1,481 Certified Professional Biller jobs in the United States
Certified Coder Medical Billing Specialist
Posted today
Job Viewed
Job Description
Job Description
ORGANIZATION INFORMATION:
Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.
ESSENTIAL JOB FUNCTIONS:
Essential functions of the job include, but are not limited to, medical and dental insurance understanding of coordination of benefits, claims processing, and follow up. Utilizing a computer for data entry, conducting research, electronic communications, attending meetings, drafting and distributing reports, interacting with others, reconciling data, creating and updating spreadsheets. Communicating with others is an essential job function.
SALARY: $58,700-$73,300
***MUST BE LOCATED IN OHIO***
BENEFITS:
- PTO
- Vision
- Dental
- Health
- 401k
- Sick time
MAJOR AREAS OF RESPONSIBILITIES:
Review Coding, Auditing, and billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.
Prepare and submit clean claims to various insurance companies to include both paper and electronic.
Extensive insurance follow-up and working knowledge of the appeals resolution process is required.
- Working in EMR system's workques to process claims per coordination of benefits
- Review billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.
- Responsible for contacting insurance companies and navigating insurance websites in order to secure and expedite payments.
- Assisting in payment research in a timely and accurate manner.
- Answer billing inquiries from patients, clerical staff and insurance companies.
- Identify and resolve patient billing complaints.
- Assist with patient inquiries for revenue department
- Review assigned workques daily to ensure claims are timely
- Evaluate patient’s financial status and rebill claims in conjunction with team and third party billing company
- Follows and reports status of delinquent accounts.
- Perform various collection actions including contacting patients by phone,
- Correcting and resubmitting claims to third party payers as appropriate in conjunction with Epic/Ochin
- Participate in educational activities and attends monthly staff meetings.
- Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Perform other duties for Finance Department.
EDUCATION/LICENSURE:
· High school diploma, Associate’s preferred
· Medical billing certification or equivalent education on the job, formal education required.
· AAPC or other appropriate Professional Coding Certification required
· CPC, CPA, CPMA or relevant certification
KNOWLEDGE, SKILLS, ABILITIES AND OTHER QUALIFICATIONS:
· Financial management, payment processing, and/or accounting experience, and/or formal training or certification preferred
· Must have strong knowledge of CPT and ICD-10 codes and basic medical terminology skills.
· Experience with EMR (Electronic Medical Record) and medical billing software preferred.
· Knowledge of third-party operating procedures and practices, with the ability to read and process EOB’s.
· Ability to travel to multiple clinics in Ohio for trainings and meetings as needed.
· Proven record of accomplishment of exceeding goals; evidence of the ability of consistently make good decisions through a combination of analysis, experience and judgment; abilities in problem solving, project management and creative resourcefulness.
OTHER INFORMATION:
Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA
Certified Coder Medical Billing Specialist
Posted today
Job Viewed
Job Description
Job Description
ORGANIZATION INFORMATION:
Established in 1984, Equitas Health is a regional not-for-profit community-based healthcare system and federally qualified community health center look-alike. Its expanded mission has made it one of the nation’s largest HIV/AIDS, lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ+) healthcare organizations. With 22 offices in 12 cities, it serves more than 67,000 individuals in Ohio, Kentucky, and West Virginia each year through its diverse healthcare and social service delivery system focused around: primary and specialized medical care, retail pharmacy, dental, behavioral health, HIV/STI prevention, advocacy, and community health initiatives.
ESSENTIAL JOB FUNCTIONS:
Essential functions of the job include, but are not limited to, medical and dental insurance understanding of coordination of benefits, claims processing, and follow up. Utilizing a computer for data entry, conducting research, electronic communications, attending meetings, drafting and distributing reports, interacting with others, reconciling data, creating and updating spreadsheets. Communicating with others is an essential job function.
SALARY: $58,700-$73,300
***MUST BE LOCATED IN OHIO***
BENEFITS:
- PTO
- Vision
- Dental
- Health
- 401k
- Sick time
MAJOR AREAS OF RESPONSIBILITIES:
Review Coding, Auditing, and billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.
Prepare and submit clean claims to various insurance companies to include both paper and electronic.
Extensive insurance follow-up and working knowledge of the appeals resolution process is required.
- Working in EMR system's workques to process claims per coordination of benefits
- Review billing reports; ensure timeliness and accuracy of all claim submissions and billing procedures.
- Responsible for contacting insurance companies and navigating insurance websites in order to secure and expedite payments.
- Assisting in payment research in a timely and accurate manner.
- Answer billing inquiries from patients, clerical staff and insurance companies.
- Identify and resolve patient billing complaints.
