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Job Title : Certified Medical Coder Location : 1400 Pelham Parkway South, Jacobi Medical Center, Bronx, NY 10461 Duration : 2 Months long Project Education : High School Diploma/GED, AHIMA, RHIA or RHIT and/or CCP, CCS Shift Details : This role is remote now, with 1–2 weeks of onsite training at the start - The Hiring Manager is flexible. Job Description : Scope of Role & Responsibilities: • Medical coding in an acute care setting., • Must possess proficient computer skills (e.g., MS Word, Excel, ICD 9 CM, CPT 4, Encoder), • Knowledge of coding guidelines, payor guidelines, federal billing guidelines., • Knowledge of anatomy, physiology & disease processes., • Ability to research coding related issues., • Competence in coder training., • Must have CCS and knowledgeable with 3M/HDS coding application., • Outpatient and ED experience.

Job Overview We are seeking a skilled and detail-oriented Medical Coder with strong experience in acute care, outpatient, and emergency department (ED) coding. This role begins with 1–2 weeks of onsite training and transitions to a fully remote position once proficiency is demonstrated. The ideal candidate will be certified, experienced, and capable of working independently with minimal supervision. Key Responsibilities • Perform accurate medical coding for acute care, outpatient, and emergency department cases, • Apply appropriate ICD-9-CM, CPT-4, and coding guidelines, • Ensure compliance with payor guidelines and federal billing regulations, • Utilize coding tools such as Encoder and 3M/HDS applications, • Review clinical documentation to assign appropriate codes, • Research and resolve coding-related issues, • Maintain coding accuracy and productivity standards, • Support coder training and knowledge sharing when needed Required Qualifications • Certification required: CCS, RHIA, RHIT, or equivalent (from AHIMA), • Minimum 4+ years of outpatient coding experience, • Strong experience in Emergency Department (ED) coding, • Hands-on experience with EPIC and 3M coding systems, • Proficiency in:, • ICD-9-CM and CPT-4 coding, • MS Word and Excel, • Solid understanding of:, • Anatomy, physiology, and disease processes, • Coding compliance and billing regulations, • Ability to work independently with minimal training Preferred Qualifications • Strong inpatient coding background, • Prior experience training or mentoring coders, • Familiarity with multiple healthcare systems or hospital environments Benefits: Pride Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

Apply today! Job Description Must have a minimum of 3 years of Inpatient or Outpatient Facility or Physician Based Coding Experience **Must have one or more of the following; (CCS, RHIT, RHIA, CPC, COC, CCS-P) We have immediate openings for Hospital Coders. Advanced knowledge of hospital informa

Risk Adjustment Medical Coder Location: Remote Schedule: Monday–Friday, 9:00 AM – 5:00 PM Position Overview Join a growing Risk Adjustment team at a pivotal time of expansion. We are seeking an experienced Risk Adjustment Coder & Audit

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 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: Facility Outpatient Coder with a specialization in claim edits and denials. Qualified candidates will have 3+ years of coding experience, experience with multispecialty coding, and the ability to consistently meet performance standards. Proficiency with Microsoft applications and the ability to navigate multiple facility systems. *** What You Will Do: • Review medical records and assign accurate codes for diagnoses and procedures., • Assign and sequence codes accurately based on medical record documentation., • Assign the appropriate discharge disposition., • Abstract and enter the coded data for hospital statistical and reporting requirements., • Communicate documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution., • Maintain a 95% coding accuracy rate and a 95% accuracy rate for APC assignment and meet site-designated productivity standards., • Be responsible for tracking continuing education credits to maintain professional credentials., • Attend Datavant Health sponsored education meetings/in-services., • Demonstrate initiative and judgment in the performance of job responsibilities., • Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues., • Function in a professional, efficient, and positive manner., • Adhere to the American Health Information Management Association's code of ethics., • Be customer-service focused and exhibit professionalism, flexibility, dependability, and a desire to learn., • Handle a high complexity of work function and decision-making., • Possess strong organizational and teamwork skills. What You Need to Succeed: • AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC)., • 2+ years of coding experience in a hospital and/or coding consulting role., • Proficiency with most or all of these coding specialties (Same Day Surgery, Observation, Injections/Infusions), • Proficiency with most or all of these coding specialties (Ancillary, Emergency Department, Injections/Infusions, E/M leveling), • Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills., • Experience in computerized encoding and abstracting software., • Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually, • Experience in computerized encoding and abstracting software What We Offer: • Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays, • Benefits for PRN employees: 401k savings plan w/match, • Free CEUs every year, • Stipend provided to assist with education and professional dues (AHIMA/AAPC), • Equipment: monitor, laptop, mouse, headset, and keyboard, • Comprehensive training led by a credentialed professional coding manager, • Exceptional service-style management and mentorship (we're in this together!) Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is:$20—$35 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 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. 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 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. 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, • 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). 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 DescriptionCertified Medical Coder – Outpatient & Emergency Department Location: Bronx, NY Pay Rate: • Local: $30 – $37/hour, • 5 Days/Week, • Day Shift: 08:00 AM – 04:00 PM The position begins with 1–2 weeks of onsite training, followed by a remote work arrangement, offering flexibility while maintaining high productivity standards. Key Responsibilities • Assign accurate ICD-10, CPT, and HCPCS codes for outpatient and ED encounters, • Review and analyze medical records for completeness and accuracy, • Ensure compliance with federal regulations and payer-specific guidelines, • Utilize coding systems such as EPIC and 3M/HDS, • Research and resolve coding discrepancies, • Maintain strong knowledge of anatomy, physiology, and disease processes, • Collaborate with team members and support coder training initiatives, • Work independently with minimal supervision post-training, • Meet productivity and quality benchmarks in a remote environment, • High School Diploma or GED required, • Minimum 4+ years of outpatient coding experience, • Emergency Department (ED) coding experience required, • Hands-on experience with EPIC and 3M/HDS coding systems, • Inpatient coding experience preferred For more details contact at or Call / Text at 516-806-4227. About Navitas Healthcare, LLC 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 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: This is a remote position, open to candidates who reside in: Arizona; Florida; Georgia; Illinois; Iowa; Kansas; Michigan; Missouri; Nebraska; New Jersey; North Carolina; Ohio; Oklahoma; Pennsylvania; South Carolina; Tennessee; Texas; or Virginia. While your daily work will be completed from your home office, occasional travel may be required for team meetings and company events. Pay Transparency: The base pay for this role in the states of New Jersey and New York is: $65,412 - $85,853 per year. The base pay for this role 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 Duties: Medical coding in an acute care setting; must possess proficient computer skills (e.g., MS Word, Excel, ICD 9 CM, CPT 4, Encoder); knowledge of coding guidelines, payor guidelines, federal billing guidelines; knowledge of anatomy, physiology & disease processes; ability to research coding related issues; competence in coder training; must have CCS and knowledgeable with 3M/HDS coding application. Inpatient and ED experience. This is the pay range that Right Sourcing reasonably expects to pay someone for this position, however, as a supplier your expected pay range may vary and/or include certain benefits like: Medical, Dental, Vision, 401K [include any compulsory benefits such as commissions, incentive bonuses, etc. if applicable]. Skills: Three years experience Knowledge of ICD10 Education: High School Diploma/GED, AHIMA, RHIA or RHIT and/or CCP, CCS, Schedule Notes: This role is remote now, with 12 weeks of onsite training at the start - The Hiring Manager is flexible. Experience Requirements: Must have EPIC and 3M experience CCS or CPC certification required. Ideal candidate has both inpatient and outpatient coding experience. Work Arrangement: Starts onsite for training, then transitions to remote work once duties are mastered. Additional Notes: Seeking certified coders with strong Outpatient and ED coding background. Candidate should be able to work with minimal training.

