<h3>Job Description</h3>
Job DescriptionDescription:
JOB TITLE: Surgery Medical Coder II
DEPARTMENT: Business Office
REPORTS TO: Coding Manager and Director of Revenue Cycle
FLSA STATUS: Hourly
JOB SUMMARY: The Surgery Medical Coder is responsible for all Endovascular &amp; Neurosurgery coding, accurately assigning CPT, 
ICD-10, and HCPCS codes for professional services rendered by neurosurgeons, ensuring proper documentation and compliance with federal, state, and payer-specific guidelines. This role requires a highly skilled and detail-oriented individual with at least 2-3 years of experience in neurosurgical and endovascular coding. The ideal candidate must hold a recognized medical coding certification and demonstrate expertise in coding complex neurosurgical procedures, including but not limited to craniotomies, aneurysm repairs, embolization’s, and spinal surgeries. 
 
JOB DUTIES &amp; RESPONSIBILITIES:
· Accurately assign CPT, ICD-10, and HCPCS codes for endovascular and neurosurgical procedures, ensuring proper reimbursement.
· Review and interpret operative reports, procedure notes, and medical records to assign appropriate codes.
· Ensure compliance with CMS, AMA, and payer-specific regulations regarding coding and billing guidelines.
· Identify and resolve coding discrepancies by collaborating with physicians, clinical staff, and revenue cycle team members.
· Apply National Correct Coding Initiative (NCCI) edits and payer-specific coding guidelines to ensure clean claim submissions.
· Collaborate with neurosurgeons and endovascular specialists to ensure proper documentation supports coding and billing and resolve any documentation discrepancies.
· Provide education to providers on documentation best practices and coding updates to maximize reimbursement and reduce compliance risks.
· Assist in the development and maintenance of coding procedures and training materials.
· Analyze and resolve coding-related denials and rejections by working with the billing and accounts receivable teams.
· Appeal insurance denials with supporting medical documentation and correct coding guidelines.
· Audit and review coding accuracy to minimize denials and optimize reimbursement. Stay current with coding guidelines, regulations, and updates, ensuring continuous compliance with industry standards.
· Participate in the review of claim denials and provide necessary corrections or explanations.
· Maintain coding productivity and accuracy rates as established by the organization.
· Stay up to date with industry coding changes, including CPT, ICD-10, HCPCS, and payer-specific policies, and apply updates accordingly.
· Notifies supervisor of recurring problems regarding office charges.
· Attends staff meetings and participates in special committees as required
· Work closely with the Managers and Directors and clinical staff to resolve any charge-related issues or discrepancies.
· Other duties and assignments as necessary
PERFORMANCE REQUIREMENTS
· Communicates well and effectively 
· Demonstrates acute awareness of insurance company contracts 
· Reports to work regularly without undue tardiness
· Maintains positive attitude and demonstrates the utmost in professionalism
· Dresses appropriately and professionally 
· Works independently, without supervision
· Completes work accurately and in a timely manner
· Maintains effective working relationships with physicians, administration and other staff members
TYPICAL PHYSICAL DEMANDS:
<ul>
<li>Prolonged sitting, standing, some bending, stooping and stretching and/or walking</li>
<li>Eye-hand coordination and manual dexterity sufficient to operate a computer keyboard, photocopier, fax machine, telephone, calculator, and other office equipment</li>
<li>Normal range of hearing and vision to record, prepare, and communicate appropriate reports</li>
</ul>
TYPICAL WORKING CONDITIONS: 
<ul>
<li>Work is performed in an office environment, with contact with office staff, physicians, etc.</li>
<li>Overtime as required</li>
</ul>
EDUCATION &amp; EXPERIENCE
· High school diploma or GED required 
· Must be certified, CPC and other applicable credentials, 5 years of coding experience minimum. 
· Proficient with Microsoft Office, Teams, including Outlook and Excel. 
Requirements:

Surgery Medical Coder II

<h3>Job Description</h3>
We are seeking a detail-oriented and analytical Internal Auditor with Medical Coding to join our team. The ideal candidate will play a critical role in evaluating and improving the effectiveness of our internal controls, billing and auditing governance processes. This position requires a strong understanding of medical coding, including ICD-9 and ICD-10, as well as familiarity with medical terminology and records. The Internal Auditor will work closely with various departments to ensure compliance with regulations and standards while identifying areas for improvement.
Responsibilities
 
