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

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

Professional Coder I

Responsible for reviewing patient medical records and assigning accurate CPT, IC...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

High school diploma or GED required
additional training in medical terminology or office administration preferred
Two (2) years of medical coding experience, preferably with Professional Coder Level I experience
CPC Certification or CPC- A Certification required
Proficiency in interpreting medical terminology and healthcare documentation
Strong attention to detail and accuracy in data entry
Effective communication and customer service skills
Ability to operate standard office equipment and use electronic health record (EHR) systems
Organizational skills to manage multiple tasks and maintain documentation
Ability to work independently and as part of a team in a fast-paced environment

Job Responsibility

Review and code medical records using standard coding systems
Audit provider documentation for accuracy and completeness
Communicate with providers to clarify documentation
Assist with billing processes and generate reports
Support training and implementation of new systems
Maintain confidentiality and adhere to safety protocols
Preforms related duties as assigned

Fulltime

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

Medical Coder

We are looking for a Medical Coder to join a healthcare organization in Sacramen...

Location

United States , Sacramento

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 2 years of medical coding experience in a healthcare setting that requires careful attention to detail, or in an outpatient setting
Working knowledge of ICD-10, CPT, and evaluation and management coding principles
Background in outpatient coding with the ability to review provider documentation and assign codes accurately
Certified coding credential or comparable formal coding qualification
Familiarity with electronic health record and coding applications such as Epic, EncoderPro, or similar tools
Strong analytical ability and careful attention to detail when interpreting clinical information
Effective written and verbal communication skills for provider queries and collaboration across teams

Job Responsibility

Examine clinical records and determine the correct diagnosis and procedure codes for charge capture within required turnaround times
Apply ICD-10, CPT, and evaluation and management coding standards to physician and provider documentation with a strong focus on accuracy and compliance
Sequence diagnoses and procedures appropriately to support ethical billing practices and proper reimbursement outcomes
Investigate complex, uncommon, or unclear cases to identify the most accurate coding approach using current industry guidance and reference tools
Recognize services that require billing modifiers, including special reporting situations, and ensure they are reflected correctly on coded encounters
Communicate with physicians and other providers to resolve incomplete, conflicting, or ambiguous documentation before finalizing codes
Monitor accounts with missing documentation and follow through to help move encounters toward accurate coding and billing completion
Support claims follow-up activities by addressing coding edits, denials, audit requests, and other reimbursement-related inquiries
Contribute to compliance reviews, internal audits, and ongoing education efforts while staying current on regulatory and payer guideline updates

What we offer

Medical insurance
Vision insurance
Dental insurance
Life and disability insurance
401(k) plan

Analyst SIU Certified Coder

The Certified Professional Coder (CPC) will perform medical claim reviews for th...

Location

United States , Work at Home

Salary:

43888.00 - 93574.00 USD / Year

CVS Health

Expiration Date

June 19, 2026

Requirements

AAPC Coding certification
3+ years of experience in medical coding or documentation auditing
Strong knowledge of standard industry coding guides and guidelines including CPT, HCPCS, ICD-10, CMS 1500 and UB04 data elements
Maintains up-to-date coding knowledge, including new changes to coding compliance and reimbursement
Experience with researching coding and policies
Experience with Microsoft products
Excel and Word
Strong attention to detail and ability to review and interpret data
Demonstrates strong communication skills

Job Responsibility

Conduct a comprehensive medical record audit to ensure the CPT/HCPCS or modifiers billed are consistent with medical record documentation
Provide detailed written summary of medical record review findings
Articulate findings to investigators, Medicaid plan leadership, law enforcement, legal counsel, providers, state regulators, etc
Research and accurately apply state or CMS guidelines related to the audit with minimal support
Review and discuss cases with Medical Directors to validate decisions
Assist with investigative research related to coding questions, state and federal policies
Identify potential billing errors, abuse, and fraud
Identify opportunities for savings related to potential cases which may warrant a prepayment review
Maintain appropriate records, files, documentation, etc
Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics

What we offer

Medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
bonus, commission or short-term incentive program

Fulltime

Medical Coder

We are looking for a detail-oriented Medical Coder to support billing operations...

Location

United States , Cedar Rapids

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Certified Professional Coder (CPC), CCS, or equivalent certification required
1–3+ years of medical coding experience (specialty experience a plus: e.g., orthopedics, cardiology, etc.)
Strong knowledge of ICD-10, CPT, and HCPCS coding systems
Familiarity with EHR/EMR systems
High attention to detail and accuracy
Strong analytical and problem-solving skills
Ability to work independently and meet deadlines

Job Responsibility

Review medical records, physician notes, and documentation to assign accurate codes for diagnoses and procedures
Apply ICD-10-CM, CPT, and HCPCS coding standards in accordance with payer and regulatory requirements
Ensure coding accuracy to support timely billing and reimbursement
Identify and resolve coding discrepancies or incomplete documentation
Collaborate with providers, billing teams, and compliance staff to clarify documentation
Maintain up-to-date knowledge of coding guidelines, payer policies, and healthcare regulations
Assist with audits and ensure adherence to HIPAA and compliance standards

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Hospital Based Inpatient Coder III

Utilizing an electronic medical record and computerized encoder, assigns and seq...

Location

United States , Miramar

Salary:

Not provided

Memorial Healthcare System

Expiration Date

Until further notice

Requirements

High School Diploma or Equivalent
Certified Coding Associate (CCA) - American Health Information Management Association (AHIMA)
Three (3) years inpatient coding experience in a hospital setting or a graduate of the MHS coder intern program
Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), or Certified Coding Specialist (CCS)
Proficient in basic computer skills and ability to utilize a computerized encoder and electronic medical record system
Requires critical thinking skills, effective communication skills, decisive judgment and the ability to work with minimal supervision
Must be able to work in a stressful environment and take appropriate action

Job Responsibility

Assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures
Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements
Formulates physician queries for validation of pathological findings
Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up
Seeks clarification from providers or other designated resources to ensure accurate and complete coding
Attends educational meetings and seminars to maintain certification and continuing education requirements
Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections and follows procedure to notify billing as needed
Reviews accounts and performs needed correction for internal audits and external denials
Reviews inpatient medical records to assign and sequence all appropriate diagnosis and procedure codes utilizing encoder software and following official coding guidelines
Reviews Medicare Severity Diagnosis Related Groups (MSDRGs) and All Patient Refined Diagnosis Related Groups (APRDRGs) for appropriate code assignment

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

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Coder I - Billing & Audit

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