Coding & Reimbursement Specialist Job at Beacon Hill (Linthicum)

Medical Reimbursement Specialist

We are in search of a Medical Reimbursement Specialist to join our team. Station...

Location

United States , Princeton

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 3 years of experience in a similar role
Proficient in benefit functions
Demonstrated expertise in billing functions
Experience in claim administration
Familiarity with collection processes
Ability to handle and resolve medical denials
Comprehensive knowledge of Medicare

Job Responsibility

Analyze and categorize outstanding claims based on payer, denial reason, and claim value
Investigate and take corrective action on unpaid, denied, or underpaid claims
Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
Submit corrected claims and formal appeals as required
Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
Maintain comprehensive records of all payer interactions
Identify the root causes of denials and implement best practices to prevent future issues
Suggest changes to workflow to enhance claim submission accuracy and speed
Conduct training for in-house billing teams on claim recovery strategies

What we offer

medical, vision, dental, and life and disability insurance
eligibility to enroll in company 401(k) plan

Fulltime

Medical Coding Review Specialist

We are seeking a highly motivated, detail-oriented Medical Coding Review Special...

Location

United States , Remote

Salary:

21.42 USD / Hour

MMC Group LP

Expiration Date

Until further notice

Requirements

Certified Medical Coder credential from a recognized organization such as AAPC, AHIMA, CPC, CCS
3 to 5 years of medical coding experience, preferably within reimbursement review, claims review, or retrospective coding environments
Strong experience with inpatient coding, CPT codes, CPT modifiers, retrospective coding reviews
Experience with IDRE and the ability to clearly explain the IDR process during the interview
Working knowledge of ICD-10-CM, CPT, HCPCS
Strong ability to read and interpret EOBs, claim adjustments, recoupments, and corrections
Excellent written communication skills, with the ability to draft professional and accurate determination letters
High attention to detail and commitment to accuracy and compliance
High School Diploma or GED required

Job Responsibility

Perform retrospective payment reimbursement reviews with a strong focus on coding accuracy and reimbursement analysis
Review and analyze inpatient coding scenarios, including CPT code application, modifiers, and reimbursement outcomes
Conduct retrospective coding reviews to ensure appropriate coding, billing accuracy, and payment determination support
Interpret and evaluate Explanations of Benefits, EOBs, including recoupments, corrections, denials, and other claim adjustments
Assess how CPT codes interact with one another and how modifiers impact reimbursement outcomes
Apply broad coding knowledge across multiple provider specialties
Support work related to the IDRE process, including accurate documentation and case review
Draft final and binding payment determination letters for distribution to clients and disputing parties
Maintain a high level of productivity, accuracy, and compliance in a deadline-sensitive environment

What we offer

Medical, dental, and vision coverage
Life and disability insurance
Additional voluntary benefits

Fulltime

HCC Coding Auditor

The HCC Coding Auditor will perform code audits and abstractions using the Offic...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High School diploma or equivalent is required
Excellent verbal and written communication skills
Minimum of 1 year of experience in hospital inpatient/outpatient settings, medical office coding, or risk adjustment coding OR 3+ years of experience in one or more of the following areas: Claims Processing, Insurance Verification, Provider Credentialing, Member Services, Member Enrollment, Medical Records Management, Health Information Management, Medical Assisting, Nursing, Billing, Benefits and Eligibility, or Provider Education
Coding certification from AAPC or AHIMA is required within six (6) months of hire: Certified Professional Coder (CPC)
Certified Professional Coder-Apprentice (CPC-A)
Certified Risk Adjustment Coder (CRC)
Certified Risk Adjustment Coder-Apprentice (CRC-A)
Certified Coding Associate (CCA)
Certified Coding Specialist (CCS)
Registered Health Information Management Technician (RHIT)

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Medical Record reviews and audits based on organizational priorities. These can include prospective and concurrent Clinical Documentation Improvement (CDI) workflows and retrospective auditing. Review and audits may lead to the addition, deletion, adjustment, or confirmation of diagnoses for risk adjustment
Performs code abstraction and/or coding quality audits of medical records to ensure ICD-10CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS (HCC) Risk Adjustment guidelines
Performs coding quality audits within multiple EMRs, databases, and/or vendor platforms to support employed and independent clinic risk adjustment strategies
Identifies revenue, reimbursement, and provider educational opportunities while complying with state and federal regulations
Prepares and/or performs auditing analysis and provides feedback on noncompliance issues detected through auditing
Complies with all aspects of coding, abides by all ethical standards, and adheres to official coding guidelines
Provides measurable, actionable solutions to providers that will result in improved accuracy for documentation and coding practices to ensure chronic conditions are recaptured annually
Ensures that rendered physician services for claim submission and any subsequent payments are as accurate as possible while complying with regulatory guidelines, including CMS, DHS, and OIG
Assist coding leadership by making recommendations for process improvements to enhance coding quality goals and outcomes further

Fulltime

Clinician Coding Liaison - New Clinician Onboarding Specialist

Location

United States , Charlotte

Salary:

