Professional Coder I Job at Tucson Medical Center (Tucson)

Compliance Coordinator

This position is accountable for collaborating with and assisting the Valley Chi...

Location

United States , Madera

Salary:

38.25 - 56.60 USD / Hour

Valley Children's Healthcare

Expiration Date

Until further notice

Requirements

High School Diploma/G.E.D. (required)
College Degree - 4 year Healthcare related field (preferred)
CPC - Certified Professional Coder - AAPC - American Academy of Professional Coders (required)
CPMA - Certified Professional Medical Auditor - AAPC - American Academy of Professional Coders within 18 months of hire or transfer into position (required)
Minimum four (4) years Experience in a healthcare environment (required)
Experience with researching, evaluating, interpreting and tracking changes in laws, regulations and guidelines and implementing changes in policies and procedures. (required)
Experience with Medi-Cal and commercial payer guidelines preferred, particularly Evaluation and Management. (preferred)
Experience with hospital (facility) coding and billing (preferred)
Public speaking skills highly recommended.
Must have excellent verbal and written communication skills and able to communicate effectively providing verbal feedback in a professional manner.

Job Responsibility

Collaborating with and assisting the Valley Children's Healthcare Corporate Compliance Officer and the Compliance Manager with the development, implementation and facilitation of comprehensive healthcare corporate compliance, risk management and creating and performing improvement programs and compliance training for Valley Children's Healthcare professional service providers.
Provides content expertise with organization of projects and teams, statistical reports, and analyzing medical records for completeness, timeliness and accuracy.
Plans, organizes and implements the monitoring, evaluation and continuous improvement activities and works collaboratively to facilitate the organizational goals, mission and corporate culture of Valley Children's Healthcare.

Fulltime

Compliance Coordinator

This position is accountable for collaborating with and assisting the Valley Chi...

Location

United States , Madera

Salary:

38.25 - 56.60 USD / Hour

Valley Children's Healthcare

Expiration Date

Until further notice

Requirements

High School Diploma/G.E.D. (required)
College Degree - 4 year Healthcare related field (preferred)
CPC - Certified Professional Coder - AAPC - American Academy of Professional Coders (required)
CPMA - Certified Professional Medical Auditor - AAPC - American Academy of Professional Coders within 18 months of hire or transfer into position (required)
Minimum four (4) years Experience in a healthcare environment (required)
Experience with researching, evaluating, interpreting and tracking changes in laws, regulations and guidelines and implementing changes in policies and procedures. (required)
Experience with Medi-Cal and commercial payer guidelines preferred, particularly Evaluation and Management. (preferred)
Experience with hospital (facility) coding and billing (preferred)
Public speaking skills highly recommended.
Must have excellent verbal and written communication skills and able to communicate effectively providing verbal feedback in a professional manner.

Job Responsibility

Collaborating with and assisting the Valley Children's Healthcare Corporate Compliance Officer and the Compliance Manager with the development, implementation and facilitation of comprehensive healthcare corporate compliance, risk management and creating and performing improvement programs and compliance training for Valley Children's Healthcare professional service providers.
Provides content expertise with organization of projects and teams, statistical reports, and analyzing medical records for completeness, timeliness and accuracy.
Plans, organizes and implements the monitoring, evaluation and continuous improvement activities and works collaboratively to facilitate the organizational goals, mission and corporate culture of Valley Children's Healthcare.

Fulltime

Physician Coding Review Specialist

Location

United States

Salary:

26.55 - 39.85 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

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

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

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

New

Clinical Documentation Coordinator

We are looking for a Clinical Documentation Coordinator for full-time permanent ...

