422 Coding jobs in Boise

Coding Auditor Educator at Highmark Health in Boise, Idaho, United States Job Description Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching plans in accordance with federal and state regulations and guidelines ESSENTIAL RESPONSIBILITIES: + Plans and conducts audits and reports on the documentation, coding and billing performed at AHN entities. Reviews, develops and delivers training programs and educational materials to address deficiencies identified in the audits compliant with regulatory requirements. Provides written audit guidance. Participates with management in the assessment of external audit findings and responds as needed. Attends meetings and interacts with management to resolve issues and provide advice on new programs. Provides guidance to system entities in response to external coding audits conducted by the Medicare Administrative Contractor, the RAC, MIC, ZPIC, etc. Determine appeal action, prepare appeal letter follow up and identify education issues. (20%) + Develops audit detail summary spreadsheets and reports to address any coding, documentation, financial impact and profitability. Conducts education/training or works with external resources to present final audit findings to department staff, physicians and appropriate individuals. (20%) + Validates the ICD-CM, ICD-PCS, CPT and HCPCS Level II code and modifier systems, missed secondary diagnoses and procedures and ensures compliance with DRG/APC structure and regulatory requirements. Performs periodic claim form reviews to check code transfer accuracy from the abstracting system and the chargemaster. (10%) + Is responsible for or works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs in the facilities to identify patterns, trends and variations in the facilities frequently assigned DRG/APC groups. Once identified, evaluate the cases of the change or problems and takes appropriate steps to effect resolution. (10%) + Reviews and interprets medical information, classifies that information into the appropriate payor specific groups consisting of ICD-CM ICD-PCS and CPT codes for diagnoses and procedures and calculates the DRG and APC. (10%) + Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines. Assures compliance with the coding guidelines and regulatory requirements. (10%) + Performs other duties as assigned or required including training/mentoring of new staff, performing audits and research related to special projects and providing coverage for coding manager(s). (10%) + Depending on location provides or arranges for education/training of facility healthcare professionals in use of coding guidelines and practices, proper documentation techniques, medical terminology and disease processes as it relates to the DRG/APC and other clinical data quality management factors. With technical direction and assistance from management, designs and implements coder education program, continuing education programs and Medical Staff education programs. Establishes and monitors performance and maintains appropriate documentation thereof. (10%) + Other duties as assigned. QUALIFICATIONS: Minimum + High school diploma / GED + Certification from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) + AHIMA Credentials (Inpatient or Outpatient): Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS) + AAPC Credentials (Outpatient): Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Professional Medical Auditor (CPMA) + 5 years with hospital or physician coding and/or auditing, as well as, education techniques and methods. (Internal transfer and promotion candidates may have a minimum of 3 years experience) + In-depth knowledge of ICD CM, ICD PCS and CPT/HCPCS coding systems. Must be proficient in DRG/APC structure, National Correct Coding Initiatives, ICD CM/PCS Official Guidelines, Outpatient Prospective payment system and Coding Clinic references. Current working knowledge of encoder, grouper, abstracting and other related software. + Strong analytical and communication skills Preferred + Associates Degree + 3 years with claims processing and data management + Past auditing and strong education/training background in coding and reimbursement Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Companys Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employees responsibility to comply with the companys Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements. Pay Range Minimum: $25.85 Pay Range Maximum: $40.18 Base pay is determined by a variety of factors including a candidates qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets. Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at California Consumer Privacy Act Employees, Contractors, and Applicants Notice Req ID To view full details and how to apply, please login or create a Job Seeker account

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare.

The Coding Operations Manager is essential to the Provider HIM Coding division. This position oversees the daily operations of designated client accounts and team members, focusing on resource scheduling, productivity, quality assurance, employee management, and client relations. You will:

Customer Retention and Satisfaction

Maintain customer retention and satisfaction at 95% or higher by promptly addressing customer needs and proactively resolving potential issues.

Conduct account review meetings with clients.

Performance Reporting

Provide monthly performance data to clients (e.g., volume metrics, six-month trends, quality audit scores, and productivity levels).

Include action plans for performance improvement as needed.

Operational Management

Ensure that direct reports meet established accuracy and productivity standards.

Manage performance improvement initiatives by monitoring productivity and quality levels.