- Assist with patient inquiries for revenue department
- Review assigned workques daily to ensure claims are timely
- Evaluate patient’s financial status and rebill claims in conjunction with team and third party billing company
- Follows and reports status of delinquent accounts.
- Perform various collection actions including contacting patients by phone,
- Correcting and resubmitting claims to third party payers as appropriate in conjunction with Epic/Ochin
- Participate in educational activities and attends monthly staff meetings.
- Maintain strictest confidentiality; adheres to all HIPAA guidelines/regulations.
- Perform other duties for Finance Department.
EDUCATION/LICENSURE:
· High school diploma, Associate’s preferred
· Medical billing certification or equivalent education on the job, formal education required.
· AAPC or other appropriate Professional Coding Certification required
· CPC, CPA, CPMA or relevant certification
KNOWLEDGE, SKILLS, ABILITIES AND OTHER QUALIFICATIONS:
· Financial management, payment processing, and/or accounting experience, and/or formal training or certification preferred
· Must have strong knowledge of CPT and ICD-10 codes and basic medical terminology skills.
· Experience with EMR (Electronic Medical Record) and medical billing software preferred.
· Knowledge of third-party operating procedures and practices, with the ability to read and process EOB’s.
· Ability to travel to multiple clinics in Ohio for trainings and meetings as needed.
· Proven record of accomplishment of exceeding goals; evidence of the ability of consistently make good decisions through a combination of analysis, experience and judgment; abilities in problem solving, project management and creative resourcefulness.
OTHER INFORMATION:
Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA
Certified Coder
Posted today
Job Viewed
Job Description
+ Oakland, CA
+ Information Systems
+ Health Information Servcies
+ Full Time - Day
+ 28.19 - 46.95
+ Req #:41965-31091
+ FTE:1
+ Posted:August 6, 2025
**Summary**
**SUMMARY:** Reads and interprets medical record documentation to assign diagnosis codes, assigns CPT codes, and applies knowledge of payer reimbursement guidelines to ensure proper reimbursement. Performs related duties as required.
**DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE:The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
1. Adheres to the ICD-9-CM (International Classification of Diseases, 10th revision, Clinical Modification) coding conventions, official coding guidelines approved by the cooperating parties, the CPT (Current Procedural Terminology) rules established by the American Medical Association, and any other official coding rules and guidelines established for use with mandated standard code sets.
2. Selection and sequencing of diagnoses and procedures must meet the definitions of required data sets. Utilizes up-to-date versions of CPT and ICD-10-CM resources and remains current on changes in coding and billing standards.
3. Strives for the optimal payment to which the facility is legally entitled, remembering that it is unethical and illegal to maximize payment by means that contradict regulatory guidelines.
4. Consults physicians for clarification and additional documentation prior to code assignment when there is conflicting or ambiguous data in the health record.
5. Diagnosis coding must be accurate and carried to highest level of specificity; assigns and reports codes that are clearly and consistently supported by documentation in the health record.
6. Follow up status of charges held for clearance; work error reports.
7. Responsible for properly performing month end tasks within the established time-frame including running month end reports for each center assigned and tracking of cases that are not yet billed for the month.
8. Provides feedback and education to physicians regarding billing and documentation.
9. Works with the Billing & Collection team to resolve coding issues.
10. Performs professional fee and documentation audits for a wide variety of specialties.
11. Manage work files to resolve coding edits by researching and using the most up-to-date tools available in order to make the appropriate and compliant corrections for reimbursement.
**MINIMUM QUALIFICATIONS:**
Education:High School Diploma or equivalent required, Associate's degree preferred.
Minimum Experience:Five years relevant coding experience.
Minimum Experience:Experience coding and auditing professional fee surgical procedures and office visits. Required
Licenses/Certifications:Certified Coding Specialist (CCS-P) or Certified Professional Coder (CPC) certification required from AHIMA or AAPC.
Alameda Health System is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military background.
Certified Coder
Posted today
Job Viewed
Job Description
+ Oakland, CA
+ Information Systems
+ Health Information Servcies
+ Full Time - Day
+ 28.19-46.95
+ Req #:41966-31092
+ FTE:1
+ Posted:August 6, 2025
**Summary**
**SUMMARY:** Reads and interprets medical record documentation to assign diagnosis codes, assigns CPT codes, and applies knowledge of payer reimbursement guidelines to ensure proper reimbursement. Performs related duties as required.
**DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE:The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
1. Adheres to the ICD-9-CM (International Classification of Diseases, 10th revision, Clinical Modification) coding conventions, official coding guidelines approved by the cooperating parties, the CPT (Current Procedural Terminology) rules established by the American Medical Association, and any other official coding rules and guidelines established for use with mandated standard code sets.
