Trabajos medical coder en Boston, MassachusettsCrear alertas

3-6 Month - Remote - Medical Coder W2 Candidates Only $35-$40/hr • Must have strong experience with RADV, • Must comfortable code for Government and State Models, • Coders assist with code abstraction and coding quality audits using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and procedures, • Current core coding credentials through AHIMA or AAPC

Job Description The Coding Network (TCN) is looking to contract with an Ophthalmology E&M coder to perform the Ophthalmology E&M coding for a number of clients throughout the country. The coder will access the operation reports via a remote connection to the client's EMR and return the coded cases. Hours can range from a 15-40 hour/week commitment. NOTE: We do not have needs for surgical Ophthalmology at the moment, our current needs are for E&M only. If you are a coder with non-ophthlamology coding experience please apply directly at our website All applicants must: · Have a minimum of 3 years of Ophthalmology E&M Specific Coding · Have an active coding certification (CPC, RHIA, RHIT) · Live and work in the · Take and pass TCN’s Ophthalmology E&M Coding Exam If you meet the above criteria and are willing to test please submit your resume. Job Types: Full-time, Part-time, Contract Work Location: Remote Company DescriptionTCN has been providing specialty specific medical coding for over 20 years. TCN's 800+ US based coders cover over 55 medical specialties and subspecialties for clients in all 50 states. For more information visit has been providing specialty specific medical coding for over 20 years. TCN's 800+ US based coders cover over 55 medical specialties and subspecialties for clients in all 50 states. For more information visit

Job Description Shift is the leading AI platform for insurance. Shift combines generative, agentic, and predictive AI to transform underwriting, claims, and fraud and risk - driving operational efficiency, exceptional customer experiences and measurable business impact. Trusted by the world's leading insurers, Shift delivers AI when and where it matters most, at scale and with proven results. Our culture is built on innovation, trust, and a drive to transform the insurance industry through our SaaS platform. We come from more than 50 different countries and cultures and together we are creating the future of insurance. As part of our US Healthcare Payment Integrity and Customer Success organization, you will leverage deep technical and clinical coding expertise to design, implement, and support payment integrity solutions that improve claim payment accuracy. You will partner with customers, product, and engineering teams to develop actionable edit logic, perform audits, and drive continuous improvement to reduce waste and help customers recover overpayments. What you'll do • Serve as a subject matter expert on claim payment accuracy across pre-pay and post-pay workflows, including claim editing, audits, compliance, and recovery processes., • Define, validate, and operationalize claim edit logic and payment integrity rules (pre-pay edits, post-pay analytics, recovery workflows) to maximize accuracy and value for customers., • Perform coding and clinical audits (inpatient, outpatient, professional) validating ICD, CPT, HCPCS, Revenue Codes, APR/DRG, POA, modifiers, and other relevant elements., • Support customer appeals and clinical/policy reviews by assessing appropriateness of billed services/supplies and recommending commercially reasonable edits or recovery actions., • Regularly review payer policies and external benchmarks to identify gaps in the edit library; propose and lead development of new edit concepts and remediation plans., • Collaborate with Product, Data Science, and Engineering on tooling, rule deployment, testing, and troubleshooting; participate in UAT and release activities., • Manage multiple audits, projects, and customer inquiries with minimal supervision; produce clear, actionable documentation and executive-level summaries., • 5+ years experience in healthcare claims, provider/hospital billing, revenue cycle, or health plan payment integrity., • 3+ years as a certified medical coder in a payer, provider, or RCM environment., • Strong working knowledge of Medicare, Medicaid, Medicare Advantage, Part D, TRICARE, commercial payers, and related regulations., • Demonstrated expertise auditing for coding accuracy and completeness (ICD, CPT, HCPCS, revenue codes, APR/DRG, POA)., • Proven analytical and problem-solving skills, with ability to synthesize data into reliable, business-relevant insights., • Excellent written and verbal communication skills; able to compose sensitive, non-routine correspondence and present findings to clinical and non-clinical stakeholders., • Bachelor's degree in healthcare administration, business, or related field, or equivalent experience (5-10)., • Certified medical coding credentials required (CPC and/or CCS preferred; CCA, CIA, or equivalent acceptable). In addition to base salary, your total rewards package will include additional components such as incentive pay, equity, and benefits. If you're interviewing for this role, speak with your Talent Acquisition Partner to learn more about the specific details for this position. US Base Salary Pay Range$85,000—$110,000 USD To support our permanent, full time employees at every stage of their careers and lives, we provide a competitive total rewards and benefits package. Here are the global benefits we'd like to highlight: • Flexible remote and hybrid working options, • Competitive Salary and a variable component tied to personal and company performance, • Company equity, • Multiple Learning and Development opportunities, including Focus Fridays, a half-day each month to focus on learning and personal growth, • Generous PTO and paid holidays, • Mental health benefits At Shift we strive to be a diverse and inclusive workforce. We welcome applications from and hire people who will contribute to the diversity of our company, without regard to race, color, religion, marital status, age, national or ethnic origin, physical or mental disability, medical condition, pregnancy, genetic information, gender identity or expression, sexual orientation, or other non-merit criteria. Shift Technology is committed to providing reasonable accommodations for qualified individuals with disabilities in our application and employment process. Should you require accommodation, please email and we will work with you to meet your accessibility needs. Please be aware of scammers and only trust correspondence that comes from emails ending in "shift-technology.com". We will never do initial outreach to you via Whatsapp/Text/SMS, never ask for banking information or personal identification numbers (ex. Social Security Number) as part of our recruitment process. Shift Technology does not accept unsolicited CVs from recruiters or employment agencies in response to the Shift Technology Careers page or a Shift Technology social media post. Any unsolicited CVs, including those submitted directly to hiring managers, are deemed to be the property of Shift Technology.