Coder I - Billing & Audit Job at Memorial Healthcare System (Miramar)

Medical Coder - Revenue Integrity Audit

At Clarus, we inspire you to explore your passions, nurture and cultivate your t...

Location

Philippines , Pasig, Manila

Salary:

Not provided

Clarus RCM

Expiration Date

Until further notice

Requirements

Graduates in life sciences with 1 - 4 years of experience in Medical Coding
1-2 years audit experience
Prior clinical and/or coding background preferred
Experience in specialties such as Cardiology, Radiology, Pathology, Anesthesia, Emergency Room, Surgery, as well as in-patient settings
Sound understanding of coding/billing process and typical issues leading to denials and missed charges
Exposure to CPT-4, ICD-9, ICD-10, and HCPCS coding
Good knowledge of medical coding and billing systems, regulatory requirements, auditing concepts, and principles

Job Responsibility

Performs Charge Reviews on the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPT coding, by reviewing the medical record, facility protocol, and other applicable documentation. The reviews may include the verification of billing data for accuracy and completeness, following regulatory requirements, to resolve edits or exceptions detected during system processing of the claim in the customer systems
Reviews that modifiers applied are appropriate based upon reviews, and/or makes necessary adjustments to patient account charges and/or balances
Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and standards
Evaluates if account combinations and account splits are appropriately applied
Aggregates charge capture issues, clinical documentation issues and revenue education opportunities to help clinicians understand their documentation responsibilities
Provides charge review results and presents findings to internal and client stakeholders
Coordinates charge reviews for retrospective or concurrent, and other billing reviews as identified
Reviews denial trends for documentation and missed charges/revenue opportunities and provides feedback on educational gaps

What we offer

Attractive Salary package
Saturday and Sunday Fixed Off
Other Benefits

Fulltime

Senior Billing & Coding Compliance Consultant

Our client is seeking a Senior Billing & Coding Compliance Consultant to serve a...

Location

United States , Dallas

Salary:

Not provided

Medasource

Expiration Date

Until further notice

Requirements

High School Diploma or equivalent and six (6) years of experience in a professional billing environment with emphasis on coding, auditing, and/or compliance responsibilities
Certification as Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or Certified Medical Coder (CMC) required
Must obtain Certified Professional Medical Auditor (CPMA) certification within 12 months of hire
Strong knowledge of CPT, HCPCS, and ICD-9-CM coding systems, medical record documentation standards, and accepted billing/coding standards
Ability to analyze medical records, billing history, payer rules, and other data to validate regulatory compliance and organizational billing integrity
Experience developing and conducting coding and compliance training and presentations for individuals and groups
Strong verbal and written communication skills
Ability to work independently and collaboratively as a team member
Proficiency in Microsoft Office (Word, Excel, PowerPoint)
Detail-oriented with strong organizational and prioritization skills

Job Responsibility

Serve as a billing integrity project leader for all service lines, developing and conducting individual or group presentations on coding, billing, and compliance topics
Develop and deliver standardized and specialty-driven coding and compliance training (“onboarding”) for new providers
Perform post-onboarding pre-bill reviews of professional charges for any service line
Assist in ensuring pending charges are reviewed and released in a timely manner
Independently review the adequacy of medical record documentation to support procedure, modifier, and diagnosis coding, identify compliance risks, and develop recommended solutions or action plans
Summarize findings and develop action plans for risk mitigation
Research and respond to coding, documentation, and reimbursement policy questions or problems
Support and/or conduct risk-based billing compliance audits and provide resulting education in coordination with the Compliance Office
Complete charge review and follow-up Epic work queue assignments for any service line
Provide training to new internal or contractor staff on audit software, Epic, audit plans, and work queue assignments

What we offer

Competitive medical, dental, vision, Health Savings Account, Dependent Care FSA, and supplemental coverage
401k plan with company match
Paid time off, sick time, and paid company holidays
Employee Assistance Program (EAP) providing services like virtual counseling, financial services, legal services, life coaching

Certified Medical Coder

At Clarus, we inspire you to explore your passions, nurture and cultivate your t...

Location

Philippines , Pasig, Manila

Salary:

Not provided

Clarus RCM

Expiration Date

Until further notice

Requirements

Graduates in life sciences with 1 - 4 years of experience in Medical Coding
Experience in specialties such as Cardiology, Radiology, Vascular, Pathology, Anesthesia, Emergency Room, Surgery, and others
Exposure to CPT-4, ICD-9, ICD-10, and HCPCS coding
CCS/CPC/CPC-H/CIC/COC certification from AAPC /AHIMA would be a plus - Proof of current certification is required
Good knowledge in medical terminology, Human Anatomy and Physiology can apply
Good knowledge of medical coding and billing systems, regulatory requirements, auditing concepts, and principles

Job Responsibility

Perform a review of codes ascribed to medical records, review the diagnosis and CPT codes as per ICD-10 and CPT-4 systems of coding
Perform Coding for Outpatient and/or Inpatient records with a minimum of 95% accuracy and as per turnaround time requirements
Support the team leaders in delivering high quality and efficient services
Exceeds the productivity standards for Medical Coding - as per the productivity norms for inpatient and/or specialty specific outpatient coding standards
Maintains high degree of professional and ethical standards
Focuses on continuous improvement by working on projects that enables customers to arrest revenue leakage while following the standards
Focuses on updating coding skills, knowledge, and accuracy by participating in coding team meetings and educational conferences

What we offer

Attractive Salary package
Good opportunity to grow your career and become a certified coder

Client Partner - Medical Coding - Inpatient Coding - IP/DRG

Start your career as a Client Partner for Inpatient Medical Coding - IP /DRG wit...

