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Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) CalOptima CalOptima Health is seeking a highly motivated Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) to join our team. The Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal) will be responsible for assisting with all Hierarchical Condition Categories (HCC) projects and Medi-Cal Annual Wellness Visit Initiative Program. The incumbent will handle risk adjustment-related activities to ensure the Centers for Medicare &amp; Medicaid Services (CMS) and Department of Health Care Services (DHCS) coding and documentation guidelines are met. The incumbent will assist in improving risk score performance through collaboration with CalOptima Health's health networks, contracted providers and Program of All-Inclusive Care for the Elderly (PACE) providers. The incumbent will substantiate and verify the member's medical records using International Classification of Diseases (ICD)-10 Clinical Modification (CM) official guidelines for coding and reporting during the review process. The incumbent will verify the accuracy, completeness and appropriateness of diagnosis codes based on the medical documentation provided. As part of the medical records review, travel may be required to physician offices or physician medical groups throughout Orange County. Position Information: 
<ul>
<li>Department: Financial Analysis </li>
<li>Salary Grade: 309 - $68,015 - $108,824 ($32.70 - $52.3192) </li>
<li>Work Arrangement: Full Telework **This position is eligible for telework in California.** </li>
</ul>
 Duties &amp; Responsibilities: 
<ul>
<li>80% - Program Support
<ul>
<li>Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.</li>
<li>Reviews and assesses the accuracy, completeness, specificity and appropriateness of diagnosis codes based on documentation and creates tools/tip sheets for audit staff to utilize for future audits based on findings.</li>
<li>Conducts in depth retrospective and prospective medical record audits to assess the accuracy of ICD-10 CM coding for chronic conditions as it pertains to HCC for CalOptima Health Community Network (CHCN), PACE providers and delegated health networks.</li>
<li>Tracks all network HCC activities, including training, audit results and evaluating future outcomes, which includes monitoring performance improvement of network providers by observing patterns and trends and recommending solutions to the manager.</li>
<li>Reviews medical record information to identify all appropriate coding CMS HCC categories and DHCS coding and monitors the DHCS and CMS websites for updates.</li>
<li>Reviews additional data identified from audits to ensure timely data entry for CMS sweeps.</li>
<li>Identifies providers for education and training opportunities following ICD-10-CM coding guidelines based on HCC audit results and Medi-Cal Annual Wellness Visit Initiative Program and reports findings to the Manager.</li>
<li>Assists with CMS Risk Adjustment Data Validation (RADV) and Office of Inspector General (OIG) audits, including workflow or data collection requirements and creating and maintaining HCC audit results when applicable.</li>
<li>Performs code abstraction on supported clinical documentation identified as opportunities through Natural Language Processing (NLP) software. </li>
</ul>
</li>
<li>15% - Administrative Support
<ul>
<li>Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.</li>
<li>Assists manager in evaluating existing reports for PACE members provided by CMS and collaborates with Financial Analysis to create any custom report required to assist with audits. </li>
</ul>
</li>
<li>5% - Other-
<ul>
<li>Completes other projects and duties as assigned. </li>
</ul>
</li>
</ul>
 Minimum Qualifications: 
<ul>
<li>Bachelor's degree in public health, business administration or related field PLUS 5 years of risk adjustment coding and chart audit/quality experience in a managed care or health care environment required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying. </li>
<li>Have access to means of transportation for work away from the primary office approximately 20% of the time required.</li>
</ul>
 Preferred Qualifications: 
<ul>
<li>Registered Health Information Technician (RHIT) or Certified Risk Adjustment Coder (CRC). </li>
<li>Experience with conducting presentations and performing physician education.</li>
</ul>
 Required Licensure / Certifications: 
<ul>
<li>Current Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) by the American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) required. Certification is required to be current and maintained during employment.</li>
</ul>
 Knowledge &amp; Abilities: 
<ul>
<li>Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds. </li>
<li>Work independently and exercise sound judgment.</li>
<li>Communicate clearly and concisely, both orally and in writing.</li>
<li>Work a flexible schedule; available to participate in evening and weekend events.</li>
<li>Organize, be analytical, problem-solve and possess project management skills.</li>
<li>Work in a fast-paced environment and in an efficient manner.</li>
<li>Manage multiple projects and identify opportunities for internal and external collaboration.</li>
<li>Motivate and lead multi-program teams and external committees/coalitions.</li>
<li>Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.</li>
</ul>
 Physical Requirements (With or Without Accommodations): 
<ul>
<li>Ability to visually read information from computer screens, forms and other printed materials and information.</li>
<li>Ability to speak (enunciate) clearly in conversation and general communication.</li>
<li>Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.</li>
<li>Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.</li>
<li>Lifting and moving objects, patients and/or equipment 10 to 25 pounds</li>
</ul>
 Work Environment: If located at the 500, 505 Building or a remote work location: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.</li>
<li>There are no harmful environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate.</li>
</ul>
 If located at PACE: 
<ul>
<li>Work is typically indoors in a clinical setting serving the frail and elderly.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 If located in the Community: 
<ul>
<li>Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed. </li>
<li>Employee will occasionally work outdoors in varied temperatures.</li>
<li>There may be harmful or hazardous environmental conditions present for this job.</li>
<li>The noise level in this work environment is usually moderate to loud.</li>
</ul>
 About CalOptima Health: CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay! About our Benefits &amp; Wellness options: At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the <a href="https://apptrkr.com/get_redirect.php?id=6299515&amp;targetURL=https://alliantbenefits.cld.bz/25caloptimacabenguide" target="_blank">2025 CalOptima Health Benefits Guide</a> regarding our comprehensive benefits and wellness package. IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is June 26, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date. The selection process may include, but is not limited to, a skills assessment, phone screen and interview. The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet. Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application. CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together. CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics. If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability. To apply, please visit: <a href="https://apptrkr.com/6299515" target="_blank">https://jobs.caloptima.org/jobs/certified-coding-specialist-sr-hcc-medicare-and-medi-cal-505-city-parkway-west-california-united-states</a> Copyright ©2025 Jobelephant.com Inc. All rights reserved. <a href="https://www.jobelephant.com/" target="_blank">Posted by the FREE value-added recruitment advertising agency</a> jeid-d4deeaad9bc4a74cb61631e4900eb19a