35.50 - 53.25 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification, or Coding Specialist (CCS) certification, or Coding Specialist – Physician (CCS-P) certification issued by the American Health Information Management Association (AHIMA) or Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC). Additional specialty credential preferred.
Completion of advanced training through a recognized or accredited program, equivalent in scope and rigor to post-secondary education or equivalent knowledge. High school diploma or GED required.
Typically requires 4 years of experience in expert-level professional coding.
Advanced Coding Expertise: In-depth knowledge of ICD, CPT, and HCPCS coding guidelines, ensuring accurate and compliant coding practices.
Medical Terminology & Anatomy: Strong understanding of medical terminology, anatomy, and physiology to support precise code assignment.
Epic & Reporting Solutions: Advanced knowledge of Epic and other reporting tools to analyze data, generate reports, and optimize workflow efficiencies.
Critical Thinking & Analytical Skills: Highly proficient in problem-solving and analytical thinking with strong attention to detail.
Interpersonal Communication: Excellent verbal and written communication skills, with the ability to educate and collaborate effectively with physicians, APCs, clinical leadership, and coding teams.
Advanced Computer Skills: Proficiency in Microsoft Office Suite, electronic coding applications, and email communication.
Organizational & Prioritization Skills: Ability to efficiently manage multiple tasks, set priorities, and meet deadlines in a fast-paced environment.

Job Responsibility

Deliver proactive coding education through newsletters, scorecards, and presentations, covering CPT (E&M, modifiers), ICD-10-CM, HCPCS, Risk Adjustment, payer requirements, and rejection resolutions.
Lead onboarding and compliance training for all employed Physicians/APPs, including Locum Tenens, residents, and students, ensuring documentation accuracy from the start.
Provide individualized documentation feedback by reviewing new clinician records and conducting spot checks, escalating non-coding issues to appropriate teams.
Serve as the primary contact for coding inquiries, coordinating with internal teams to resolve complex issues such as NCCI bundling and high-complexity charge edits.
Monitor Epic work queues (charge review, follow-up, claim edit) to ensure timely and accurate charge submissions and reduce claim denials.
Collaborate across departments—including CMOs, Clinical Informatics, Risk Adjustment, and Population Health—to enhance documentation practices and system optimization.
Participate in specialty and department meetings, identifying trends and delivering targeted education to improve coding and documentation accuracy.
Refine Epic documentation tools, including templates, order entries, diagnosis lists, and SmartSets/SmartPhrases, to improve efficiency and accuracy.
Ensure compliance with regulatory standards, including Medicare, Medicaid, and AHIMA’s Standards of Ethical Coding, while maintaining expert knowledge of evolving policies.
Promote a culture of ethical coding and continuous improvement, supporting clinicians with timely updates, feedback, and education to ensure accurate reimbursement and compliance.

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

Coding Reimbursement Specialist III

Subject matter expert in at least one specialty, e.g., oncology, gynecology, sur...

Location

United States

Salary:

25.30 - 37.95 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Maintain coding certification (CPC, CCS, RHIT, RHIA)
Minimum of 2 years of coding experience required
CPC or equivalent coding credential required
Extensive knowledge of coding, medical terminology, anatomy, and physiology
Extensive knowledge of and the ability to apply the payer specific rules regarding coding, bundling, and adding appropriate modifiers
High School Diploma or GED required
Subject matter expert in at least one specialty, e.g., oncology, gynecology, surgical coding (not including primary care procedures) and infusion coding including chemotherapy and infusions involving multiple drugs

Job Responsibility

Assigns CPT and ICD codes in cases of moderate to high complexity
Reads, interprets and assigns CPT codes from provider documentation, e.g., infusion record or operative report
Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered
Appends all modifiers
Ranks CPT codes when multiple codes apply
Assigns Evaluation and Management (E/M) codes
Performs reconciliation process to ensure all charges are captured
Processes automated or manually enters charges into applicable billing system
Researches and analyzes coding and payer specific issues
Processes charges on a timely basis and communicates with team members and practice management on an ongoing basis

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
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance

Fulltime

Clinician Coding Liaison - Podiatry

Location

United States , Milwaukee

Salary:

35.50 - 53.25 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) certification
Coding Specialist (CCS) certification
Coding Specialist – Physician (CCS-P) certification issued by AHIMA
Professional Coder (CPC) certification issued by AAPC
Completion of advanced training through a recognized or accredited program, equivalent in scope and rigor to post-secondary education or equivalent knowledge
High school diploma or GED
Typically requires 4 years of experience in expert-level professional coding
Advanced knowledge of ICD, CPT, and HCPCS coding guidelines
Strong understanding of medical terminology, anatomy, and physiology
Advanced knowledge of Epic and other reporting tools

