Know Pf Establishment Code Jobs in Usa
15,832 positions found — Page 3
$32.60 - $48.90 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
* Position: Senior Coding Educator
* Location: Skokie, IL
* Full Time
* Hours: Monday-Friday, 8:00am-4:30pm
A Brief Overview:
The purpose of this job is to educate physicians, other qualified billing providers, and ancillary staff on their documentation for all specialties and review providers progress notes, as needed, to ensure coding/billing compliance in accordance with coding rules, third party payor guidelines, governmental regulations, and MG's Coding Compliance Program. The Senior Analyst will conduct face-to-face summary review sessions to report findings to the Practice Manager, Provider audited, and/or Senior Management of the MG. Through the audit/review process, this person will also conduct a report back to the provider and practice manager any income enhancing opportunities that might be uncovered in the investigation. The Senior Analyst, as a coding and billing expert, will assist all freestanding and provider-based outpatient departments with ICD-10, CPT-4, and HCPCS coding education and billing regulation interpretation. They will also assist in conducting department presentations.
What you will do:
* Analyzes progress notes, op reports, pathology reports, encounter forms, explanation of benefits, patient insurance information, and various other health information documents for pro-fee coding and billing accuracy.
* Assigns appropriate ICD-10, CPT, and HCPCS codes to medical record documentation under review by applying physician specialty coding rules, third party payor guidelines, and Medicare Local Medical Review Policies.
* Assists Manager/Director with providing information to the physician or medical specialty based on the Office of Inspector General's (OIG) and Centers for Medicare and Medicaid Services (CMS) risk areas. Reads the OIG's Semi-Annual reports and the OIG'S/CMS's Annual Workplan, in addition to notifications published on government websites.
* Performs physician and departmental documentation reviews based on industry standard coding and billing guidelines and payer policies to provide documentation and workflow improvement opportunities.
* Works with MG physicians or clinic personnel, HIRS, to interpret medical record documentation and/or documentation summary as necessary.
* Works with Customer Service and MG Operations to review and resolve escalated patient coding disputes.
* Works collaboratively with Billing, HIRS, overseeing provider/specialty and Denials Management Team to provide educational and/or income enhancing opportunities when issues are identified by those teams.
* Conducts educational sessions with Site Directors, Practice Managers, and providers on frequently seen coding errors in their site and assists with implementing changes to improve coding quality and minimize compliance risk.
* Provides feedback to Manager/ Director that identifies inefficient coding/operational processes.
* Assists with related special projects as assigned by Manager/ Director.
* Initiate and provide coding education to all MG billing providers, focusing on Evaluation and Management (E&M) documentation and billing requirements, as well as any specialty-specific coding guidelines.
* Works on special projects with the Hospital Billing Business Office and/or the Finance Department to perform reimbursement analysis functions as assigned by Manager/ Director.
* Submits ideas to Manager of Coding Quality & Auditing departmental newsletter based on coding/billing issues, coding help-line questions, or results of provider audits. May produce Monthly Newsletter if assigned.
* Participates in Coding and Business Operation Education in-services assigned by Manager
* Researches multi-specialty coding and billing questions received from the Coding Help-line/email for EHMG provider/staff and provides verbal or written response as appropriate. Maintains filing system of all questions received and answers provided to caller.
* Identifies trends or patterns of questionable coding and billing practices at Hospital Outpatient and Medical Group sites and reports issues to Manager.
* Reports compliance concerns to Manager or compliance hotline according to the Endeavor Healthcare Corporate Compliance Policy/Procedures.
* Develops physician coding tools such as ICD-10 and CPT-4 cheat sheets, coding grids, tip sheets and other educational material for multi-specialty providers to identify appropriate codes or modifiers reimbursed by payers for services performed.
* Assists in the creation of progress note templates per specialty utilizing the CMS documentation regulations or CPT Assistant guidelines as requested by physician's) or assigned by supervisor.
* Attends multi-specialty physician coding, billing, reimbursement seminars to maintain and increase coding, billing, reimbursement expertise/ knowledge.
* Maintains coding credential by obtaining the requiring continuing education credits per calendar year.
What you will need:
* Degree: Bachelor's degree in Health Information Management, Healthcare Administration, Nursing, or related field required; equivalent years of work experience in related field will be considered in lieu of degree
* Certification: RHIA, RHIT, CCS-P, CCS, or CPC required. CPMA preferred.
