CrawlJobs Logo

Physician Billing Certified Coder I

valleychildrens.org Logo

Valley Children's Healthcare

Location Icon

Location:
United States , Madera

Category Icon
Category:
-

Job Type Icon

Contract Type:
Not provided

Salary Icon

Salary:

28.90 - 42.00 USD / Hour

Job Description:

The Certified coder I is responsible for properly reviewing provider documentation and can perform all coding functions. Possesses a solid understanding of the professional billing workflow and assists with general billing duties as necessary to include claim edits, claims processing, claim rejections, data entry, and queries and communicates with physicians on documentation issues related to code assignment and provides feedback to physicians and the physician billing entity on variances between hospital and physician CPT coding as needed. Helps identify and resolve incorrect claims issues and is responsible for drafting letters to coordinate appeals as well as other areas related to billing as assigned by the manager.

Job Responsibility:

  • Properly reviewing provider documentation and can perform all coding functions
  • Possesses a solid understanding of the professional billing workflow and assists with general billing duties as necessary to include claim edits, claims processing, claim rejections, data entry, and queries
  • Communicates with physicians on documentation issues related to code assignment and provides feedback to physicians and the physician billing entity on variances between hospital and physician CPT coding as needed
  • Helps identify and resolve incorrect claims issues and is responsible for drafting letters to coordinate appeals as well as other areas related to billing as assigned by the manager

Requirements:

  • Minimum two (2) years experience or RHIT certificate preferred
  • Minimum two (2) years experience in ICD-10 CM/PCS and CPT-4 coding experience with outpatient surgery medical records preferred
  • Minimum one (1) year anesthesiology coding experience preferred
  • Ability to work independently with limited supervision
  • Skilled in gathering and reporting information
  • Ability to multi-task and prioritize needs in order to meet timelines
  • Knowledge of medical terminology and anatomy
  • Knowledge of CPT, IDC-10, ASA and HCPCS coding
  • High school diploma as accredited by the US Department of Education or GED required
  • Certified Professional Coder (CPC) required

Additional Information:

Job Posted:
January 04, 2026

Employment Type:
Fulltime
Work Type:
On-site work
Job Link Share:

Looking for more opportunities? Search for other job offers that match your skills and interests.

Briefcase Icon

Similar Jobs for Physician Billing Certified Coder I

HCC Coding Auditor

The HCC Coding Auditor will perform code audits and abstractions using the Offic...
Location
Location
United States , Irving
Salary
Salary:
Not provided
christushealth.org Logo
CHRISTUS Health
Expiration Date
Until further notice
Flip Icon
Requirements
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
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
Read More
Arrow Right

Director, Revenue Cycle Compliance

Baptist Health is hiring a Director, Revenue Cycle Compliance to join the Compli...
Location
Location
United States , Jacksonville
Salary
Salary:
Not provided
baptistjax.com Logo
Baptist Health (Florida)
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Healthcare coding experience required
  • At least one of the following required, two preferred: Certified in Healthcare Compliance (CHC) or to be obtained within 1 year of hire
  • Certified Professional Coder (CPC)
  • Certified Revenue Cycle Representative (CRCR)
  • Certified Revenue Cycle Executive (CRCE)
  • Certified Coding Specialist (CCS) or equivalent credential
  • Certified Inpatient Coder (CIC)
  • Certified Risk Adjustment Coder (CRC)
  • Bachelor's Degree
  • Over 5 years Healthcare Revenue Cycle Compliance Required
Job Responsibility
Job Responsibility
  • Serves as a key compliance leader supporting Baptist Health's Revenue Cycle operations across its hospitals, provider-based clinics, freestanding emergency departments, and physician enterprise
  • Oversees compliance activities related to coding, billing, documentation, education, and auditing within the revenue cycle
  • Ensures adherence to applicable federal and state regulations and internal policies by leading designated compliance initiatives, managing frontline teams, and fostering a culture of integrity and accountability throughout the organization
  • Fulltime
Read More
Arrow Right

