Clinic Coder II Job at American Nursing Care (Omaha)

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Clinic Coder II

As a Coder, you will ensure precise communication with insurance companies so th...

Location

United States , Omaha

Salary:

20.86 - 29.46 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

Certified Professional Coder, upon hire
Certified Professional Coder Hospital Apprentice, upon hire
Certified Professional Coder Apprentice, upon hire
Certified Coding Associate, upon hire
Cardiology Coding, upon hire
Certified Coding Specialist, upon hire
Certified Coding Specialist - Physician Based, upon hire
Certified Cardiovascular and Thoracic Surgery Coder, upon hire
Certified Health Care Compliance, upon hire
Certified Interventional Radiology Cardio Coder, upon hire

Job Responsibility

Accurately abstract information from the medial records into the appropriate coding systems, ensuring compliance with established guidelines
Determine the most appropriate diagnosis after a thorough review of the medical records. Work closely with practice staff with regards to coding and assignment of a MS-DRGs (Diagnosis Related Group) and APCs (Ambulatory Payment Classification)
Code medical records using ICD-9-CM and CPT-4 coding rules and guidelines. Ensure through and compliant coding to support patient records and submission of billing for payment
Accurately sequence diagnostic and procedural codes according to organization specified procedures and assigns MSDRG/APC as appropriate. Provide codes various departments upon request
Enter and validate charges using appropriate tools and validates diagnoses with the medical documentation provided
Compare charges on accounts with the procedures coded and identifies any discrepancies. Notify Coding Manager of any discrepancies and collaborates as needed to rectify the account

What we offer

medical
prescription drug
dental
vision plans
life insurance
paid time off (full-time benefit eligible team members may receive a minimum of 14 paid time off days, including holidays annually)
tuition reimbursement
retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings

Fulltime

Value Based Coder II

The Value Based Coder II is an experienced professional within the Quality Manag...

Location

United States , Houston

Salary:

25.30 - 35.74 USD / Hour

American Nursing Care

Expiration Date

Until further notice

Requirements

Bachelor’s degree in healthcare or equivalent work experience and/or 5 years of related job or industry experience in lieu of degree
Certified Professional Coder (CPC) from AAPC, OR Certified Coding Specialist (CCS) from AHIMA, OR Certified Risk Adjustment Coder (CRC) from AAPC
2+ years of experience in outpatient coding
2+ years focused on risk adjustment and HCC principles
Advanced knowledge of CPT and ICD-10 coding, with significant expertise in HCC coding guidelines and risk adjustment models
Strong understanding of federal and state guidelines on all coding systems and sponsored programs
Proficiency in developing and delivering educational content
Effective interpersonal, communication, and presentation skills (both verbal and written)
Ability to manage multiple priorities and work independently
Computer literacy in medical information systems, records management software, and encoder software

Job Responsibility

Comprehensive Record Review & HCC Expertise: Independently review patient medical record information via population health tools on both a retroactive and prospective basis to identify, assess, monitor, and review network coding opportunities as it pertains to risk adjustment and HCC
Validate the accuracy and completeness of HCC documentation and coding
Advanced Documentation Improvement & Education: Analyze clinical documentation across the network to identify patterns, trends, and opportunities for improvement related to HCC capture
Develop and deliver effective education materials and tools to help network providers improve clinical documentation and support Hierarchical Condition Category coding capture
Provide targeted provider 1:1 education on documentation best practices, HCC guidelines, and risk adjustment principles
Compliance & Regulatory Insight: Continuously monitor and interpret evolving HCC coding guidelines, CMS regulations, and compliance trends within the risk adjustment landscape, applying this knowledge to daily coding and education efforts
Champion a culture of compliance by advocating for best practices and providing robust provider support to ensure CommonSpirit adheres to all federal and coding guidelines pertaining to HCC and risk adjustment
Safeguard medical records and preserve the confidentiality of personal health information through adherence to all relevant policies
Process Improvement & Collaboration: Actively participate in network performance improvement initiatives, offering insights and solutions based on coding expertise
Collaborate with providers and office staff to address documentation deficiencies and coding gaps

What we offer

medical
prescription drug
dental
vision plans
life insurance
paid time off
tuition reimbursement
retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings

Fulltime

Clinical Policy Clinical Coder Rn Ii

The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpret...