* Experience: 3-5 years of related experience in physician and hospital outpatient medical billing, reimbursement, physician audits, chart review, coding compliance, medical office or patient accounts. 1-2 years' experience working with Senior Physician Management a plus
Other required skills
* The ability to work independently, with little to no supervision
* Strong presentation and communication skills
* The ability to interpret and analyze medical record documentation, encounter forms, and lab reports, Explanation of Benefits, CMS claim forms, third party payor guidelines and government regulations.
* Aptitude for medical terminology, ICD-10, CPT-4, and HCPCS coding systems.
* Demonstrated expertise in multi-specialty evaluation & management (E/M) coding.
* Knowledge of research steps utilized to identify appropriate code selection or billing requirements.
* Proficiency in MS Office's suite of products, including Excel and PowerPoint, and the internet.
* Experience with Epic Billing Systems, including chart review, transaction inquiry, etc.
Benefits:
* Career Pathways to Promote Professional Growth and Development
* Various Medical, Dental, and Vision options
* Tuition Reimbursement
* Free Parking at designated locations
* Wellness Program Savings Plan
* Health Savings Account Options
* Retirement Options with Company Match
* Paid Time Off and Holiday Pay
* Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals - Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) - all recognized as Magnet hospitals for nursing excellence. Located in Naperville, Linden Oaks Behavioral Health, provides for the mental health needs of area residents. For more information, visit you work for Endeavor Heal
$30.46 - $45.69 - The hourly pay rate offered is determined by a candidate's expertise and years of experience, among other factors.
Position Highlights:
- Position: Supervisor, Hospital Coding
- Location: Warrenville, IL
- Full Time/Part Time: Full Time
- Hours: Monday-Friday, [hours and flexible work schedules]
A Brief Overview:
The Supervisor, Medical Coding, is responsible for overseeing the medical coding team, ensuring accurate code assignments, adherence to coding guidelines, and compliance with regulatory requirements. This position plays a pivotal role in maintaining financial accuracy and integrity within the hospital.
What you will do:
- Supervise and provide leadership to a team of medical coders, offering guidance, training, and support to ensure high-quality code assignments.
- Oversee and review diagnostic (ICD-10-CM) and procedural (CPT) codes assigned to medical records, validating their accuracy and adherence to coding guidelines.
- Conduct internal coding audits to monitor coding accuracy and consistency, providing feedback and guidance to coding staff.
- Collaborate with clinical staff, physicians, and clinical documentation specialists to ensure accurate coding and identify opportunities for documentation improvement.
- Stay current with coding guidelines, conventions, and regulatory changes, and disseminate information to the coding team.
- Ensure coding practices comply with federal, state, and local healthcare regulations and standards, including HIPAA.
- Generate coding reports, analyze coding data, and provide insights into coding accuracy, trends, and process improvement opportunities.
- Provide ongoing training and development opportunities for coding staff, ensuring they stay updated on best practices and regulations.
- Collaborate closely with clinical staff, health information management, and other departments to streamline the flow of coding-related information.
- Maintain strict confidentiality and security of patient data, complying with HIPAA and other privacy regulations.
What you will need:
- RHIA or RHIT American Health Information Management Association (AHIMA) required
- 5+ Years of medical coding experience, with at least 2 years in a supervisory or leadership role.
Benefits:
- Career Pathways to Promote Professional Growth and Development
- Various Medical, Dental, and Vision options
- Tuition Reimbursement
- Free Parking at designated locations
- Wellness Program Savings Plan
- Health Savings Account Options
- Retirement Options with Company Match
- Paid Time Off
- Community Involvement Opportunities
Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals ? Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) ? all recognized as Magnet hospitals for nursing excellence. For more information, visit you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.
Please explore our website ( ) to better understand how Endeavor Health delivers on its mission to ?help everyone in our communities be their best?.
Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.
Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.
EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.
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Position at a Glance:
- Work Location: Great Lakes Physician Practice
- Address: Lakeshore Orthopedics & Sports Medicine: Jamestown, NY and Dunkirk, NY; Surgeries at UPMC Chautauqua.