Provider Educator

Under the general direction of the Professional Coding Manager, this individual ...
Location
Location
United States , Weymouth
Salary
Salary:
79600.00 - 113800.00 USD / Year
southshorehealth.org Logo
South Shore Health
Expiration Date
April 06, 2026
Flip Icon
Requirements
Requirements
  • Equivalent to four (4) years of high school education
  • Bachelor's degree is preferred
  • Greater than three (3) years ICD10/CPT coding/auditing experience in acute care and medical specialty setting is preferred
  • CCS - Certified Coding Specialist or CPC with Certified Professional Medical Auditor
  • Certified Coding Specialist - American Health Information Management Association (AHIMA)
  • Certified Professional Medical Auditor (CPMA) - American Academy of Professional Coders (AAPC)
Job Responsibility
Job Responsibility
  • Assess professional provider documentation and professional coding education needs
  • Perform provider education using various communication tools and training platforms
  • Summarize chart audit results, trends, and corresponding action plans
  • Present education for new providers
  • Collaborate with SSH leadership, Coders, Billing Staff, Physician Billing Managers and I.S to identify and provide feedback
  • Collaborate with PB Coding Manager to create educational presentations
  • Perform post-presentation quality assurance reviews
  • Stay updated on current coding information
  • Communicate coding, billing and documentation specificity changes to providers
  • Participate in regular meetings
  • Fulltime
Read More
Arrow Right
New

Compliance Analyst II

As a community, the University of Rochester is defined by a deep commitment to M...
Location
Location
United States of America , Rochester
Salary
Salary:
63815.00 - 95723.00 USD / Year
urmc.rochester.edu Logo
University of Rochester
Expiration Date
Until further notice
Flip Icon
Requirements
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
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
Read More
Arrow Right

Professional Medical Coder

Under experienced leadership the Professional Surgical Coder is an advanced codi...
Location
Location
United States , Weymouth
Salary
Salary:
30.25 - 43.30 USD / Hour
southshorehealth.org Logo
South Shore Health
Expiration Date
March 20, 2026
Flip Icon
Requirements
Requirements
  • Equivalent to an Associate's Degree in Medical Information Technology (with course work in medical terminology, anatomy, physiology, disease processes, ICD-10-CM coding required and prospective payment preferred)
  • Two to three (2-3) years in a surgical practice preferred
  • CPC - Certified Professional Coder OR CCS-P Certified Coding Specialist- Physician Based
  • Strong proficient computer and data entry skills to gather and interpret data
  • Strong analytical skills to gather and interpret data
Job Responsibility
Job Responsibility
  • Analyzes patient medical records and interprets documentation to identify all diagnoses and procedures performed
  • Assigns proper ICD-10CM and CPT-4 diagnostic and procedural codes to charts and related records
  • Identifies any and/or all complications or comorbidities
  • Assesses the appropriateness of medical record documentation to ensure that it supports the procedure(s), diagnosis', as well as complications and/or comorbid conditions documented
  • Answers provider/clinician questions regarding coding principles
  • Remains abreast of developments in medical record technology by pursuing a program of professional growth and development
  • Works collaboratively with appropriate team members to recommend strategies for process improvement
  • Assists in responses to billing review requests
  • Abides by Standards of Ethical Coding as set forth by American Health Information Management Association (AHIMA)
  • Meets coding, quality and productivity standards
  • Parttime
!
Read More
Arrow Right

Client Partner

Location
Location
India , Noida
Salary
Salary:
Not provided
accesshealthcare.com Logo
Access Healthcare LLC
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Minimum 1 to 4 years of experience in IPDRG medical coding -US Healthcare
  • Any Graduate
  • associate’s degree in health information management, Medical Coding, or a related field preferred
  • Specialization: Inpatient DRG
  • Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required.
Job Responsibility
Job Responsibility
  • Assign DRG Codes: Accurately assign DRG codes to inpatient records using ICD-10- CM/PCS coding systems based on clinical documentation and physician notes. Ensure codes reflect the correct diagnosis, procedures, and the overall complexity of care.
  • Clinical Documentation Review: Review and analyze medical records to verify diagnoses, procedures, and treatments. Work with physicians and healthcare providers to clarify and improve clinical documentation when needed for proper coding.
  • DRG Assignment: Utilize the DRG methodology to ensure accurate and consistent DRG assignment based on the severity of illness (SOI) and risk of mortality (ROM), among other factors. Apply coding conventions and guidelines as per CMS (Centers for Medicare & Medicaid Services) and payer requirements.
  • Continuous Education: Keep up to date with coding guidelines, coding technology, and industry changes related to DRGs, including changes in ICD-10-CM/PCS, federal regulations, and insurance payer policies.
  • Billing Support: Work closely with the billing department to resolve coding issues and ensure that all claims are processed correctly and promptly for reimbursement. Ensure timely submission of all inpatient claims for accurate payment processing
Read More
Arrow Right