Location

United States , Las Vegas

Salary:

39.00 - 60.00 USD / Hour

Dynamic Computing Services

Expiration Date

Until further notice

Requirements

Valid license by the State of Nevada to practice as a Registered Nurse and one of the following, Certified Clinical Documentation Specialist (CCDS), Certified Clinical Documentation Specialist-Outpatient (CCDS-O) or Certified Document Improvement Practitioner (CDIP)
An international medical graduate degree and one of the following: Certified Document Improvement Practitioner (CDIP), Certified Clinical Documentation Specialist (CCDS), Certified Clinical Documentation Specialist-Outpatient (CCDS-O)
Certification in one of the following: Certified Coding Specialist (CCS), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA), issued by the American Health Information Management Association, Certified Professional Coder (CPC), Certified Professional Coder-Physician-based (CPC-P), AND one of the following: Certified Document Improvement Practitioner (CDIP), Certified Clinical Documentation Specialist (CCDS), Certified Clinical Documentation Specialist-Outpatient (CCDS-O)
Knowledge of: Medicare reimbursement system and coding structures
hospital policies and procedures
Joint Commission Accredited Health care Organizations standards, state statutes governing hospital services and health care, Medicare/Medicaid guidelines and other relevant regulations and standards
clinical medical and nursing procedures
disease processes
department and hospital safety practices and principles
patient rights

Job Responsibility

Responsible for improving the overall quality and completeness of clinical documentation
Facilitates modifications to clinical documentation through extensive interactions with physicians, nursing staff, other members of the health care team and Health Information Management (HIM) coding staff to ensure that appropriate reimbursement and clinical severity is captured for the level of service rendered to all patients with a DRG based payer

Fulltime

Automations Systems Technicians

This position is 100% onsite* Hours of Operation: M-F 5am to 6pm working an 8 ho...

Location

United States , Menomonee Falls

Salary:

30.70 - 46.05 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

Bachelor's Degree (or equivalent knowledge) in Business Management
Bachelor's Degree (or equivalent knowledge) in Computer Science or related field
Typically requires 3 years of experience in business process mapping, analysis, defining business and user requirements, acceptance testing and documentation with experience in the specific function/area supported
Experience with application users, vendors and other technical experts, providing operational support for clinical systems, analyzing business and clinical processes, and providing user training/education
Project management experience with ability to use project management software
Necessary analytical skills to make sound recommendations based on data analysis, and clinical user needs, assuring maximum productivity, and continuous process improvement
Ability to balance multiple tasks, be detail and results oriented, set appropriate priorities and accomplish assignments in a thorough and timely fashion
Strong organizational, problem and issue resolution skills. Ability to gather and organize data
Strong communication skills
Intermediate computer skills including experience in using the Microsoft Office Suite (Word, PowerPoint, Excel, Access) or similar products and experience with large scale automated systems

Job Responsibility

Identifies, maps, measures, analyzes and improves clinical and business processes, problems and requirements for assigned application(s)
Performs current and future workflow analysis and maps out critical business processes using industry standards and best practices
Develops test plans, tests cases, and test scripts to validate performance of clinical/business functions. Conducts effective unit, integration, and end-user acceptance testing through execution of the tests, tracking of problem reports and documenting all final outcomes
Facilitates clinical/business practice processes which result in successful software transitions and system utilization. Identifies and analyzes opportunities for application product development, optimization and technical improvements/changes that foster streamlined and integrated workflows
In collaboration with information technology, translates user requirements into functional design specifications and reviews with users to insure accuracy. Ensures accurate data maintenance and reviews the technological impact of business requirements
Develops and maintains process documentation including current workflows, requirements, functional specifications, installation instructions, product test procedures, user manuals, procedures and troubleshooting guidelines. Completes change and quality control documentation using department standards
Reviews data integrity and audits reports to identify/resolve potential issues, and analyzes opportunities for system process improvements and/or product development. Collaborates with information technology to implements changes. Performs data analysis to support data requirements and initiatives
Develops end user training/education modules, and delivers training on system capabilities/functionalities as appropriate to the product or application, and related systems. Assists users in using the full functionality of the application(s) and process flow. Evaluates training effectiveness, maintains and updates training curriculum as needed
Consults with providers, leadership, physicians, and other clinicians to identify problems and resolutions related to equipment, applications, and functionality
Provides input into project timelines. Ensures projects are completed successfully within deadlines

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

Fulltime

Payment Integrity Nurse Coder RN III

The Payment Integrity Nurse Coder RN III is responsible for investigating, revie...