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. 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! Seeking: PRN IP Audit Specialist 3+years' experience. Experience with Streamline evaluator, Cerner, 3/m a plus. Will be responsible for onboarding and monthly IP coding QA; CCS certification. 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). 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 Hi, we're Oscar. We're hiring a SIU Investigator to join our SIU team. Oscar is the first health insurance company built around a full stack technology platform and a relentless 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 SIU Investigator identifies and investigates aberrant behavior observed in medical claims data and member enrollment data. You will manage an investigative caseload from case identification through to resolution, including data mining, investigation planning, data analysis, sampling, medical records requests, audit interpretation, overpayment recovery, reporting to regulatory agencies and monitoring ongoing provider behavior. The Senior Analyst will meet metrics set forth related to caseload, turn around times, and other unit-wide goals. You will report into the Investigations Manager, SIU. Work Location: This is a remote position, open to candidates who reside in: Arizona, Florida, Georgia, Illinois, Iowa, Kansas, Michigan, Missouri, Nebraska, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and Virginia. You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. If you live within commutable distance to our New York City office (in Hudson Square) or our Tempe office (off the 101 at University Ave), you will be expected to come into the office at least three days each week. Otherwise, this is a remote / work-from-home role. Thursdays are a required in-office day for team meetings and events, while your other two office days are flexible to suit your schedule. The base pay for this role in the states of New Jersey and New York is: $72,036 - $94,546 per year. The base pay for this role in all other locations is: $64,832 - $85,092 per year. You are also eligible for employee benefits, participation in Oscar's unlimited vacation program and annual performance bonuses. Responsibilities: • Identify and conduct investigations into suspected FWA with high autonomy, • Document findings to include formal investigative reports, tables, graphs, audit logs, and other supporting documentation, • Met metrics to align with caseload, turn around times, and other unit-wide goals, • Continue to monitor providers with substantiated findings to track behavior change, • Participate in the development and presentation of FWA-related education for Oscar teams, • Build evidentiary files for potential recovery, legal action, and/or referrals to appropriate outside agencies, • Compliance with all applicable laws and regulations, • 3+ years of healthcare fraud investigation experience or professional investigation experience with law enforcement agencies, • Bachelor's degree in Criminal Justice or a related field, • Experience with HIPAA, data privacy, and/or data security processes, • Certified Fraud Examiner (CFE), Accredited Healthcare Fraud Investigator (AHFI), Certified AML [Anti-Money Laundering] and Fraud Professional (CAFP), or similar 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 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. 2,500 Sign on Bonus* 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; CCS certification. 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. 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.

Key Responsibilities: - Review and accurately assign medical codes to patient records using ICD-10 and CPT coding systems - Ensure all codes are in compliance with coding guidelines and regulations - Work closely with healthcare providers to clarify any coding discrepancies - Maintain a thorough und

Continuing Medical Education (CME) - Receive an annual stipend for continuing medical education. One Medical providers also demonstrate:. Free One Medical memberships for yourself, your friends and family.

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