<ul>
<li>Displays courtesy, tact, and diplomacy when dealing with employees, physicians, and outside institutions.</li>
<li>Identifies risk areas, creates an audit strategy, requests correct reports, concisely identifies the issues and provides recommendations for effective corrective actions.</li>
<li>Participates actively and enthusiastically in identifying project issues and workflow.</li>
<li>Contributes recommendations in project issue resolution.</li>
<li>Conducts follow-up review with requesting/reviewed departments to ensure points of clarification on items are met.</li>
<li>Collecting, validating, and analyzing data related to project and extracting and interpreting data to summarize findings.</li>
<li>Maintain current industries knowledge.</li>
<li>Manages time efficiently to meet assigned tasks deadlines as required.</li>
<li>Must be comfortable working from and updated internal ticketing system in an organized and timely manner.</li>
<li>Collecting, validating, and analyzing data related to projects and extracting and interpreting.</li>
<li>Must be comfortable and willing to share knowledge and historical project information to train.</li>
<li>Must be willing and able to research and interpret policies and guidelines as needed for projects.</li>
</ul>
Experience and Skills
Education:
Bachelors or Associate degree
Two (2) to five (5) years’ experience
Skills and Knowledge:
<ul>
<li>Ability to work under nominal supervision performing duties in an area where procedures are standardized by independent decisions are required.</li>
<li>Ability to multitask.</li>
<li>Proficient in Epic applications/knowledge of company operating systems</li>
<li>Full knowledge of medical terminology, ICD-10-CM and CPT guidelines</li>
<li>Full knowledge of NYS Medicaid and Third-Party Regulations.</li>
<li>Knowledge of CMS Regulations.</li>
<li>Computer literacy.</li>
<li>Microsoft Suite proficient.</li>
<li>Good organizational and communication skills.</li>
</ul>
Licenses/Certifications:
<ul>
<li>Certified Professional Coders (CPC) or</li>
<li>Certified Coding Specialists (CCS) or</li>
<li>Certified Coding Specialists Physicians (CCSP) or</li>
<li>Certified Outpatient Coder (COC) or</li>
<li>Certified Professional Medical Auditor (CPMA) desirable</li>
<li>Other Specialty Certification</li>
</ul>
Join our team as an Internal Auditor where your expertise will contribute significantly to our commitment to excellence in healthcare operations.

Medical Coder - Internal Auditor

<h3>Job Description</h3>
Job DescriptionDescription:
University Health Network is looking for a full-time Certified Medical Coder to focus on risk adjustment for the clinically integrated network associated with The University of Tennessee Medical Center and University Physicians’ Association.
 
This position requires normal business hours Monday-Friday. This is a remote position with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the Knoxville, TN region.
 
This role involves performing detailed clinical documentation and risk adjustment reviews and accurately coding procedures and diagnoses using ICD-10-CM, CPT, HCPCS, and modifiers for professional services associated with The University of Tennessee Medical Center and University Physicians’ Association.
 
Essential Duties and Responsibilities (this list does not include all duties assigned)
Performs coding services while meeting daily production and quality goals
<ul>
<li>Conduct thorough reviews of clinical documentation to ensure accuracy and compliance with coding standards.</li>
<li>Assign appropriate ICD-10-CM, CPT, HCPCS, and modifiers for professional services.</li>
<li>Collaborate with healthcare providers to clarify diagnoses and procedures to ensure accurate coding.</li>
<li>Uses CMS and HHS risk adjustment mapping tools to identify HCC coding and documentation opportunities</li>
<li>Participate in ongoing education and training to stay current with coding updates and guidelines</li>
<li>Actively participates in designated team meetings</li>
<li>Consistently meets coding productivity and accuracy standards while managing different responsibilities and workflows. If unable to maintain productivity and accuracy standards, team members will work onsite at the UHN office until standards are met and maintained.</li>
</ul>
Partners with providers, practice staff, and UHN Coding team to improve quality and efficiencies in coding and documentation
<ul>
<li>Educates and coaches on compliant coding and documentation practices and accurate risk adjustment guidelines</li>
<li>Facilitates and supports a culture of compliance, ethics, and integrity</li>
<li>Recognized as an expert in risk adjustment coding compliance</li>
<li>Interacts effectively and builds respectful working relationships across the organization.</li>
</ul>
Maintains HIPPA Guidelines for privacy
<ul>
<li>Respects the privacy of all patients 100% of the time</li>
<li>Understands and abides by HIPAA laws and regulations and UPA HIPAA policy at all times</li>
<li>Obtains consent to release protected health information</li>
<li>Reports all HIPAA issues to the Supervisor</li>
</ul>
Remains current on coding rules and guidelines
<ul>
<li>Remains up to date with official AMA ICD-10 coding guidelines and regulations, Medicare, other MA and commercial plans, and internal guidelines</li>
<li>Remains up to date with CMS and HHS HCC risk adjustment models</li>
<li>Meets CEU requirements and remains in good standing with AAPC/AHIMA certifications</li>
</ul>
Full benefit package available, including PTO, Medical, Dental, Vision, STD/LTD, Life Insurance, 401k + Company Match, and more!
Requirements:
<ul>
<li>Current CPC or RHIT certification required.</li>
<li>CRC required within 6-months of hire</li>
<li>Preferred at least two years of professional medical coding experience in an ambulatory care setting. E/M coding experience a plus.</li>
<li>Preferred experience and knowledge of HCC coding, knowledge related to chronic illness diagnosis, treatment, and management</li>
<li>Must be a team player with effective written and verbal communication, relationship-building, and interpersonal skills</li>
<li>Must be initiative-taking, highly organized, and have excellent time management</li>
<li>Must possess good problem solving and critical thinking skills</li>
<li>Exceptional attention to detail and proficiency in Microsoft Outlook (Outlook, Word, Excel, and PowerPoint)</li>
<li>Demonstrates integrity by adhering to high standards of personal and professional conduct</li>
</ul>