Certified Coding Specialist Sr (HCC-Medicare and Medi-Cal)

<h3>Job Description</h3>
Job DescriptionCertified Professional Coder- Medical Billing Department (CPC/ CPC-A) Job Type Full-time Full Job Description Bayview Physicians Group is a rapidly growing outpatient multi-specialty medical group, that strongly believes the doctor-patient relationship is the cornerstone of quality healthcare. We staff more than 600 positions in the Hampton Roads area. Individuals who possess excellent customer service skills, strong collegial relationships, and the desire to promote a positive work environment are encouraged to apply. We offer a competitive benefits package to our full time employees and we are always accepting applications from qualified candidates.&nbsp; We are currently seeking a full-time CPC or CPC-A Certified Professional Coder. If you are an Apprentice you are also encouraged to apply. We can offer you the opportunity to work &nbsp;and grow as a coder for a large multi-specialty group. We are willing to train the right candidate. This will offer coders from all levels of experience the opportunity to work with a diverse group of CPC's on a variety of specialties. Some of the specialties include: Hospitalists, Cardiology, Pulmonary and Critical Care, Sleep Specialists, Endocrinology, Podiatry, OB/GYN, Colo/Rectal, Urgent Care, Dermatology, ENT and much more. Remote and/or Hybrid opportunities are available. Duties &amp; Responsibilities:
<ul>
<li>Review charge tickets, progress notes, and op notes to apply appropriate CPT, ICD-10 and HCPCS codes.&nbsp;</li>
<li>Review denied claims queue’s needing coding review for multispecialty claims and identify how to correct the claim to ensure&nbsp;payment.</li>
<li>Participate in month end closing processes. This requires end of month black out dates. Extended hours and weekend shifts may be required during the month end time frame. (Aprx last week of the month)</li>
<li>Maintains required annual CEU’s</li>
<li>Special Projects as assigned</li>
</ul>
Qualifications:
<ul>
<li>Must be&nbsp;licensed&nbsp;as a Certified Professional Coder (CPC) or Certified Professional Coder- Apprentice (CPC-A)</li>
<li>Ability to communicate effectively &amp; professionally orally and in writing.</li>
<li>Must demonstrate the ability to work as a team member.</li>
<li>Must demonstrate a positive attitude, and helpful demeanor.</li>
<li>Attention to detail a must</li>
<li>Ability to work independently with little to no direct supervision</li>
<li>Self-starter who is willing to learn and grow</li>
<li>General knowledge of standard office equipment such as computers, fax machine, photo copier, etc.</li>
<li>General medical office experience a plus</li>
<li>Locations in Chesapeake and Virginia Beach</li>
</ul>
Education and/or Experience:
<ul>
<li>CPC or CPC-A Required</li>
</ul>
Additional Benefits Offered to full time CPC Coders:&nbsp;
<ul>
<li>Remote work from home opportunity available to CPC coders after 1 year of successful employment</li>
<li>Reimbursement of AAPC annual dues</li>
<li>All CPT, ICD-10, HCPCS and Specialty books are provided annually</li>
<li>Access to Codify</li>
<li>Opportunities for continued training available by specialty</li>
</ul>
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McWmaLuGP7