2. Selection and sequencing of diagnoses and procedures must meet the definitions of required data sets. Utilizes up-to-date versions of CPT and ICD-10-CM resources and remains current on changes in coding and billing standards.
3. Strives for the optimal payment to which the facility is legally entitled, remembering that it is unethical and illegal to maximize payment by means that contradict regulatory guidelines.
4. Consults physicians for clarification and additional documentation prior to code assignment when there is conflicting or ambiguous data in the health record.
5. Diagnosis coding must be accurate and carried to highest level of specificity; assigns and reports codes that are clearly and consistently supported by documentation in the health record.
6. Follow up status of charges held for clearance; work error reports.
7. Responsible for properly performing month end tasks within the established time-frame including running month end reports for each center assigned and tracking of cases that are not yet billed for the month.
8. Provides feedback and education to physicians regarding billing and documentation.
9. Works with the Billing & Collection team to resolve coding issues.
10. Performs professional fee and documentation audits for a wide variety of specialties.
11. Manage work files to resolve coding edits by researching and using the most up-to-date tools available in order to make the appropriate and compliant corrections for reimbursement.
**MINIMUM QUALIFICATIONS:**
Education:High School Diploma or equivalent required, Associate's degree preferred.
Minimum Experience:Five years relevant coding experience.
Minimum Experience:Experience coding and auditing professional fee surgical procedures and office visits.
Required Licenses/Certifications:Certified Coding Specialist (CCS-P) or Certified Professional Coder (CPC) certification required from AHIMA or AAPC.
Alameda Health System is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military background.
Certified Coder
Posted today
Job Viewed
Job Description
+ Oakland, CA
+ Information Systems
+ Health Information Servcies
+ Full Time - Day
+ 28.19-46.95
+ Req #:41093-30377
+ FTE:1
+ Posted:July 24, 2025
**Summary**
**SUMMARY:** Reads and interprets medical record documentation to assign diagnosis codes, assigns CPT codes, and applies knowledge of payer reimbursement guidelines to ensure proper reimbursement. Performs related duties as required.
**DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE:The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
1. Adheres to the ICD-9-CM (International Classification of Diseases, 10th revision, Clinical Modification) coding conventions, official coding guidelines approved by the cooperating parties, the CPT (Current Procedural Terminology) rules established by the American Medical Association, and any other official coding rules and guidelines established for use with mandated standard code sets.
2. Selection and sequencing of diagnoses and procedures must meet the definitions of required data sets. Utilizes up-to-date versions of CPT and ICD-10-CM resources and remains current on changes in coding and billing standards.
3. Strives for the optimal payment to which the facility is legally entitled, remembering that it is unethical and illegal to maximize payment by means that contradict regulatory guidelines.
4. Consults physicians for clarification and additional documentation prior to code assignment when there is conflicting or ambiguous data in the health record.
5. Diagnosis coding must be accurate and carried to highest level of specificity; assigns and reports codes that are clearly and consistently supported by documentation in the health record.
6. Follow up status of charges held for clearance; work error reports.
7. Responsible for properly performing month end tasks within the established time-frame including running month end reports for each center assigned and tracking of cases that are not yet billed for the month.
8. Provides feedback and education to physicians regarding billing and documentation.
9. Works with the Billing & Collection team to resolve coding issues.
10. Performs professional fee and documentation audits for a wide variety of specialties.
11. Manage work files to resolve coding edits by researching and using the most up-to-date tools available in order to make the appropriate and compliant corrections for reimbursement.
**MINIMUM QUALIFICATIONS:** Education:High School Diploma or equivalent required, Associate's degree preferred. Minimum Experience:Five years relevant coding experience. Minimum Experience:Experience coding and auditing professional fee surgical procedures and office visits. Required Licenses/Certifications:Certified Coding Specialist (CCS-P) or Certified Professional Coder (CPC) certification required from AHIMA or AAPC.
Alameda Health System is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military background.
Certified Coder
Posted today
Job Viewed
Job Description
+ Oakland, CA
+ Information Systems
+ Health Information Servcies
+ Full Time - Day
+ 28.19-46.95
+ Req #:41092-30376
+ FTE:1
+ Posted:July 24, 2025
**Summary**
**SUMMARY:** Reads and interprets medical record documentation to assign diagnosis codes, assigns CPT codes, and applies knowledge of payer reimbursement guidelines to ensure proper reimbursement. Performs related duties as required.