Location

India , Noida

Salary:

Not provided

Access Healthcare LLC

Expiration Date

Until further notice

Requirements

Graduates in life sciences with 1 - 4 years experience in Medical Coding
Candidates holding CCS/CIC with hospital coding experience are preferable
Good knowledge of Medical Coding and billing systems, medical terminologies, regulatory requirements, auditing concepts, and principles
Maintains a working knowledge of CPT-4, ICD-10-CM, and ICD-10-PCS coding principles, governmental regulations, UHDDS guidelines, AHA coding clinic updates, and third-party requirements regarding coding and documentation guidelines
Knowledge of Physician query process and ability to write physician queries in compliance with OIG and UHDDS regulations
Knowledge of MS-DRG, MDC, AP-DRG, APR-DRG with hands-on experience in handling MS-DRG
Knowledge of CC and MCC when used as a secondary diagnosis
Understanding and exposure to Clinical Documentation Improvement (CDI) program to work in tandem with MS-DRG
Hands-on experience in any Encoder tools specific to Hospital coding, such as 3M, Trucode, etc., is preferred
Maintains a high level of productivity and quality

Job Responsibility

Reviewing Inpatient and observation medical records, determining and assigning accurate diagnosis (ICD-10-CM) codes and Procedure codes (ICD-10-PCS and CPT) codes with appropriate modifiers in addition to reporting any deviations promptly
The coders will focus on undergoing certifications sponsored by AAPC and AHIMA as they mature with the process

What we offer

Access health care has now partnered with AAPC to handhold in-house certification training for coders and sponsor examinations

Fulltime

New

Coder I - MPG - FT - Days - MSS - Remote Eligible

Memorial is seeking an experienced Medical Coder with a strong background in pro...

Location

United States , Miramar

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

High School Diploma or Equivalent (Required)
Certified Coding Associate (CCA) - American Health Information Management Association (AHIMA), Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA), Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA), Registered Health Information Technician (RHIT) - State of Florida (FL), Registered Health Information Technician (RHIT AHIMA) - American Health Information Management Association (AHIMA)
For HIM coder, one (1) year hospital-based outpatient coding experience
For Physician Billing Coder, one (1) year diagnostic/procedural office coding experience with surgical coding experience or six (6) months working within the Memorial Health System
Requires critical thinking skills, effective communication skills, decisive judgment, and the ability to work independently with minimal supervision
Must be able to work in a stressful environment and take appropriate action
Proficient in basic computer skills
Ability to perform job duties using an electronic medical record system
Strong knowledge of anatomy, physiology and medical terminology
Knowledge of coding classification systems and procedures

Job Responsibility

Reviews medical record documentation
May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance
For physician billing, collaborates with billing department to ensure all bills are satisfied
For hospital, routes to billing charge entry errors and/or account edits preventing completion of coding and/or billing
Makes appropriate coding corrections, when advised, and follows procedure to notify billing
May assign and sequence basic CPT (Current Procedural Terminology) procedure codes (non-complex), and modifiers based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, Local Medical Review Policy (LMRP) guidance in encoder software and/or department coding policies and procedures
Using encoder, reviews Ambulatory Payment Classifications (APC) and Enhanced Ambulatory Patient Groups (EAPG) assignments
Reviews Local Coverage Determination (LCD) edits and guidance for codes meeting medical necessity
Researches medical record for any additional diagnoses documented to meet medical necessity
Reviews and validates the accuracy of data in the Admission, Discharge Transfer (ADT) fields following HIM coding procedures and processes

Fulltime

Medical Coding Multi Specialty QA Specialist

The Medical Coding Multi Specialty QA Specialist (CPC Certified) is responsible ...

Location

United States , Oak Brook

Salary:

28.00 - 32.00 USD / Hour

Jorie AI

Expiration Date

Until further notice

Requirements

High school diploma or equivalency
AAPC Certified Professional Coder (CPC) certification is required
Other relevant certifications (CPMA, CEMC) are a plus
Maintain departmental productivity levels and compliance with quality standards
A minimum of 4 years of experience in a multi-specialty physician practice or clinic, coding multiple medical/surgical specialties/subspecialties
A minimum of 3 years of prior experience translating coding error trending and quality assurance and translating these results into process improvements with minimum supervision required
Advanced knowledge of ICD10, CPT and HCPCS coding guidelines, payer and governmental policies
Proficiency in using medical billing software and EHR systems
Attention to detail with the ability to identify/resolve problems and document the outcome
Ability to collaborate effectively in a team setting to maximize quality and efficiency of operations

