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Physician / ObGyn / Texas / Permanent / OB/GYN- Established Practice in Western Texas- Great Work-Life Balance! Job
✦ New
Salary not disclosed
United States 1 day ago

We are looking for a BC/BE OB/GYN to join an established practice in Western Texas:- Permanent, employed position- Join a large, experienced team of physicians with an excellent support staff- Favorable call schedule with hospitalist program handling secondary call- Access to state-of-the-art facilities and technology, including two dedicated GYN Surgery Suites with DaVinci robotics- Highly reputable and accommodating group that emphasizes quality of care and work-life balance- Competitive compensation and benefits, including sign-on bonus, quality/production incentives and loan repaymentPlease contact Alex James at or call/text Alex at if you are interested in learning more!

permanent
Physician / Dermatology / Maryland / Permanent / DERMATOLOGIST FLEXIBLE, NO RED TAPE ESTABLISHED PRIVATE PRACTICE IN NEW ENGLAND METRO Job
✦ New
Salary not disclosed

DERMATOLOGISTS FLEXIBLE OPPORTUNITIES, NO RED TAPE ESTABLISHED PRIVATE PRACTICE IN BALTIMORE, MD METRO Join a highly rated, physician-led dermatology group that has served patients across the Baltimore metro area for nearly 20 years.

With a full suite of in-house servicesfrom surgical suites and phototherapy to a dedicated call center and on-site pharmacythis is a practice designed to let you focus on medicine, not red tape.

ABOUT THE PRACTICE: Privately owned, with over a dozen physicians and APPs across multiple modern clinics Offers general, cosmetic, and surgical dermatology, including MOHS and radiation therapy In-house billing and centralized call center to streamline operations On-site pharmacies, compounding services, and dedicated surgical suites at key locations State-of-the-art EMR (NextTech) and mole mapping capabilities CULTURE & ENVIRONMENT: Collaborative, provider-first atmosphere with excellent patient reviews Strong clinical mentorship culture, including a structured Gap Year program for students pursuing careers as physicians or advanced practice providers MAs and support staff are consistently assigned to the same provider (no rotation) Dedicated office space for physicians at all sites ROLE FLEXIBILITY: Openings available in general dermatology, surgical dermatology, and cosmetic dermatology Several onsite locations available throughout the Baltimore, MD metro region Full-time, part-time, hybrid, and virtual-only positions available Full-time physicians typically work four 10-hour days per week Virtual medicine opportunities available to physicians located anywhere in the U.S.

with an active state license; Maryland licensure is required for patient care in the state FACILITY HIGHLIGHTS: Largest site includes 29 patient rooms and multiple laser/RN services On-site phototherapy and mole mapping capabilities Three ambulatory surgical suites and a dedicated MOHS wing with eight surgical rooms On-site pharmacies staffed by licensed techs; insurance billed for prescriptions COMPENSATION & BENEFITS: Competitive compensation structure based on experience and practice setting Full benefits package including medical, dental, and select licensing costs Preceptorship and mentorship opportunities available QUALIFICATIONS: Board certified (or board eligible) in Dermatology Current Maryland license or the ability to obtain one Active DEA license New graduates welcome, including those completing residency or fellowship in 2026 INTERESTED? Apply on our website, HERE .

NOT READY TO APPLY YET? Request more info, HERE .

Matthew Sherriff ext.

1 (CALL) (SMS) SHS Recruitment Partners The healthcare hiring shortcut you were looking for.

JOB ID: 24997


Remote working/work at home options are available for this role.
permanent
Physician / Otolaryngology / New York / Permanent / ENT to join established, full-service practice. Job
✦ New
Salary not disclosed
United States 1 day ago

ENT to join a progressive healthcare system in central New York.

Join an established, full service practice consisting of three ENTs and four Advanced Practice Clinicians.

Instant referral base provided by 300+ Primary Care network.

Enjoy full support staff and dedicated clinic space.

Strong financial package includes salary in the $270-470K range plus incentive program, comprehensive benefits, relocation assistance and more.

Salary will be adjusted for training, experience, certification and other factors.

Charming, historic town located on Lake Otsego is 90 minutes from both Albany and Syracuse and under one hour to Utica.

With its abundance of recreational and cultural pleasures, central New York provides a great place to live for both individuals and families.

There is a strong feeling of community within this region.

The surrounding areas have an abundance of lakes, streams and mountains that form the Catskill Mountain Range and provide ample opportunity for outdoor adventures.

permanent
Physician / Rheumatology / Minnesota / Permanent / Upper Midwest client looking for Rheumatologist for established busy practice Job
✦ New
Salary not disclosed

Rheumatology position available in one of the fastest growing cities in the Upper Midwest.

Join an established, busy practice with two very collaborative Rheumatologists, one Pediatric Rheumatologist and one Nurse Practitioner in a physician led, integrated health system.

Population is almost 200,000 and has easy and quick access to Minneapolis.