Certified Medical Coder - University Health Network

<h3>Job Description</h3>
Job Description
<ul>
<li>Coding for Cath lab services&nbsp;</li>
<li>Identifies missing documentation&nbsp;</li>
<li>Flexible schedule after training</li>
<li>Experience with Epic is a plus</li>
<li>Contract role, fully REMOTE</li>
<li>MUST have coding credential: RHIT, RHIA, or CIRCC</li>
<li>MUST have 5+ years cath lab charging or cardiology coding experience</li>
</ul>
Company DescriptionClient Information must be withheld until meeting with Staffing Agency 
<h3>Company Description</h3>
Client Information must be withheld until meeting with Staffing Agency

Outpatient Medical Coder

<h3>Job Description</h3>
Job Description
Summary: Responsible for assignment of accurate Evaluation and Management (E&amp;M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers, and quantities derived from medical record documentation (paper or electronic) for outpatient encounters. Trains and educates MTF staff on coding issues and plays a significant role in coding compliance activities.
Duties &amp; Responsibilities:
<ul>
<li>Responsible for the assignment of accurate E&amp;M, ICD, CPT, and HCPCS codes and modifiers from medical record documentation.</li>
<li>Identifies and abstracts information from medical records (paper or electronic) for special studies and audits, internal and external.</li>
<li>Interacts with MTF staff to ensure documentation is clear and supports coding assignments. </li>
<li>Educates MTF staff through individual or group in-services and training sessions.</li>
<li>Maintains a delinquency report of missing records in order to facilitate the completion of work within the required thresholds.</li>
<li>Position requires excellent computer/communication skills for provider and staff interactions.</li>
<li>Knowledge of anatomy/physiology and disease process, medical terminology, coding guidelines (outpatient), documentation requirements, familiarity with medications and reimbursement guidelines; and encoder experience.</li>
<li>Candidate must have the ability to handle multiple projects and appropriately prioritize tasks to meet deadlines.</li>
</ul>
Requirements:
<ul>
<li>Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC) CCS-P (Certified Coder Specialist - Physician (CCS-P) with the appropriate level of experience.</li>
<li>An accrediting institution recognized by the American Health Information Management Association (AHIMA) and/or the American Academy of Professional Coders (AAPC) must accredit education.</li>
<li>CONTINUED EDUCATION REQUIREMENTS: Contract medical coders will obtain the required continued education hours at no expense to the government in order to maintain the current and proper national certification(s) required for the position.</li>
<li>Experience. A minimum of three years of experience in the outpatient setting (physician's office or ambulatory surgery centers) within the last five years, including assignment of E&amp;M, CPT, and HCPCS codes.</li>
</ul>