Medical Coder

<h3>Job Description</h3>
Job Description
Position: Medical Coder
Location: Manchester, New Hampshire
Company Overview:
We are a leading healthcare staffing and recruiting agency, dedicated to connecting top talent with the best healthcare organizations nationwide. We are currently seeking a skilled and experienced Medical Coder to join our team in Manchester, New Hampshire.
Position Overview:
As a Medical Coder, you will be responsible for reviewing and accurately coding medical records for billing and insurance purposes. You will work closely with healthcare providers, insurance companies, and other healthcare professionals to ensure proper coding and billing practices. This is a full-time, on-site position.
Key Responsibilities:
- Review and accurately code medical records for billing and insurance purposes
- Ensure compliance with all coding guidelines and regulations
- Work closely with healthcare providers to clarify any discrepancies or missing information
- Communicate with insurance companies to resolve any coding or billing issues
- Stay up-to-date with changes in coding guidelines and regulations
- Maintain confidentiality of patient information
- Collaborate with other members of the healthcare team to ensure accurate and timely billing
- Provide support and training to other staff members as needed
Qualifications:
- High school diploma or equivalent required
- Certification as a Medical Coder (CPC, CCS, etc.) preferred
- Minimum of 2 years of experience in medical coding
- Strong knowledge of ICD-10, CPT, and HCPCS coding systems
- Familiarity with medical terminology and procedures
- Excellent attention to detail and accuracy
- Strong communication and interpersonal skills
- Ability to work independently and in a team environment
- Proficient in Microsoft Office and electronic medical record systems
We Offer:
- Competitive salary and benefits package
- Opportunity for growth and advancement within the company
- Supportive and collaborative work environment
- Continuing education and training opportunities
- Full-time, on-site position with flexible scheduling options
If you are a highly skilled and experienced Medical Coder looking for a new opportunity, we encourage you to apply for this position. Join our team at MBC Talent Connections and make a positive impact in the healthcare industry.