Coding Services Manager

We are looking for a Coding Services Manager (Professional Services) for a full-...
Location
Location
United States , Las Vegas
Salary
Salary:
77000.00 - 124000.00 USD / Year
dcshq.com Logo
Dynamic Computing Services
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Equivalent to a Bachelor’s Degree in Health Information Management or related field
  • five (5) years of coding/auditing experience in an acute care setting
  • three (3) years of supervisory/management role experience
  • Certified Professional Coder (CPC) or multiple specialty-specific coding certifications from AAPC or Certified Coding Specialist, Physician-based (CCS-P) or Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) from AHIMA
  • Knowledge of Federal, state and county laws and regulations governing coding
  • modern theories, principles and practices of effective supervision
  • coding principles and guidelines including ICD-10-CM/PCS, CPT/E&M, and HCPCS
  • coding documentation and billing regulations related to Medicare, Medicaid, and commercial insurance
  • revenue cycle workflows including charges/charge master, code edits, auditing, denials management, and documentation improvement
  • budget principles and practices
Job Responsibility
Job Responsibility
  • Manages the daily operations and delivery of physician office and professional fee coding services with adherence to established coding guidelines
  • responsible for managing the coordination of accurate and compliant Professional Services coding of pertinent medical information
  • ensures accurate assignment of codes and compliance with regulatory requirements
  • Assists in determining strategic priorities and planning for unit operations and participates in the audit projects and provides education to the Professional Services coding team based on the audit findings
What we offer
What we offer
  • Employer Paid Pension Plan through Nevada Public Employees’ Retirement System “PERS”
  • Vesting in the pension plan after 5 years of qualifying employment
  • Health/Dental/Vision Insurance – Less than $20 per paycheck for employee-only coverage
  • Consolidated Annual Leave (CAL) – CAL is used for personal leave, holidays (twelve scheduled holidays per year), doctor appointments, vacation, and sick days up to 16 consecutive scheduled work hours (short-term sick leave), etc.
  • Extended Illness Bank (a/k/a Sick Bank)
  • 457 Deferred Compensation Plan
  • Comprehensive Group Health Insurance Plan
  • Nevada has no State Income Tax
  • No Social Security (FICA) Deduction
  • Fulltime
Read More
Arrow Right

Physician Coding Review Specialist

Location
Location
United States
Salary
Salary:
26.55 - 39.85 USD / Hour
advocatehealth.com Logo
Advocate Health Care
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Coding Associate (CCA) certification issued by the American Health Information Management Association (AHIMA)
  • Coding Specialist - Physician (CCS-P) 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)
  • Professional Coder (CPC) certification issued by the American Academy of Professional Coders (AAPC)
  • Specialty Coding Professional (SCP) certification issued by the Board of Medical Specialty Coding and Compliance (BMSC)
  • Specialty Medical Coding Certification issued by the American Academy of Professional Coders (AAPC)
  • Advanced training beyond High School that includes the completion of an accredited or approved program in Medical Coding Specialist
  • Typically requires 5 years of experience in expert-level professional coding and at least 3 years of experience in the education of clinicians in physician revenue cycle processes, health information workflows, and medical record auditing experience
  • Advanced knowledge of ICD, CPT, and HCPCS coding guidelines
Job Responsibility
Job Responsibility
  • Review assigned codes, which most accurately describe each documented diagnosis and/ or procedure according to established CPT, HCPCS, and ICD-10-CM coding guidelines along with modifier usage and medical terminology
  • Monitor all coding accuracy at various levels of detail and maintain coding quality as needed
  • Track coding issues and review coding inaccuracies to highlight areas of improvement
  • Report or resolve escalated issues as necessary
  • Responsible for reviewing Clinician documentation and billed codes for Medical Group physicians and non-physician clinicians
  • Review of medical records in collaboration with key stakeholders such as Internal Audit, Compliance, and Clinic Operations
  • Responsible for completing all certified coder quality reviews
  • Working in collaboration with Coding Production Leads and Supervisors
  • Follows the prospective and/or retrospective review plan to sample employed Clinician's medical record documentation in comparison to services selected for billing, based on best practice methodologies which will be presented and reviewed with Clinicians to provide feedback on proper coding and documentation practices
  • Follows the necessary schedules for team assignments of documentation/coding accuracy
What we offer
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
Read More
Arrow Right