- Status: Full-time position
- Immigration Status Considered: Accepts: J1 and H-1B Candidates
- Enhanced compensation package includes:
- Productivity and Quality Incentive
- Residency Stipend
- $50,000 Sign on Bonus
- Student Loan Repayment
- CME Stipend & Days
- Relocation Benefit
- PSLF Eligible
- Employer paid occurrence-based malpractice insurance
Great Lakes Physician Practice (GLPP), part of UPMC's integrated health system, is seeking a skilled and dynamic Orthopaedic Surgeon to join our established group providing high-quality general orthopaedic care in a community-focused setting in Western New York! This is a general orthopaedic surgery opportunity with a preference for adult reconstruction.
- Established Team: Work with two experienced orthopaedic surgeons at UPMC Chautauqua, which is designated as a Center of Excellence for Orthopaedics.
- Advanced Practice Provider Support: Dedicated team of seven APPs assisting in the office, OR, and hospital settings.
- UPMC Affiliation: Connection to a larger network of specialists and resources with UPMC Hamot providing administrative and business support services to Great Lakes Physician Practice.
- Technology: Fully integrated Epic electronic medical record across the health system.
- Referral Base: Robust primary care referral network ensuring consistent patient volume and continuity of care.
- Modernization & Growth: Robotic assistance with planned ongoing investment, including a major upcoming OR renovation and recent radiology upgrades, highlighting a strong commitment to advancing surgical care.
Qualifications:
- MD/DO from an accredited medical school
- Accredited Orthopaedic Surgery Residency Program completion
- American Board Eligible or American Board Certified in Orthopaedic Surgery
- Fellowship training in adult reconstruction is a plus, though not a requirement
- Ability to obtain an unrestricted New York Medical License and ability to obtain necessary credentials
- DEA certification
What Can UPMC Do for You?
- Non-Profit Health System, Employed Model *PSLF Eligible
- Competitive Compensation package with the opportunity to earn additional incentives
- Comprehensive Medical, Dental, and Vision Insurance
- Employer-paid Short and Long-Term Disability Coverage
- Group Life Insurance
- Paid Parental Leave
- Tuition Assistance available for self, spouse/domestic partner, and dependents
- 403(b) Retirement Plan with 50% employer match, plus an employer-paid pension plan. Participate in both!
- Relocation Assistance for customary and reasonable moving expenses
About Great Lakes Physician Practice (GLPP)
Great Lakes Physician Practice (GLPP) is a network of primary care and specialty physicians dedicated to making quality care for families more accessible and more comprehensive than ever before. UPMC Hamot provides administrative and business support services to Great Lakes Physician Practice, which employs more than 50 physicians and 20 advanced practice providers including Cardiology, Gastroenterology, General Surgery, Internal Medicine, Family Medicine, Nephrology, Neurology, Pulmonary/Sleep Medicine, Women's Health, Orthopaedics, Aesthetics, and Neurosurgery. The GLPP network has 12 locations, with the largest facilities in Fredonia and a state-of-the-art medical mall in Jamestown. For more information on the practice and the hospital,
Discover Jamestown, NY, Chautauqua County!
Get ready to experience a community where history meets innovation, and natural beauty surrounds you at every turn.
- Rich Heritage: Immerse yourself in the history of Lucille Ball at the National Comedy Center or explore the Chautauqua Institution, a renowned cultural center.
- Natural Beauty: Enjoy the picturesque landscapes of Chautauqua Lake, where outdoor adventures abound, from hiking and biking to fishing and boating.
- Arts and Culture: Dive into the vibrant arts scene with galleries, theaters, and music venues showcasing local talent and world-class performances, plus the Lucille Ball Comedy Center.
- Education Hub: Home to Jamestown Community College and nearby universities, Jamestown offers educational opportunities for lifelong learning.
- Friendly Community: Experience the warmth and hospitality of small-town living, where neighbors become friends and community spirit thrives.
- Family-Friendly: Discover family-friendly attractions like the Roger Tory Peterson Institute of Natural History and the Jamestown Audubon Center.
- Affordable Living: Enjoy a comfortable lifestyle with affordable housing options and a lower cost of living compared to larger cities.
- Convenient Location: Located near major cities like Buffalo and Erie, Jamestown offers easy access to urban amenities while maintaining its small-town charm.
Join us in Western New York, Chautauqua County! It's more than just a place to work - it's a place to call home. Explore the charm and potential and see why so many healthcare professionals choose to build their lives and careers here!
Our Values
At UPMC, we're driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community.
Supporting a Diverse Workplace
UPMC respects that talent and skill are not limited but enhanced by the diversity and cultural expertise staff brings to the workplace. Having a diverse employee presence at all levels provides a wealth of benefits. It ensures we have the knowledge, critical thinking, agility, and innovation required of a leading and forward-thinking integrated health care system.