<h3>Job Description</h3>
Job DescriptionMedical CoderPart-Time (20 hrs. per week): M-F 8 AM - 12PMStarting Pay: $18 - $22/hr. DOEPosition Overview:At Conceptions Fertility Center we are passionate about providing empathetic, personalized, and exceptional patient care. We work to help people grow and build their families through a variety of treatment options. We are currently looking for experienced, compassionate, and dynamic team players to join our growing practice. If you are looking for a rewarding environment where your talent and skills will change people’s lives, then we want to talk to you. This position is integral to our practice and requires working closely with patients, providers, and other staff. We are seeking a detail-oriented and organized Medical Coder to join our billing team. The ideal candidate will have a strong understanding of medical terminology, anatomy, physiology, and coding guidelines. You will play a crucial role in ensuring accurate and timely coding of medical records, which is essential for billing, reimbursement, and compliance with regulatory requirements. The position will also provide support, as needed, to our billing team helping with other billing related tasks. Responsibilities: 
<ul>
<li>Review and analyze medical records, patient charts, and documentation related to fertility treatments rendered at the clinic.</li>
<li>Assign appropriate medical codes to diagnoses, procedures, and services using ICD-10, CPT, and HCPCS code sets.</li>
<li>Ensure the accuracy and completeness of coded information to facilitate proper reimbursement and compliance with regulatory requirements.</li>
<li>Communicate regularly and effectively with healthcare providers to clarify documentation and coding queries, helping them to understand the necessity of your recommendations.</li>
<li>Stay updated on changes in coding guidelines, regulations, and reimbursement policies relevant to fertility treatments.</li>
<li>Collaborate with billing specialists to resolve coding-related denials, rejections, and queries from insurance companies.</li>
<li>Participate in coding audits and quality improvement initiatives to enhance coding accuracy and efficiency.</li>
<li>Maintain confidentiality of patient information and adhere to HIPAA regulations.</li>
<li>Provide coding-related education and training to clinical and administrative staff as needed.</li>
<li>Assist the billing team with billing related tasks as assigned by the Billing Supervisor and Practice Manager.</li>
</ul>
 Qualifications: 
<ul>
<li>High school diploma or equivalent; certification in medical coding (e.g., CPC, CCS) required.</li>
<li>Proven experience as a Medical Coder in a healthcare setting.</li>
<li>In-depth knowledge of medical terminology, anatomy, physiology, and pharmacology.</li>
<li>Proficiency in using coding classification systems such as ICD-10, CPT, and HCPCS.</li>
<li>Strong analytical and critical thinking skills with attention to detail.</li>
<li>Excellent communication and interpersonal and conflict resolution skills.</li>
<li>Ability to work independently and collaboratively in a fast-paced environment.</li>
<li>Familiarity with electronic health record (EHR) systems and medical billing software.</li>
<li>Commitment to maintaining confidentiality and adhering to ethical standards.</li>
</ul>
 We Offer: 
<ul>
<li>Competitive pay</li>
<li>Comprehensive training</li>
<li>Medical, dental, vision, and 401(k) matching.</li>
<li>A fun, motivated group of people at a clinic that makes a difference in people’s lives.</li>
</ul>
 