Job Responsibility

Deliver proactive coding education through newsletters, scorecards, and presentations, covering CPT (E&M, modifiers), ICD-10-CM, HCPCS, Risk Adjustment, payer requirements, and rejection resolutions
Lead onboarding and compliance training for all employed Physicians/APPs, including Locum Tenens, residents, and students, ensuring documentation accuracy from the start
Provide individualized documentation feedback by reviewing new clinician records and conducting spot checks, escalating non-coding issues to appropriate teams
Serve as the primary contact for coding inquiries, coordinating with internal teams to resolve complex issues such as NCCI bundling and high-complexity charge edits
Monitor Epic work queues (charge review, follow-up, claim edit) to ensure timely and accurate charge submissions and reduce claim denials
Collaborate across departments—including CMOs, Clinical Informatics, Risk Adjustment, and Population Health—to enhance documentation practices and system optimization
Participate in specialty and department meetings, identifying trends and delivering targeted education to improve coding and documentation accuracy
Refine Epic documentation tools, including templates, order entries, diagnosis lists, and SmartSets/SmartPhrases, to improve efficiency and accuracy
Ensure compliance with regulatory standards, including Medicare, Medicaid, and AHIMA’s Standards of Ethical Coding, while maintaining expert knowledge of evolving policies
Promote a culture of ethical coding and continuous improvement, supporting clinicians with timely updates, feedback, and education to ensure accurate reimbursement and compliance

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
Premium pay such as shift, on call, and more based on a teammate's job
Incentive pay for select positions
Opportunity for annual increases based on performance

Fulltime

Lead Coding Specialist Inpatient

Join our in-house Coding Team at Baptist Health South Florida, where you'll find...

Location

United States , Remote

Salary:

31.20 - 40.56 USD / Hour

Baptist Health

Expiration Date

Until further notice

Requirements

Associates degree
AHIMA Certified Coding Specialist certification
Prefer RHIA or RHIT or equivalent experience
At least five years Inpatient or Outpatient Surgery, Ancillary and Emergency Room coding experience in a large healthcare institution required
Excellent verbal and written communication skills
Knowledgeable in health information systems, database management, spreadsheet design, and computer technology
Strong computer proficiency (MS Office – Word, Excel and Outlook)
Must be able to work under pressure and meet deadlines
Ability to work independently

Job Responsibility

Serve as primary support to the Coding Supervisor
Assist in supervision of coding, abstracting and reimbursement supporting billing
Ensure compliance and efficient operations
Ensure established goals and ICD-10-CM/PCS guidelines, CPT, and coding conventions are adhered to
Assist with monitoring reports and workflows identifying opportunities for improvement
Monitor work volume and distribution
Review and reconcile reports
Provide coding training within the Coding Department
Perform research on coding issues
Monitor coding personnel activities ensuring accurate and timely processing

What we offer

Sign-On Bonus: Up to $5,000
Flexible scheduling
Supportive and engaged leadership
Commitment to employee wellness, engagement, and success
Growth and development opportunities including CEU access and recertification reimbursement
Individual quarterly performance bonus opportunities
Performance-based recognition

Fulltime

Hospital Coding Quality Specialist - Inpatient

Location

United States

Salary:

28.55 - 42.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Coding Specialist (CCS) certification issued by the American Health Information Management Association (AHIMA)
Health Information Administrator (RHIA) registration issued by the American Health Information Management Association (AHIMA)
Health Information Technician (RHIT) registration issued by the American Health Information Management Association (AHIMA)
Associate's Degree in Health Information Management or related field
Typically requires 5 years of experience in hospital coding for a large complex health care system, which includes hospital coding, denial review and/or coding quality review functions
Demonstrated leadership skills and abilities
Demonstrates knowledge of National Council on Compensation Insurance, Inc. (NCCI) edits, and local and national coverage decisions
Expert knowledge and experience in ICD-10-CM/PCS and CPT coding systems, G-codes, HCPCS codes, Current Procedural Terminology (CPT), modifiers, and Ambulatory Patient Categories (APC), MS-DRGs (Diagnosis related groups)
Advanced knowledge in Microsoft Applications, including but not limited to
Excel, Word, PowerPoint, Teams

Job Responsibility

Reviews coded health information records to evaluate the quality of staff coding and abstracting, verifying accuracy and appropriateness of assigned diagnostic and procedure codes, as well as other abstracted data, such as discharge disposition
Ensure accurate coding for outpatient, day surgery and inpatient records
Verifies all codes and sequencing for claims according to American Hospital Association (AHA) coding guidelines, CPT Assistant, AHA Coding Clinic and national and local coverage decisions
Works collaboratively with coding leadership per their direction in reviewing records with focused diagnosis and procedure codes, including specific APCs, DRGs and OIG work plan targets to assure compliance in all areas of coding, which may give visibility into documentation that is driving codes
Works collaboratively with coding leadership to identify focused prospective records that need to be reviewed
Identifies coder education opportunities, team trends, and consideration of topics to mandate for second level account review, before the account is final coded
Reviews encounters flagged for second level review, including but not limited to
hospital acquired conditions (HACs), complications and other identified records such as core measures or trends as identified by coding leadership
Perform review of coded encounter for appropriate risk-adjustment, including accurate severity and risk of mortality assignment
Responsible for coding participation in the Clinical Documentation Improvement and Hospital Coding alignment process

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

Coding & Reimbursement Specialist

Beacon Hill

Location:
United States , Linthicum

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
April 11, 2026

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