**DUTIES & ESSENTIAL JOB FUNCTIONS:** NOTE:The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
1. Adheres to the ICD-9-CM (International Classification of Diseases, 10th revision, Clinical Modification) coding conventions, official coding guidelines approved by the cooperating parties, the CPT (Current Procedural Terminology) rules established by the American Medical Association, and any other official coding rules and guidelines established for use with mandated standard code sets.
2. Selection and sequencing of diagnoses and procedures must meet the definitions of required data sets. Utilizes up-to-date versions of CPT and ICD-10-CM resources and remains current on changes in coding and billing standards.
3. Strives for the optimal payment to which the facility is legally entitled, remembering that it is unethical and illegal to maximize payment by means that contradict regulatory guidelines.
4. Consults physicians for clarification and additional documentation prior to code assignment when there is conflicting or ambiguous data in the health record.
5. Diagnosis coding must be accurate and carried to highest level of specificity; assigns and reports codes that are clearly and consistently supported by documentation in the health record.
6. Follow up status of charges held for clearance; work error reports.
7. Responsible for properly performing month end tasks within the established time-frame including running month end reports for each center assigned and tracking of cases that are not yet billed for the month.
8. Provides feedback and education to physicians regarding billing and documentation.
9. Works with the Billing & Collection team to resolve coding issues.
10. Performs professional fee and documentation audits for a wide variety of specialties.
11. Manage work files to resolve coding edits by researching and using the most up-to-date tools available in order to make the appropriate and compliant corrections for reimbursement.
**MINIMUM QUALIFICATIONS:** Education:High School Diploma or equivalent required, Associate's degree preferred. Minimum Experience:Five years relevant coding experience. Minimum Experience:Experience coding and auditing professional fee surgical procedures and office visits. Required Licenses/Certifications:Certified Coding Specialist (CCS-P) or Certified Professional Coder (CPC) certification required from AHIMA or AAPC.
Alameda Health System is an equal opportunity employer and does not discriminate against any employee or applicant for employment based on race, color, religion, national origin, age, gender, sex, ancestry, citizenship status, mental or physical disability, genetic information, sexual orientation, veteran status, or military background.
Certified Coder
Posted today
Job Viewed
Job Description
Job Description
Salary: $20-45/hour DOE
Certified Coder
Bloom Value Corporation
Bloom Value Corporation is a technology start up based in Sacramento, CA, USA. Founded by a diverse group of IT industry and healthcare leaders, Bloom Value is focused on financial and operational value optimization. Our founders include Enterprise AI pioneers, Finance and Operations experts, Change Management experts and Physicians. The team has Research, Development and Consulting experience across a broad range of industries and provider institutions.
Bloom is looking for talented certified coders with a flair for technology and learning. Candidates will be using there coding skills to help clients with Risk Adjustment. Simultaneously, candidates will also be involved in helping develop AI Solutions to support risk coding.
Job Location: Remote
Job Type: Contract/Part Time With Opportunity To Convert To Full Time
Core Job Responsibilities
- Conduct retrospective, prospective, and concurrent Risk Adjustment audits.
- Drives industry best practices and performance on driving key KPIs (#visits, RAF score, AWV completion rates, Coding accuracy chart reviews, HCC recapture)
- Collaborate with the Coding team to identify and enhance opportunities for improving risk adjustment coding, provider coding accuracy, and tracking of risk score trends
- Identify HCC and Quality education and training opportunities for providers to ensure compliant documentation, based on audit results.
- Assist provider engagement and operations teams to maximize efficiency for provider conducted risk and quality visits.
- Produce Weekly Status Reports.
- Retrieve electronic records and obtain records from external sources.
- Perform general administrative tasks
Educational and Skills Required
- Coding Certification through AHIMA or AAPC (at least one below):
- Certified Professional Coder (CPC), Certified Risk Coder (CRC), Certified Coding Specialist for Providers (CCS-P), or Registered Health Information Management Technician (RHIT)
- High School Diploma or GED equivalence
- Proficiency in Excel, Word, PowerPoint, and Outlook, and in general file folder organization/usage
- EMR Knowledge/experience a plus
- Able to read, write legibly, and speak in English with professional quality
Position Requirements
- Strong knowledge of the healthcare industry special programs, including:
- HEDIS, Quality Measures
- Risk Adjustment and HCC
- Responsible, diligent and attention to detail characteristics
- Strong organizational skills.
- Able to manage multiple assignments effectively.
- Capable of working independently and completing tasks with minimal supervision.
- Able to relate and communicate positively, effectively, and professionally with others.
- Previous experience in customer service with excellent communication abilities preferred.
- Ability to work calmly and respond courteously when under pressure.