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<h3>Job Description</h3>
Job DescriptionDescription:
The Medical Coder will be responsible for accurately assigning diagnostic and procedure codes to patient encounters and medical services, ensuring compliance with coding guidelines and regulations. The ideal candidate will have strong knowledge of medical coding systems, such as ICD-10 and CPT, and experience in coding for OBGYN, laboratory, and mammography services.
Responsibilities:
<ul>
<li>Coding and Abstracting: Review patient medical records, encounter forms, and other documentation to accurately assign diagnostic (ICD-10) and procedure (CPT/HCPCS) codes based on coding guidelines and documentation standards. Abstract relevant information from medical records, including diagnoses, procedures, treatments, and services rendered, to support accurate coding.</li>
<li>Code Validation and Accuracy: Verify the accuracy and completeness of coded data, ensuring that codes assigned reflect the documented diagnoses, procedures, and services provided during patient encounters. Resolve coding discrepancies or inconsistencies by collaborating with healthcare providers, clinical staff, and other stakeholders to obtain additional information or clarification.</li>
<li>Compliance and Documentation: Ensure compliance with coding guidelines, regulations, and payer policies, including but not limited to CMS guidelines, NCCI edits, and local coverage determinations (LCDs). Maintain up-to-date knowledge of coding updates, changes, and revisions, and apply coding updates appropriately to ensure accurate coding practices.</li>
<li>Quality Assurance and Auditing: Perform regular audits and quality checks of coded data to identify coding errors, discrepancies, and opportunities for improvement. Assist with internal coding audits, external coding reviews, and compliance audits to ensure coding accuracy and adherence to regulatory requirements.</li>
<li>KPI Requirements: Meet or exceed Key Performance Indicators to include 95% or above coding accuracy, 48 hour timely charge entry and claim edit/denial reconciliation rate, and 120-150 charts per day productivity, depending on chart complexity.</li>
<li>Coding Education and Training: Provide coding education and training to healthcare providers, clinical staff, and administrative staff on coding guidelines, documentation requirements, and best practices for accurate coding. Assist with developing and implementing coding-related policies, procedures, and protocols to support coding compliance and accuracy.</li>
<li>Collaboration and Communication: Collaborate with billing staff, revenue cycle management team members, and healthcare providers to resolve coding-related issues, denials, and reimbursement discrepancies. Communicate effectively with internal and external stakeholders regarding coding-related inquiries, coding updates, and documentation requirements.</li>
</ul>
Requirements:
<ul>
<li>Certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) required.</li>
<li>Minimum of 2-3 years of experience in medical coding, preferably in an OBGYN, laboratory, mammography or women's health practice setting.</li>
<li>Strong knowledge of medical coding systems, including ICD-10, CPT, and HCPCS, and coding guidelines and regulations.</li>
<li>Proficiency in using coding software and electronic health records (EHR) systems for coding and documentation.</li>
<li>Excellent attention to detail, analytical skills, and problem-solving abilities in reviewing and assigning diagnostic and procedure codes.</li>
<li>Strong communication and interpersonal skills, with the ability to collaborate effectively with healthcare providers, clinical staff, and administrative staff.</li>
<li>Commitment to maintaining coding accuracy, compliance with coding guidelines, and confidentiality of patient health information.</li>
</ul>

<h3>Job Description</h3>
Job DescriptionMedical Coder (Anesthesia)
 Make a measurable impact by combining high-accuracy anesthesia coding with client-facing collaboration to support medical practices across New England.
Our client is a healthcare management firm providing strategic and operational support to practices throughout the region. This dual-impact role offers the best of both worlds: production coding and client interaction. You’ll ensure accuracy in anesthesia coding while participating in audits and documentation reviews, perfect for a coder who thrives in detail-driven work and professional communication.
What’s in it for you:
<ul>
<li>$63,000 – $73,000 annual salary</li>
<li>Full medical, dental, and vision coverage</li>
<li>$1,000 employer HSA contribution</li>
<li>401(k) with 5% Safe Harbor match</li>
<li>5% discretionary profit sharing</li>
<li>PTO, sick time, and paid holidays</li>
<li>Free access to affiliated family practices, imaging, and surgical centers</li>
<li>Location: Manchester, NH (100% onsite)</li>
</ul>
Key Responsibilities:
<ul>
<li>Code anesthesia cases accurately and efficiently</li>
<li>Conduct documentation reviews and audits for client practices</li>
<li>Present findings and compliance insights to clients</li>
<li>Identify documentation gaps and recommend improvements</li>
<li>Maintain up-to-date knowledge of CPT, ICD-10, ASA crosswalk, and modifiers</li>
<li>Partner with team members to uphold coding standards and client satisfaction</li>
</ul>
Qualifications:
<ul>
<li>3+ years of medical coding experience with a focus on anesthesia</li>
<li>Strong knowledge of ASA crosswalk and anesthesia billing practices</li>
<li>Experience in or ability to perform client-facing presentations</li>
<li>Exceptional attention to detail and strong organizational skills</li>
</ul>
Qualified candidates should apply today and email their resume to <a href="mailto:aj@jasurdagroup.com" target="_blank">aj@jasurdagroup.com</a> for immediate consideration.