Location

United States , Los Angeles

Salary:

102183.00 - 163492.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing
At least 8 years of experience in Clinical Nursing
At least 3 years of experience with Medi-Cal and Medicare in a managed care environment
Experience in performing and creating clinical documentation
Experience in regulatory compliance for a health plan
Experience with medical coding systems
Proficient with clinical policy through skills in literature searching and clinical research analysis based on the best available evidence
Working knowledge of clinical policies
Working knowledge of CPT/HCPC codes and claims
Ability to translate regulatory requirements into auditable tools

Job Responsibility

Translate approved clinical policies and utilization management criteria into clear, codified claims rules and system logic to support accurate claims adjudication
Develop, revise, and recommend clinical policies and internal utilization management criteria when standard clinical guidelines are insufficient to support appropriate decision-making based on codified claim rules
Assess the downstream claims impact of new or revised clinical policies prior to implementation and recommend configuration updates to mitigate operational or financial risk
Participate in validation of claims configuration changes to ensure policies are applied correctly and consistently across all lines of business
Monitor post-implementation claims activity to identify configuration issues, unintended denials, or payment discrepancies related to clinical policy application
Support remediation of claims configuration defects by identifying root causes and coordinating corrective actions with internal teams
Participate in and lead specialty and cross-functional workgroups and committees focused on healthcare services clinical policies, utilization management processes, strategic initiatives, policy governance, operational alignment, and continuous improvement efforts
Ensure timely dissemination of accurate and consistent policies and procedures across departments
Promote collaboration, engagement, and a positive work environment while supporting departmental initiatives and team-based activities
Manage assigned projects from concept through implementation, ensuring timelines, quality standards, and deliverables are met

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Compliance Analyst II

As a community, the University of Rochester is defined by a deep commitment to M...

Location

United States of America , Rochester

Salary:

63815.00 - 95723.00 USD / Year

University of Rochester

Expiration Date

Until further notice

Requirements

Bachelor or Associate’s degree in a related field preferred
Equivalent combination of education, professional certification(s), and substantial relevant experience will also be considered
Minimum of 3 years of healthcare coding experience required to include APG, APC, and/or DRG coding methodologies or professional coding and billing in specialty areas
Experience in a direct or supporting role within healthcare compliance preferably within an integrated health system or Academic Medical Center or other comparable setting
Strong communication, interpersonal, and public speaking skills required
Ability to efficiently produce clear, concise, and complete written audit reports required
Excellent analytical, organizational, and problem-solving skills required
Demonstrated objectivity and critical thinking in analyzing situations
must be able to evaluate facts without bias and avoid unsupported assumptions required
Ability to manage projects and effectively advise staff in a motivational and positive manner required

Job Responsibility

Provides compliance oversight and support for assigned clinical specialties across URMC and Affiliates in accordance with the OIG and OMIG compliance program guidance
Evaluates adherence to coding and billing regulations and guidelines through review, research, and analysis
Serves as a compliance resource, developing and delivering comprehensive education and training
Conducts investigations, risk assessments, and regulatory monitoring to prevent and detect fraud, waste, and abuse, specifically addressing the DRA, NY SSL § 363-d, and 18 NYCRR SubPart 521
Analyzes billing data to identify potential risk areas related to professional and/or facility payment systems
Performs audits of medical record documentation to ensure compliance with coding and billing requirements as defined by AMA, AHA, HCPCS, CMS and Medicaid guidelines
Creates and provides reports on findings to relevant stakeholders
Responds to reported compliance concerns by conducting formal investigative activities
Performs root cause analysis when deficiencies are identified
Collaborates with relevant stakeholders to determine improvement opportunities to mitigate future risk

Fulltime

Hcc coder

We are looking for experienced HCC Coders to join our team in Ambattur, Chennai....