Job Responsibility

Leverages extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding, and billing to audit coded charts
Provide coding, financial and/or operational reports, and provide feedback to improve documentation to maximize revenue and reduce denials
Performs audits of the coding team, providing feedback and education based on results
Develops overall educational materials based on common trends identified during the audit process
Conducts internal coding audits and analysis of issues holding up accounts and follows guidelines
Identifies areas of utilization improvements and monitors expected outcomes
Identifies recurring problems and procedural deficiencies and provides solutions to eliminate them
Research and update new and/or revised coding and compliance standards
Performs other related duties as required or requested

What we offer

401(k) matching up to 4%
Medical
Dental
Vision
Long/Short Term Disability insurance
Life insurance $25,000 Paid by employer
PTO 2 weeks
10 and half Holidays
Remote opportunities
Growth advancement opportunities

Fulltime

CAC Medical Biller

We are seeking a knowledgeable and detail‑oriented Certified Ambulance Biller / ...

Location

United States , Omaha

Salary:

18.00 - 28.00 USD / Hour

ONESTAFF MEDICAL

Expiration Date

Until further notice

Requirements

Certification as a Certified Ambulance Coder (CAC), Certified Ambulance Documentation Specialist (CADS), or equivalent EMS billing certification
Additional certifications such as CPB, CPC, or other medical billing/coding credentials (preferred)
1–3 years of ambulance billing, medical billing, or coding experience (preferred but not required with proper certification)
Strong knowledge of Medicare and Medicaid ambulance billing rules
Ability to read and interpret medical documentation and apply proper codes
High attention to detail with strong analytical and problem‑solving skills
Excellent communication and follow‑up abilities
Proficiency with billing software systems and Microsoft Office applications
Associate Degree

Job Responsibility

Review Patient Care Reports (PCRs), run sheets, and supporting documentation for accuracy and completeness
Apply correct ambulance billing codes, including HCPCS, CPT, and ICD‑10, according to documentation and payer requirements
Determine appropriate levels of service (BLS, ALS1, ALS2, SCT, mileage, etc.) based on medical necessity and documentation
Enter and validate charges in the billing system prior to claim submission
Ensure compliance with Medicare, Medicaid, and commercial payer guidelines
Identify missing or insufficient documentation and coordinate follow‑up with field staff or supervisors
Process claims, resolve edits, and prepare bills for submission
Review and correct returned or denied claims to support quick resolution
Maintain accurate records and meet productivity/quality benchmarks
Stay current on EMS billing regulations, compliance updates, and coding changes

What we offer

401K
Car Allowance
Eat Well
Employee Assistance Program
Flex Hours
Free Direct Deposit / Weekly Pay
Game Rooms
Gym Privileges
HealthJoy
In-House Chiropractor

Fulltime

Coder IV facility hospital based

Location

United States

Salary:

30.15 - 45.25 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Minimum of five years' of coding experience in an academic medical center or an equivalent combination of coding experience and education with demonstrated competency of knowledge base
Coding QA background or similar experience preferred
Satisfactory completion of college level courses in anatomy, physiology and medical terminology preferred
EPIC health information system experience preferred
Coding certification CCA, CIC, CPC-H, CPC, CCS, RHIT, or RHIA required
Ability to concentrate for extended periods
Knowledge of medical terminology and basic anatomy, physiology, pathophysiology, and pharmacology with ability to apply knowledge to the coding process
Demonstrates skill in coding classification systems, diagnosis, procedure selection, and sequencing guidelines
Knowledge of APC prospective payment system
Demonstrates competence in coding and correct extrapolation of official coding and select billing guidelines to specific coding situations

Job Responsibility

Ensures the timely and accurate coding and completion of patient accounts within established departmental accuracy and productivity standards
Applies correct ICD CM/PCS (Inpatient) and ICD CM/CPT codes (Outpatient) guidelines meeting departmental policy regarding compliant methods, timeframes, use of applications and productivity
Assists in demonstrating medical necessity for procedures performed by ensuring that all documented disease processes are coded
Demonstrates proficiency in utilizing official coding books as well as the electronic medical record, computer assisted coding/encoding software, and clinical documentation information systems to facilitate code assignment
Reviews facility charges as provided and edits where necessary to ensure charges are compliant and substantiated by provider documentation
May require frequent and close collaboration with multiple areas of the organization including providers, Professional Coding, and Finance for audit and problem-solving activities
Demonstrates full understanding and is compliant with correct coding initiative guidelines, regulatory requirements regarding coding of medical information including but not limited to external regulatory agencies such as Quality Improvement Organizations (QIOs), the Centers for Medicare & Medicaid Services (CMS) and other payers, and the Joint Commission
Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to official coding guidelines
Queries physician when existing documentation is unclear or ambiguous following AHIMA guidelines and established policy
Brings identified concerns to Manager Coding for resolution

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Coder I - Billing & Audit

Memorial Healthcare System

Location:
United States , Miramar

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
May 04, 2026

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