<h3>Job Description</h3>
Job Description
Job Posting: Certified Medical Coders (12-Week Contract)
Location:&nbsp;On site 100% in the Northern Wisconsin area
Schedule:&nbsp;Monday through Friday, 8:00 AM – 5:00 PM
Duration:&nbsp;Estimated 12-week engagement (Start: Mid-July, End: October)
Are you a Certified Medical Coder with a keen eye for detail and a commitment to accuracy? We are seeking skilled professionals to assist in reviewing, correcting, and reprocessing claim data to ensure precise billing and compliance with coding guidelines.
Responsibilities:
<ul>
<li>Analyze and validate claims data within the EPIC EHR/billing system to ensure adherence to ICD10, CPT, UB04, and CMS1500 claim formatting standards.</li>
<li>Correct errors and reprocess billing data to maintain compliance and streamline workflows.</li>
<li>Collaborate with teams to achieve organizational goals in accurate medical billing procedures.</li>
</ul>
Required Qualifications:
<ul>
<li>Certified Medical Coder with experience in ICD10 and CPT coding guidelines.</li>
<li>Proven ability to work with both UB04 and CMS1500 claim formats.</li>
<li>Proficiency in using electronic health records (EHR) and medical billing systems.</li>
<li>CCS (Certified Coding Specialist) and CCA (Certified Coding Associate) certifications.</li>
<li>Strong computer skills and attention to detail.</li>
<li>Reliable, dependable, and punctual work ethic.</li>
</ul>
Preferred Qualifications (Nice to Have):
<ul>
<li>Previous experience working within the EPIC system.</li>
<li>Knowledge of professional radiology billing processes.</li>
</ul>
Why Join Us:
 This is a fantastic opportunity to contribute your expertise to ensure accurate claim data processing in a dynamic healthcare setting. While there is a preference for local candidates, we welcome professionals with relevant skills and certifications who are ready to hit the ground running!
How to Apply:
 If you meet the requirements listed above and are ready for a rewarding 12-week engagement, apply today!
• Certification as a Medical Coder with knowledge of ICD-10 and industry coding standards. • Proficiency in working with UB04 and CMS1500 claim formats. • Experience using electronic health records and medical billing systems. • Certified Coding Specialist (CCS) or Certified Coding Associate (CCA) credentials. • Strong attention to detail and ability to identify discrepancies in billing data. • Excellent computer skills and familiarity with medical coding software. • Reliable and punctual work ethic with a commitment to quality. • Minimum of 3 years of experience in medical coding or related roles.

<h3>Job Description</h3>
Terms of Employment:
• W2, Contract
• 3 Months with possible extension
• Predominantly remote. There will be occasional onsite visits to our client’s office in either: Canton, MD, Washington D.C., Owings Mills, MD or Columbia, MD. Candidates must reside within the Maryland, DC, Virginia or Delaware area.
 
Overview &amp; Responsibilities
Join our client’s Special Investigations Unit (SIU) as a Medical Coder, leveraging your medical coding expertise to combat fraud, waste, and abuse in healthcare claims. This vital role involves the prepayment review of medical records to ensure accurate billing per industry standards and internal policies. You will be instrumental in clearing a significant backlog of claims and contributing to the integrity of the claims process. This is an excellent opportunity for a certified medical coder seeking a high-impact role with potential for long-term employment. Key responsibilities include:
• Review medical records and claims for fraudulent indicators and coding accuracy. 
• Determine if claims are accurately billed per industry standards (e.g., AMA guidance, AAPC guidance) and internal payment/medical policies. 
• Render determinations on claims, which may include denying or paying them based on review findings. 
• Utilize coding software (e.g., Codify, Optum Encoder Pro) or CPT manuals to aid in code review and ensure all required components of office visits are met. 
• Manage a high volume of claim reviews, contributing to the reduction of a significant backlog. 
 
Required Qualifications: 
• High School Diploma or GED.
• Active and validated Certified Professional Coder (CPC) certification or equivalent accreditation (e.g., CPMA, COC, or AHIMA accreditation) without Apprentice tag. 
• 3 years of experience in risk adjustment coding, ambulatory coding, and/or CRC coding experience in managed care, state or federal healthcare programs, or the health insurance industry.
• Experience in physician coding, specifically reviewing office visits and services rendered in a physician's office. 
• Proficiency in reviewing medical records and claims for coding accuracy. 
• Detail oriented.
 
