of the following: Certified Coding Specialist (CCS), Certified Coding Specialist Physician-based (CCS-P) or Certified Professional Coder (CPC). Reporting to the Director of Patient Financial Services, the Certified Professional Coder will be responsible for the review of