<h3>Job Description</h3>
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. 
Must be willing to travel to NYC twice a year for required meetings.
Position Purpose: The focus of this position is to establish processes to respond to ICD-10 coding changes and its effect on inpatient claims payment. Chart review will include DRG pre-payment review, hospital readmission review and outlier payment review.
<ul>
<li>Analyze moderately complex health care information; reviews medical records; integrate medical coding and reimbursement rules; provide pricing guidance.</li>
</ul>
<ul>
<li>Ensure medical coding rules and regulations including compliance requirements are adhered to for the appropriate handling of medical necessity, claims denials, and bundling issues.</li>
</ul>
<ul>
<li>Provide regular reports on project status and progress; report project results to identify coding improvement opportunities.</li>
</ul>
<ul>
<li>Collaborate with other business units to identify and implement process efficiency and quality improvement practices.</li>
</ul>
<ul>
<li>Work with IT resources to implement system efficiencies and configuration enhancements to improve claims processing operations.</li>
</ul>
<ul>
<li>Apply Coding Guidelines as described in the ICD-10 Coding Manual.</li>
<li>Performs other duties as assigned.</li>
</ul>
<ul>
<li>Complies with all policies and standards.</li>
</ul>
Education/Experience: RN Degree. One year experience preferred in hospital inpatient coding. Nursing experience in managed care organization or acute care hospital. For Fidelis Care only: One year of experience in a clinical setting or acute care hospital; RN, PA, MD, APRN, DO or MBBS license required. Coding Credential Required: Valid/Current CPC Certification, through APPC preferred or CIC through AAPC or CCS through AHIMA; RHIA/RHIT Credentials-Preferred. 
Pay Range: $68,700.00 - $123,700.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
 Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Sr Certified Medical Coder RN

<h3>Job Description</h3>
Job Description
Local, fast-paced, growing specialty practice looking for a Full-Time Medical Coder / Biller. Northlake Gastroenterology Associates is comprised of 6&nbsp;physicians, 5&nbsp;NPs, 3&nbsp;offices and 2 Ambulatory Surgical Centers. We are continuously advancing and making strides to keep up with the modernization of the medical field and industry standards as a whole.&nbsp;
Experience:&nbsp;Minimum of 5 years of medical billing required, CPC certification required
General skills and knowledge:
<ul>
<li>General experience working with insurance carriers and representatives, patients, and staff on meeting/communicating billing &amp; documentation concerns or requirements for billed services.</li>
<li>Standard industry policy and procedure in a medical office setting (i.e. billing, front desk, eligibility verification, PAs, scheduling, referrals, etc.)</li>
<li>Working reports and queues such as A/R, aging, collections, failed scrub, invalid, rejected, etc.</li>
<li>HIPAA compliance and guidelines</li>
<li>CPT &amp; ICD-10 coding from OV, procedure, hospital consults, anesthesia, etc.</li>
<li>Submitting clean claims</li>
<li>Denial management</li>
<li>Using/Understanding of NCDs, LCDs, CCI Edits, and commercial payer policies.</li>
<li>Understanding of checks &amp; balances.</li>
<li>Problem solving skills are mandatory as our billing department plays a vital roll in day to day management of the practice.</li>
<li>Excellent communication skills are necessary with the ability to discuss claim adjudication processes with patients in a professional manner.</li>
<li>Tasking and clear communication with physicians and clinical staff when necessary.</li>
<li>Exemplary organizational skills.</li>
<li>Ability to follow instructions when given tasks, general instruction, or implementation of new procedures within the billing department.</li>
</ul>
Computer/Technical Skills:
<ul>
<li>Proficiency and experience with Microsoft Word, Excel, and Adobe is required as all are used daily.</li>
<li>Ability to develop/manage office forms, letter templates, and spreadsheets is preferred.</li>
<li>Other general computer skills should be proficient as well.</li>
</ul>
Job Responsibilities:
<ul>
<li>Manage rejected, denied, invalid, failed scrubs within the billed and unbilled claim queues daily.</li>
<li>Work A/R report monthly refiling/analyzing claims data.</li>
<li>Identify and research frequent causes of denials &amp; rejections so that corrective action plans can be implemented.</li>
<li>Work denials &amp; recoupments in a timely manner to prevent exceeded filing limits.</li>
<li>Communicate any issues pertaining to claim denials/rejections with the billing supervisor.</li>
<li>Uses reports that categorize denials to assign tasks or personally work to overturn denials.</li>
<li>Researches rejections included in EOBs for resolution and files appropriately.</li>
<li>Cross training in other positions throughout the business office such as front desk, appointments, procedure scheduling, etc to fill in when needed.</li>
</ul>
Company DescriptionNorthlake Gastroenterology Associates is dedicated to providing the most advanced research and treatment of gastroenterology conditions in Southeast Louisiana. NGA has locations in Hammond, Covington and Franklinton. 
<h3>Company Description</h3>
Northlake Gastroenterology Associates is dedicated to providing the most advanced research and treatment of gastroenterology conditions in Southeast Louisiana. NGA has locations in Hammond, Covington and Franklinton.

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