Minimum Salary Range: $645,000 | Maximum Salary Range: $731,000+
*The referenced pay range represents GLPP's reasonable estimate of the compensation for this position. The pay range may include potential incentive-based compensation for achievement of quality or length of service metrics, if any are offered for the position. The successful candidate's actual compensation package will be determined based upon multiple factors which include, among other things, the candidate's expertise and experience, market factors, and related position salaries.
If you are interested in this position or would like more information, please apply today or contact:
Elizabeth Madurski | Sr. Physician Recruiter, UPMC Northern Pod |
Golden Valley Memorial Healthcare is seeking an Ophthalmologist to step into an established, high-demand surgical practice in Clinton, Missouri.
This is a rare opportunity where patient volume already exists—no ramp-up required.
What Stands Out:
Immediate surgical volume with an established patient panel supported by strong community demand
Dedicated operating time supporting efficient case flow
Strong referral network ensuring ongoing demand
Flexibility to structure clinic and surgical schedule
Support staff for clinic operations, scheduling, and patient coordination
Why This Works:
You walk into a practice that’s already busy—allowing you to focus on surgery and patient care from day one.
Somerset Oral & Maxillofacial Surgery Group is seeking a full time Surgeon to join our team. We are a well-established practice founded in 1970, and we are looking to add an additional surgeon. This is an excellent opportunity for someone to join our practice.
Our ideal candidate should be a dynamic team player with fantastic interpersonal skills. They should be well versed in all aspects of our specialty with emphasis on dentoalveolar surgery, implant surgery and in-office anesthesia. Excellent Compensation:Sign on and relocation bonus
Competitive base salary with generous bonus structure
Health insurance
Malpractice insurance
401K Profit Sharing Plan
Paid CE and board support
About the Practice:
56-year longevity with large and established referral base
Opportunity to live and work in beautiful Central New Jersey and only one hour away from New York City and Philadelphia
Completely digital and modern office with EMR, CBCT, intraoral scanners, PRF
Contact:
Please email:
Please call (9 Dr. Alan Hecht
Visit our website:
A thriving gastroenterology group in the Chicago area is seeking a Board Eligible/Board Certified Gastroenterologist to join their team. This established practice consists of 6 MDs and 3 APPs, providing comprehensive general GI and advanced endoscopy services to their patients.
Position Highlights:• Location: Chicago, IL – Access to a major metropolitan area with world-class dining, entertainment, and cultural attractions
• Practice Model: Primarily outpatient practice, with some inpatient responsibilities
• Patient Volume: 20-25 patients per day in the clinic, 15 procedures daily
• Schedule: Flexible—physicians set their own 5-day workweek
• Call: 1:5 rotation, shared equally within the group
• Visa Support: H1B candidates welcome Compensation & Benefits:
• Competitive base salary with a collections-based incentive model
• Relocation assistance available
• Supportive, team-based environment with experienced APPs Candidate Requirements:
• BE/BC Gastroenterologist with in-practice experience, preferred
• Experience in ERCP preferred This is an excellent opportunity to join a well-established group in Chicago, offering a strong referral base, competitive compensation, and a flexible schedule.
To learn more about this opportunity or others, please contact Rick Bailey.
To acquire more information about RosmanSearch click here.
Education: MD/DO
Type: Full Time
Number of Openings: 1
State: Illinois
City: Chicago
Internal number: 5863
We are an established and growing independent OB/GYN practice, seeking a passionate and dedicated 7th physician to join our team. Our practice offers the unique opportunity to tailor your work schedule and responsibilities to suit your preferences, with a flexible range of options from a traditional OB/GYN practice to a laborist model.
About the Role:
- Flexible position: Choose between full OB/GYN practice or a laborist model.
- Responsibilities include in-house call with either 6-8 24-hour shifts or 12-16 12-hour shifts per month.
- 600 deliveries per year at our community hospital, ensuring a manageable and consistent caseload.
- Level 3 NICU , 24-hour anesthesia support, and MFM consultation available for your patients.
- The hospital is equipped with robotic surgery capabilities for enhanced surgical care.
- In-office procedures including hysteroscopy , LEEP , and endometrial ablation .
Why Join Us?
- Work in a supportive, collaborative environment within a well-established, independent practice.