- Able to think critically
- Proactive attitude, able to anticipate and meet team needs.
remote work
Be The First To Know
About the latest Certified professional biller Jobs in United States !
Certified Coder (Risk Adjustment/Outpatient Required) - REMOTE
Posted today
Job Viewed
Job Description
**Job Summary**
Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Performs on-going chart reviews and abstracts diagnosis codes
+ Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly
+ Documents results/findings from chart reviews and provides feedback to management, providers, and office staff
+ Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment
+ Builds positive relationships between providers and Molina by providing coding assistance when necessary
+ Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
+ Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors
+ Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
+ Contributes to team effort by accomplishing related results as needed
+ Other duties as assigned
+ 2 years previous coding experience
+ Proficient in Microsoft Office Suite
+ Ability to effectively interface with staff, clinicians, and management
+ Excellent verbal and written communication skills
+ Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
+ Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
+ Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance
**JOB QUALIFICATIONS**
**Required Education**
Associates degree or equivalent combination of education and experience
**Required License, Certification, Association**
+ Certified Professional Coder (CPC)
+ Certified Coding Specialist (CCS)
**Preferred Education**
Bachelor's Degree in related field
**Preferred Experience**
+ Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model
+ Background in supporting risk adjustment management activities and clinical informatics
+ Experience with Risk Adjustment Data Validation
**Preferred License, Certification, Association**
+ Certified Risk Adjustment Coder - (CRC)
+ Certified Professional Payer - Payer (CPC-P)
+ Certified Coding Specialist - Physician based (CCS-P)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Certified Coder (Risk Adjustment/Outpatient Required) - REMOTE
Posted today
Job Viewed
Job Description
**Job Summary**
Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Performs on-going chart reviews and abstracts diagnosis codes
+ Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly
+ Documents results/findings from chart reviews and provides feedback to management, providers, and office staff
+ Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment
+ Builds positive relationships between providers and Molina by providing coding assistance when necessary
+ Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
+ Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors
+ Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
+ Contributes to team effort by accomplishing related results as needed
+ Other duties as assigned
+ 2 years previous coding experience
+ Proficient in Microsoft Office Suite
+ Ability to effectively interface with staff, clinicians, and management
+ Excellent verbal and written communication skills
+ Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
+ Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
+ Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance
**JOB QUALIFICATIONS**
**Required Education**
Associates degree or equivalent combination of education and experience
**Required License, Certification, Association**
+ Certified Professional Coder (CPC)
+ Certified Coding Specialist (CCS)
**Preferred Education**
Bachelor's Degree in related field
**Preferred Experience**
+ Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model
+ Background in supporting risk adjustment management activities and clinical informatics
+ Experience with Risk Adjustment Data Validation
**Preferred License, Certification, Association**
+ Certified Risk Adjustment Coder - (CRC)
+ Certified Professional Payer - Payer (CPC-P)
+ Certified Coding Specialist - Physician based (CCS-P)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Certified Coder (Risk Adjustment/Outpatient Required) - REMOTE
Posted today
Job Viewed
Job Description
**Job Summary**
Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to minimize risk and denials.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Performs on-going chart reviews and abstracts diagnosis codes
+ Develop an understanding of current billing practices in provider offices to ensure that diagnosis and CPT codes are submitted accordingly
+ Documents results/findings from chart reviews and provides feedback to management, providers, and office staff
+ Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment
+ Builds positive relationships between providers and Molina by providing coding assistance when necessary
+ Responsible for administrative duties such as planning, scheduling of chart reviews, obtaining of medical records, and provider training and education
+ Assists in coordinating management activities with other departments in Molina including Finance, Revenue analytics, Claims and Encounters, and Medical Directors
+ Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; participating in professional societies
+ Contributes to team effort by accomplishing related results as needed
+ Other duties as assigned
+ 2 years previous coding experience
+ Proficient in Microsoft Office Suite
+ Ability to effectively interface with staff, clinicians, and management
+ Excellent verbal and written communication skills
+ Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
+ Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers
+ Maintain knowledge in the latest coding guidelines (official through CMS) as well as AHA Coding Clinic guidance
**JOB QUALIFICATIONS**
**Required Education**
Associates degree or equivalent combination of education and experience
**Required License, Certification, Association**
+ Certified Professional Coder (CPC)
+ Certified Coding Specialist (CCS)
**Preferred Education**
Bachelor's Degree in related field
**Preferred Experience**
+ Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model
+ Background in supporting risk adjustment management activities and clinical informatics
+ Experience with Risk Adjustment Data Validation
**Preferred License, Certification, Association**
+ Certified Risk Adjustment Coder - (CRC)
+ Certified Professional Payer - Payer (CPC-P)
+ Certified Coding Specialist - Physician based (CCS-P)
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.