Location

India , Chennai

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Strong background in medical coding
High attention to detail and accuracy
Sound knowledge of ICD10 CM, CPT, HCPCS, and HEDIS CAT II codes
Commitment to compliance and continuous improvement
6 months to 4 years of relevant experience
HCC Coding Certification is preferred, but not mandatory

Job Responsibility

Review medical records to identify patient diagnoses and treatments
Assign appropriate ICD-10-CM diagnosis codes
Map diagnoses to Hierarchical Condition Categories (HCC)
Ensure coding accuracy and consistency
Audit records and documentation for compliance
Provide feedback and support to physicians and healthcare providers
Educate team members on clinical documentation and coding guidelines

New

IT Training Lead

The IT Training Lead will drive technology learning and user adoption across the...

Location

United States , Delray Beach

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience in IT training, instructional design, technical enablement, or learning and development
Strong knowledge of Microsoft 365
Excellent communication, facilitation, and content development skills
Ability to translate technical concepts into practical, user-friendly training.

Job Responsibility

Design, develop, and deliver IT training programs in instructor-led, virtual, and self-paced formats
Take lead in the Microsoft Copilot and AI training strategy, including onboarding, advanced use cases, responsible AI usage, and ongoing enablement
Partner with IT leadership to support new technology rollouts, system upgrades, and digital transformation initiatives
Create and maintain training content, including videos, guides, tutorials, and job aids
Identify skill gaps and develop targeted learning solutions to improve adoption and productivity
Gather feedback and measure training effectiveness to continuously improve programs.

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K Kitchen Representative

The position includes, but is not limited to, the following essential job duties...

Location

United States , New Albany

Salary:

Not provided

Circle K

Expiration Date

Until further notice

Requirements

Excellent communication skills
Team player who can work well with others or independently
Acts with integrity
keeps commitments
Contagious positive attitude
Focuses on achieving results while having fun
Frequently bend, twist at waist, kneel, squat, stand, and walk
Occasionally climb and descend ladders
Tolerate extreme cold and hot temperatures and work in and around fryers, ovens, grills, coolers, freezers, sharp objects, and loud noises
Reach, grasp, and manipulate objects with hands for entire shift, including reaching for objects overhead

Job Responsibility

Provides excellent guest service in a fast and friendly manner
Maintains a clean restaurant environment by cleaning and performing general housekeeping duties
Prepares and serves food items in accordance with all Brand, Company, and health department regulations
Ensures product quality, food safety, and operational standards are met
Keeps accurate cash, sales, and inventory control records
Follows all government laws and safety codes
Completes reports on all incidents following our 5-minute rule policy
Lives our Company values: One Team, Do the Right Thing, Takes Ownership, Play to Win

What we offer

Medical, Dental, Vision, Term Life and AD&D plans
Flexible spending and health savings accounts (FT)
Vacation paid time off
Company holidays paid at time and a half
Matching 401(k)
Tuition Reimbursement
Stock Purchase Plan
Employee Discount Program
Discount Meal Benefit
Wellness Plan

New

K Kitchen Representative

Location

United States , Decatur

Salary:

Not provided

Circle K

Expiration Date

Until further notice

Requirements

Excellent communication skills
Team player who can work well with others or independently
Acts with integrity
keeps commitments
Contagious positive attitude
Focuses on achieving results while having fun
Frequently bend, twist at waist, kneel, squat, stand, and walk
Occasionally climb and descend ladders
Tolerate extreme cold and hot temperatures and work in and around fryers, ovens, grills, coolers, freezers, sharp objects, and loud noises
Reach, grasp, and manipulate objects with hands for entire shift, including reaching for objects overhead

Job Responsibility

Provides excellent guest service in a fast and friendly manner
Maintains a clean restaurant environment by cleaning and performing general housekeeping duties
Prepares and serves food items in accordance with all Brand, Company, and health department regulations
Ensures product quality, food safety, and operational standards are met
Keeps accurate cash, sales, and inventory control records
Follows all government laws and safety codes
Completes reports on all incidents following our 5-minute rule policy
Lives our Company values: One Team, Do the Right Thing, Takes Ownership, Play to Win

What we offer

Medical, Dental, Vision, Term Life and AD&D plans
Flexible spending and health savings accounts (FT)
Vacation paid time off
Company holidays paid at time and a half
Matching 401(k)
Tuition Reimbursement
Stock Purchase Plan
Employee Discount Program
Discount Meal Benefit
Wellness Plan

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Clinic Coder II

Job Description

Job Responsibility

Requirements

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