- Opportunity to live and work in Southern New Hampshire , with easy access to Boston , just under an hour away.
- Enjoy the outdoor lifestyle with hiking in the White Mountains or exploring the ocean, all within a short drive from the office.
Qualifications:
- Board-certified or board-eligible OB/GYN.
- Passion for patient care and a commitment to providing high-quality services.
- Excellent communication skills and a desire to work in a team-oriented environment.
Benefits:
- Competitive salary with a robust benefits package.
- Flexibility to design your ideal work-life balance.
- Opportunities for career growth and professional development.
If you're ready to make an impact in an independent, thriving OB/Gyn practice and enjoy a healthy work-life balance in one of New England’s most beautiful locations, we’d love to hear from you.
Apply Today!
Oral Surgery Services
Demarcus Smith, DDS and Michael Ferguson, DDS, MD are looking for an exceptional BC/BE surgeon to join their established and prestigious practice located in beautiful Metairie, LA. The partners have built a robust, multi-location practice that proudly serve the greater New Orleans region and a highly motivated associate is needed to continue their success and help grow the practice by providing exceptional care to existing and new patients. If you are a self-starter and looking to grow alongside our team while providing exceptional care to our established referral base, we encourage you to apply! A clear path to partnership, surgeon comradery, no buy in, and the opportunity to own equity within USOSM are just some of the reasons this opportunity is unique from the others in the area. Start busy!
Dr. Demarcus Smith and Dr. Michael Ferguson offer experienced oral and maxillofacial treatments for procedures such as general tooth extractions, dental implant placement, wisdom teeth removal, facial trauma, oral pathology - visit their website to learn more
Located on the Gulf of Mexico, New Orleans is world-renowned for its distinctive music, colonial architecture, Creole cuisine, annual celebrations, and festivals. The historic heart of the city is the “French Quarter,” set along a bend on the Mississippi River. Within a short distance to the beautiful beaches in neighboring towns along the Gulf of Mexico, NOLA offers something for all! Metairie is a suburb of New Orleans and offers all the unique and charming characteristics of New Orleans with safer, quieter neighborhoods and excellent education opportunities . Metairie also boasts lower property taxes along with an array of fine dining venues, great shopping, and many family-friendly attractions.
Mentorship and a strong ramp up plan, along with a competitive base salary and production bonus will be offered along with the opportunity for equity in US Oral Surgery Management, the nation’s premier OMS Partnership SSO. USOSM provides you with the operational and administrative support to succeed and excel so that you can focus solely on clinical innovation and high-quality patient care. Our surgeon partners retain complete clinical autonomy in their practices and leverage the unique offerings of USOSM’s expertise, cultivated through supporting practices across the nation, to allow them to achieve the successful career they’ve dreamed of.
For more information on this opportunity or our other partnership offerings across the country, please contact
GI Hospitalist position available with established GI Program in South Carolina
McLeod Regional Medical Center (MRMC), a 500-provider, nonprofit healthcare system seeking a board certified or board eligible Gastroenterologist for an inpatient only, 7 on 7 off employed position. This physician will work every other week Monday to Monday for inpatient only cases and procedures.
This position will complement our long established General and Advanced GI program in Florence, SC. MRMC is the principal provider of advanced and general gastroenterology services for 1 million patients seeking treatment from the Midlands to the Coast of NC and SC. McLeod is committed to Gastroenterology and has a large expansive Endo lab that offers an abundance of both general and advanced procedure rooms with dedicated Anesthesiologist and CRNA providers. MRMC also provides dedicated GI space in the OR.
"State-of-the Art Facilities, Relocation Assistance, 8 APP Support for both Hospital/Office 7 days a week, APP First Call, Locum coverage majority of weekends/holidays and Physician led practice".
This position will provide 7 days of inpatient services working 10 hours on-site and 14 hours of covering unrestricted call each day. Working every other week, this is an excellent opportunity to do only inpatient work seeing hospital patients and ER consults. This position is eligible for paid malpractice, CME allowance, sign on incentives, competitive compensation, and other health and retirement benefits.
Support: McLeod Regional Medical Center, a 517-bed non-profit hospital in Florence, SC is the regional leader in medical excellence. McLeod has the latest technology and equipment and has the largest Endo lab in this region of South Carolina. McLeod Health recently converted to EPIC systemwide. Gastroenterology at MRMC have dedicated Anesthesia and CRNA support both in Endo lab and OR.