Great place to raise a family and low cost of living.Hospital Employee .  M-F, no weekends.   Annual Salary.  Signing Bonus available, contact us for details.  Relocation Bonus available.  CME money available.  Primarily work Monday-Friday.  Limited call.  15-17 patients per day.  Compensation with incentive based on experience, 6+ weeks' vacation, Malpractice coverage, CME allowance, and relocation package.  Regional Referral Network consists of 25 clinics and 5 hospitals.  

permanent
Sr. IT Executive Search Consultant
Salary not disclosed
Chicago, IL 3 days ago

Sr. IT Executive Search Consultant (full desk Recruiter)


About the job

The Chicago (loop) Judge Group office is looking to add an experienced, competitive, and self-motivated Sr. IT Executive Search Consultant (full desk) to join our dynamic team.


Our Sr. IT (full desk) Recruiters specialize in matching top tech talent with great leaders across all industries. They address the hiring needs and business initiatives of executives across Chicago and the United States. Our successful model, comprehensive training program and customized delivery platform empowers our associates to achieve maximum results, allowing them to focus on building net new relationships and driving sales.


Business Development & Sales Responsibilities:

  • Market Research: Conduct thorough research to identify potential prospective clients and contacts to target through a variety of different sales and marketing campaigns.
  • New Business Development: Proactively create new business development opportunities through persistent prospecting that includes phone calls, video and in-person meetings, networking events and presentations with key stake holders and hiring managers.
  • Client Expansion: Successfully expand and maintain new and existing client base, ensuring consistent pipeline of permanent direct hire job orders and other consulting and staff augmentation opportunities.
  • Relationship Management: Build strong trustworthy relationships and maintain those client relationships with honesty, integrity and ethical practices.
  • Discovery: Define client needs by documenting their business initiatives, core objectives and pain points through requirements gathering, validation and ongoing communication to help optimize search success.

Candidate Recruiting Responsibilities:

  • Head Hunting Capabilities: Identify, engage and recruit top tier talent creating a robust candidate community of active and passive information technology professionals.
  • Candidate Assessment: Understand candidates’ key skills, strengths, personality, career aspirations, motivations and areas of improvement. Screening candidates against client requirements to ensure a strong match.
  • Market Prospecting: Research targeted technical skill-sets and identify candidates through referral gathering, our internal applicant tracking database, LinkedIn Recruiter, ZoomInfo, job boards, social networking and technical user groups/blogs.
  • Emerging Tech: Priority and focus should be to cultivate relationships with candidates who have skills within emerging technologies such as data science, advanced analytics, Cyber Security, Cloud, DevOps, Blockchain, IoT and of course AI.

Minimum Requirements:

  • A minimum of 3+ years of recruiting agency business development (sales) experience and/or full desk recruiting experience; with a proven track record of success.
  • Experience breaking and developing local mid-market and/or national accounts.
  • A strong network of qualified client contacts.
  • Demonstrated experience with candidate recruitment methodologies.
  • Key traits: Energetic, competitive, confident, persistent, commission-oriented/money motivated, strong desire to succeed and grow, hunter.
  • Strong communication and presentation skills.
  • Bachelor's degree preferred.
  • Information technology industry experience preferred, but not a hard requirement for an energetic agency sales professional, that has the desire and aptitude to learn about the technology space.


What Judge will provide you?:

  • The ability to solution sell on a regional/national/international basis - without locking you into a defined territory or service offering.
  • A well-formulated career platform with an exceptional opportunity for growth.
  • A fast-paced, performance-based organization that publicly and financially rewards its employees for achieving a high level of success.
  • Competitive uncapped commissions and bonus opportunities with sizable earning potential; including cell phone reimbursement.
  • 50+ years of successful business and streamlined processes based on industry best practices - with a hands-on executive management team dedicated to the overall success of the organization and its employees.
  • A superior technology platform and state of the art, custom built Customer Relationship Management (CRM) system, giving you the opportunity to work smart, be effective, and stay organized.
  • Winning culture with a fun, friendly, and team-oriented environment.
Not Specified
Senior Coding Educator
Salary not disclosed
Skokie, IL 4 days ago
Hourly Pay Range:

$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
Not Specified
Supervisor, PB Surgical Coding
🏢 Endeavor Health
Salary not disclosed
Warrenville, IL 4 days ago
Hourly Pay Range:

$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: Supervisor PB Surgical Coding
- Location: Warrenville, IL
- 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:

- Bachelors Degree Health Administration Required or Bachelors Degree Information Technology Required
- 5+ Years of medical coding experience, with at least 2 years in a supervisory or leadership role.
- Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) Required And
- Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA) Required

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. 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.
Not Specified
Certified Coding Auditor Primary Care
Salary not disclosed
New York, NY 2 days ago

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.

Not Specified
Coding II - Inpatient - Coding & Reimbursement
Salary not disclosed
Lakeland, FL 3 days ago

Position Details

Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits.

Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With over 7,000 employees, Lakeland Regional Health offers a supportive work environment where you can thrive and grow professionally.


Active - Benefit Eligible and Accrues Time Off

Work Hours per Biweekly Pay Period: 80.00

Shift: Flexible Hours and/or Flexible Schedule

Location: 210 South Florida Avenue Lakeland, FL

Pay Rate: Min $24.73 Mid $30.92


Position Summary

Under the direction of the Coding and Clinical Documentation Improvement Manger , reviews clinical documentation and diagnostic results, as appropriate, to extract data and apply appropriate ICD-10-CM, CPT, and/or HCPCS codes and modifiers to outpatient encounters for reimbursement and statistical purposes. Communicates with physicians, physician advisor or other hospital team members as needed to obtain optimal documentation to meet coding and compliance standards. Abstracts clinical and demographic information in ICD-10 CM, CPT, and HCPCS codes and modifiers into the computerized patient abstract, Participates in ongoing continued education to assure knowledge and compliance with annual changes.

Position Responsibilities

People At The Heart Of All That We Do

  • Fosters an inclusive and engaged environment through teamwork and collaboration.
  • Ensures patients and families have the best possible experiences across the continuum of care.
  • Communicates appropriately with patients, families, team members, and our community in a manner that treasures all people as uniquely created.

Safety And Performance Improvement

  • Behaves in a mindful manner focused on self, patient, visitor, and team safety.
  • Demonstrates accountability and commitment to quality work.
  • Participates actively in process improvement and adoption of standard work.

Stewardship

  • Demonstrates responsible use of LRH's resources including people, finances, equipment and facilities.
  • Knows and adheres to organizational and department policies and procedures.

Standard Work Duties

  • Determines whether the coding assigned was properly assigned based upon clinical indicators and review of the medical documentation and application of coding guidelines.
  • Develop and apply appeal arguments to defend the coding and clinical decisions while being able to address and refute the coding determination made by the carrier/payer.
  • Drafts appeal letters, including the coding argument with clinical and coding references, to support the coding decision. This may include providing additional medical record documentation.
  • Identifies areas for education to improve complete and accurate coding and billing and provide feedback to management regarding trends or patterns noticed in the coding for discussion.
  • Continued follow-up on denials as payers may continue to deny. Collaboration with Physician Advisor as required to continue appeal process.
  • Continuously reviews changes in coding rules and regulations including in Coding Clinic, CMS, and other payer guidelines.
  • Complete denials/appeals reports for leadership.
  • Documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.
  • Assigns and sequence documents all findings in the denials management application and routes to the appropriate person in the workflow for follow-up.s diagnostic and procedural codes using appropriate classification systems utilizing official coding guidelines.
  • Performs special projects and/or other duties as assigned.


Competencies & Skills

Nonessential:

  • Computer Experience, especially with computerized encoder products and computer-assisted coding applications.
  • Requires critical thinking skills, organizational skills, written and verbal communication skills, decisive judgment, and the ability to work with minimal supervision
  • MS-DRG and APR-DRG methodology expertise required. Strong knowledge of ICD-10-CM, ICD-10-PCS, POAs, HACs, PSIs, SOIs, ROMs and mortality rates as well as physician queries.


Qualifications & Experience

Nonessential:

  • Associate Degree

Essential:

  • High School diploma with Associate Degree from accredited HIM program or certificate in coding from an accredited college.


Other information:

Certifications Essential: CCS

Certifications Preferred: Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA).

Experience Essential: 2-5 years acute care hospital inpatient coding experience within the past five years.

Not Specified
Senior Coding Specialist
✦ New
Salary not disclosed
Pittsburgh, PA 1 day ago

We are looking for a remote Coding Specialist for an award-winning hospital system! This is a great opportunity to work with a supportive team at a company that cares about its employees! This specialist will assess documentation for each service rendered in the hospital to accurately code principal diagnoses, secondary conditions, procedures, and social determinant codes using American Hospital Association & Current Procedural Terminology guidelines, payer-specific rules for commercial/Medicaid insurance, and drug administration for certain service lines.


Requirements:

  • 2 years of recent inpatient hospital coding experience
  • Must have 1 certification: RHIA, RHIT, or CCS


Benefits:

  • Health, dental, vision, and life insurance
  • Paid time off, including vacation and sick time.
  • Remote
  • Upward mobility!


Who We Are

Headquartered in Central Florida, Pivotal Placement Services is a full-service national workforce solutions firm that specializes in placing healthcare professionals from staff to leadership with both clinical and non-clinical employers. Our Comprehensive and Customer-Focused Workforce Solutions include Direct Placement and Managed Service Provider (MSP) / Vendor Managed Services (VMS) engagements nationally. Pivotal Placement Services is an Equal Opportunity Employer.


Pivotal Placement Services, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Not Specified
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