Preferred Qualifications: 
• Experience using coding software such as Codify (AAPC) or Optum Encoder Pro.

<h3>Job Description</h3>
Job DescriptionWe are seeking a Medical Coder to join our team. Individual must be detail oriented, possess excellent organization skills, have a strong work ethic, work well in a team environment. Previous medical coding experience is a must. Prior anesthesia coding experience helpful but not required. The ideal candidate has excellent attention to detail, strong work ethic, motivated, and a self starter.&nbsp; Responsibilities
<ul>
<li>Assign ICD-10 and CPT ASA code to cases</li>
<li>Perform front end revenue cycle functions along with coding</li>
<li>Maintain patient confidentiality &nbsp;</li>
<li>Be able to meet production deadlines</li>
</ul>
Qualifications
<ul>
<li>Previous experience with medical coding or billing desired</li>
<li>Strong organization skills</li>
<li>Excellent attention to detail</li>
<li>Ability analyze and draw conclusions from information available</li>
<li>Basic to intermediate computer skills</li>
</ul>

<h3>Job Description</h3>
Job Description
South Los Angeles based FQHC looking for onsite Certified HCC coder .
*This is not a remote position
Conduct the necessary audits of medical record to verify the physicians have appropriately documented the diagnoses then code these diagnoses in ICD-10 for Medicare Risk
Adjustments/Medicare Advantage. Evaluate medical information (Outpatient/Inpatient) documentation from a clinical standpoint for evidence of the possibility of additional medical conditions that may not have been documented in the past, and ensure accurate coding of the encounter data and recommend processes for accurate coding practices. This process involves a very strong understanding of medical coding.
<ul>
<li>Ascertain that medical record documentations have accurate diagnoses and conditions to assure not to up-code, fraudulently or misrepresent the patient condition and ensure compliance to prepare for random CMS medical records audit</li>
<li>HEDIS coding and record collection</li>
<li>Report Coding discrepancies patterns identified within the chart review process to the Coding Project Manager and identify corrective measures regarding compliance problems, and suggests corrective measure to the physician in understanding of what is needed regarding documentation compliance</li>
</ul>
Provider Education
<ul>
<li>Provide detailed summary to make adjustments to correct improperly paid claims and document the correct coding to be utilized</li>
</ul>
Management Feedback:
<ul>
<li>Communicate quality issues to direct supervisor &amp; COO, Team Leaders and other Managers.</li>
<li>Provide recommendations to management based on audit findings</li>
</ul>
Management reports:
<ul>
<li>Prepare management summary reports of audit findings</li>
</ul>
Additional Responsibilities:
<ul>
<li>Provide support to the Management as required.</li>
<li>Maintains detailed knowledge of coding guidelines and regulations</li>
</ul>
Qualification Experience and Skills Required Experience:
<ul>
<li>Must have CPC or CCS certification</li>
<li>Five (5) years coding experience.</li>
<li>Multi-Specialty coding experienced required.</li>
<li>Outpatient/Clinic billing experience required.</li>
<li>Physician billing office supervisory experience preferred</li>
<li>Knowledgeable in Hierarchical Condition Categories (HCC) concepts and documentation guidelines.</li>
<li>Knowledge in MACRA reporting</li>
<li>High School degree required. Some college preferred.</li>
</ul>
Company DescriptionT.H.E. Health and Wellness Centers is a nonprofit community clinic in South Los Angeles. For more than 50 years, we've provided high-quality, low cost healthcare and preventative education for all. We are an Equal Opportunity Employer. 
<h3>Company Description</h3>
T.H.E. Health and Wellness Centers is a nonprofit community clinic in South Los Angeles. For more than 50 years, we've provided high-quality, low cost healthcare and preventative education for all.\r\n\r\nWe are an Equal Opportunity Employer.

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