Requirements
• Doctor of Medicine (MD) or Doctor of Osteopathy (DO) degree
• Successful completion of Internal Medicine Residency, BE or BC
• Successful completion of Gastroenterology Fellowship, BE or BC. We are considering new grads.
McLeod Health has been recognized for its commitment to patient safety and quality care. McLeod Regional Medical Center received Top Honors in major categories by Healthgrades, a leading online resource for comprehensive information about physicians and hospitals. Additionally, McLeod Health hospitals received an “A” Hospital Safety Grade from the Leapfrog Group, reflecting their dedication to prioritizing patient safety and preventing preventable harm and errors.
U.S. News & World Report says Florence SC is #3 in Best Places to Live in South Carolina.
US News & World Report offers information on Florence, South Carolina, covering areas like education, real estate, and living costs. It includes rankings of high schools in the area, details about the city's demographics and median income, and also highlights Florence as a growing hub for shopping, recreation and entertainment. More information on
11 Best Places to Live in South Carolina in the U.S. in 2025-2026 | U.S. News
If you are interested in learning more about this opportunity, please contact Ashley Hodges at and include a copy of your CV. Please also visit to learn more about our healthcare system.The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions.
The Advisory Group is currently accepting applications for a Certified Coding Auditor to work in its New York office or remotely.
Principal duties and responsibilities:
Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payers.
Researching state and payer regulations to identify areas of risk in a variety of healthcare settings and specialties, coordinating with various team members to ensure clear expectations are communicated and deadlines are met.
Qualifications:
CPC/CCS-P with a minimum of 5 years of experience in healthcare coding/auditing (E&M, CPT, HCPCS and ICD-10), with knowledge of professional billing, coding, and documentation practices performed by physicians and other qualified healthcare providers in inpatient and outpatient settings.
Proficiency in evaluating how well clinical documentation supports medical necessity and the E/M, CPT, and HCPCS codes that were billed, across a wide range of services. The focus will be in the primary care sector (fee-for-service and risk-based), though experience in specialties such as dermatology, vascular, podiatry, wound care, home health, and personal care is preferred. Behavioral health experience is also a plus.
Proven ability to identify billing and coding issues including use of modifiers, bundling issues, CCI edits, therapeutic and diagnostic procedures, supplies, materials, injections, drugs, and units of service etc.
Solid understanding of both federal and state coding and documentation laws and regulations, applicable fraud statutes and regulations, and of federal guidelines on recoupments and other anti-FWA activity. Identify and access risk of repayment or recoupment in the event of payor scrutiny.
Familiarity with both UB-04 and CMS 1500 claims data, as well as understanding of payor remittances.
Knowledge of anatomy, physiology, and medical terminology necessary to appropriately review assignment and documentation of diagnosis codes.
Solid working knowledge of various EHR/EMR systems; experience accessing these remotely.
Strong organizational skills and task management
Highly organized with a high level of attention to detail
Ability to work in a fast paced and rapidly changing environment.
Skilled at multi-tasking with the ability to handle several different priorities simultaneously.
Strong communication skills with experience in articulating audit findings and interpretation of coding regulations
Experience with HIPAA, data privacy, and/or data security processes.
Experience working with regulators governing (public or private) health insurance carriers.
A minimum of AAPC or AHIMA certification required, that could include:
· Certified Professional Coder (CPC)
· Certified Outpatient Coder (COC™)
· Certified Professional Medical Auditor (CPMA)
· Certified Risk Adjustment Coder (CRC™)
· Certified Coding Specialist (CCS)
· Certified Coding Specialist – Physician based (CCS-P)
For consideration, please email resume and cover letter as attachments with salary expectations to with the subject title “Certified Coding Auditor - Behavioral Health.”
Marwood offers a comprehensive compensation package with full benefits. We offer a competitive wage, a collaborative work environment and an opportunity to participate in a full benefit package, including, Medical, Dental, Vision, Life, AD&D, Voluntary Life and LTD, Spouse and Dependent Life, 401k Retirement plan with a company match, Commuter, FSA/DCFSA. We offer paid days off, and paid holidays. Marwood prides itself on providing employees with a good work-life balance. There is no travel expected with this position.
The position is based in our New York location. Currently working a hybrid schedule. Remote option will be considered.
We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity and or expression, status as a veteran, and basis of disability or any other federal, state, or local protected class.