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 clinical RN experience
At least 3 years of experience in utilization management or clinical coding
Investigation and/or auditing experience
Knowledge in CPT, HCPCS, ICD-9, ICD-10, Medicare, and Medicaid rules and regulations
Knowledge of healthcare reimbursement concepts, health insurance business, industry terminology, and regulatory guidelines
Working knowledge of claims coding and medical terminology
Solid understanding of standard claims processing systems and claims data analysis
Strong project leadership and management skills required
ability to prioritize, plan, and handle multiple tasks/demands simultaneously

Job Responsibility

Investigating, reviewing, and providing clinical and/or coding expertise/judgement in the application of medical and reimbursement policies within the claim adjudication process through medical record review for Payment Integrity and Utilization Management projects
Serving as a subject matter expert (SME), performing medical records reviews to include quality audits as well as validation of accuracy and completeness of all coding elements
Providing guidance related to Payment Integrity initiatives to include concept and cost avoidance development
Training and mentoring Payment Integrity Nurse Coder, RN staff
Acting as a Subject Matter Expert, serving as a resource and mentor for other staff
Performing Quality Audits to include validation of accuracy and completeness of ICD, Rev Code, CPT, HCPCs, APR, DRG, POA, and all relevant coding elements
Serving cross functionally with Utilization Management, Medical Directors, and other internal teams to assist in identification of overpayments as well as other projects
Serving as SME for all Payment Integrity functions to include both Retrospective Data Mining as well as Pre-Payment Cost Avoidance
Identifying trends and patterns with overall program and individual provider coding practices
Supporting the creation and execution of strategies that determine impact of opportunity and recover overpayments as well as prospective internal controls preventing future overpayments

What we offer

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

Fulltime

Risk Adjustment Education Specialist

This Job will report to the Risk Adjustment Manager of Coding Operations. Respon...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

Associate degree or equivalent experience required
5 years of experience in a hospital, a physician setting, or a Managed Care Organization as a medical coder required
2 years of experience in coding with knowledge of Medicare risk adjustment (HCC Coding) required
Other experience in teaching, training, or an educator/instructor role is needed
Must have experience in creating effective training materials and presentations (PowerPoint, Adobe, etc.)
Certified Professional Coder (CPC) from AAPC is required
Certified Risk Adjustment Coder (CRC) from AAPC is preferred
An RN or LVN must obtain both CPC and CRC within 12 months of hire
Must be proficient in Prospective, Retrospective, and Concurrent review processes
Must have strong clinical knowledge of disease pathology and ability to identify clinical indicators related to chronic disease

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Subject matter experts for proper risk adjustment coding and CMS data validation
Work in conjunction with other departments, including Provider Relations, Quality, and the Medical Director, to ensure compliance with CMS risk adjustment guidelines
Analyze MRA data to identify patterns and development of provider and market-level interventions to coordinate an educational work plan for providers
Conduct provider education and training regarding risk adjustment to help ensure accurate CMS payment and improve care quality
This includes training venues such as provider offices, hospitals, webinars, conference calls, email correspondence, etc
Responsible for building positive relationships with assigned Physicians and serving as a contact for any questions or concerns that may arise
Identify those Practices that need initial or ongoing additional training
Perform other duties as necessary

Fulltime

Clinician Coding Liaison- Medical Based Specialties

This role would support our Southeast Multi-Specialty Clinicians. Remote positio...

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, 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)
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
Medical Terminology & Anatomy: Strong understanding of medical terminology, anatomy, and physiology
Epic & Reporting Solutions: Advanced knowledge of Epic and other reporting tools
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
Advanced Computer Skills: Proficiency in Microsoft Office Suite, electronic coding applications, and email communication

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

Fulltime

Professional Coder I

Tucson Medical Center

Location:
United States , Tucson

Category:
IT - Administration

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
February 14, 2026

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