Oversee the employee requisition process, ensuring timely interviewing and selection to meet customer needs.

Implement the onboarding process for new coders, coordinating equipment and access, developing training plans, and creating support structures for successful coder engagement and outcomes.

Supervise quality assurance and performance improvement efforts, providing formal development plans when standards are not met.

Manage attendance and PTO schedules.

Employee Relations

Conduct regular check-ins and one-on-one discussions with employees.

Address employee concerns promptly and escalate issues as necessary.

Facilitate biannual growth conversations and ensure timely completion of required paperwork, including new hire documents and performance reviews.

Oversee new account startups in collaboration with Client Liaisons.

Supervision, Leadership & Communication

Recruit, interview, and hire qualified staff based on defined job responsibilities.

Direct the work of employees and manage their career progression.

Ensure staffing levels meet quality service requirements as per contract agreements.

Maintain employee turnover at or below corporate standards.

Provide comprehensive orientation and training to staff, continually assessing and enhancing their competencies, including compliance with HIPAA.

Conduct timely and meaningful performance appraisals, recognize achievements, and implement performance improvement plans when necessary.

Document unplanned absences and take appropriate coverage actions while monitoring absence patterns.

Foster effective employer-employee relations and conduct thorough investigations into employee complaints, involving HR as needed.

Delegate responsibilities to a trusted staff member in your absence and ensure they are informed about ongoing operations.

Communicate effectively with colleagues across departments to align goals and foster a positive work environment.

What You Will Bring to the Table:

Relevant Associate or Bachelor's degree, ideally from an AHIMA-certified HIM Program or Nursing Program.

At least 5 years of management or supervisory experience in a hospital setting.

Industry credentials (RHIT, RHIA, or CCS) with at least 5 years of coding experience.

Excellent interpersonal and organizational skills.

Excellent client and customer relations skills.

Experience with Microsoft Office Suite (Word, Excel, Outlook) preferred.

Must be ambitious, accountable, flexible, mature, and always conduct themselves professionally.

Must communicate effectively at all levels inside and outside of the organization and express ideas and information clearly and concisely, both verbally and in writing.

Participate in team-building activities, operational improvement initiatives, and professional growth opportunities to strengthen and advance our mission and values.

We are committed to building a diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.

At Datavant our total rewards strategy powers a high-growth, high-performance, health technology company that rewards our employees for transforming health care through creating industry-defining data logistics products and services. The range posted is for a given job title, which can include multiple levels. Individual rates for the same job title may differ based on their level, responsibilities, skills, and experience for a specific job. The estimated total cash compensation range for this role is: $94,000$99,500 USD.

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status. To learn more about our commitment, please review our EEO Commitment Statement here.

Know Your Rights, explore the resources available through the EEOC for more information regarding your legal rights and protections. In addition, Datavant does not and will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay.

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Inpatient Coding Resolution Specialist at HCA Healthcare in Caldwell, Idaho, United States Job Description Description Hourly Wage Estimate: $23.62 - $5.44 / hour Learn more about the benefits offered ( ) for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used to determine your actual salary may include your specific skills, how many years of experience you have and comparison to other employees already in this role. The typical candidate is hired below midpoint of the range. Introduction This is a fully remote/work from home position. Monday-Friday flexible schedule. This position requires acute care/facility based Inpatient Coding experience. Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family Jump-start your career as an Inpatient Coding Resolution Specialist today with Parallon. Benefits Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. + Free counseling services and resources for emotional, physical and financial wellbeing + 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service) + Employee Stock Purchase Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny and adoption assistance. + Referral services for child, elder and pet care, home and auto repair, event planning and more + Consumer discounts through Abenity and Consumer Discounts + Retirement readiness, rollover assistance services and preferred banking partnerships + Education assistance (tuition, student loan, certification support, dependent scholarships) + Colleague recognition program + Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence) + Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income. Learn more about Employee Benefits (Note: Eligibility for benefits may vary by location. Come join our team as an Inpatient Coding Resolution Specialist. We care for our community Just last year, HCA Healthcare and our colleagues donated 13.8 million dollars to charitable organizations. Apply Today Job Summary and Qualifications Job Summary and Qualifications In this work from home position as an Inpatient Coding Specialist, you will be responsible for working inpatient coding related alerts/edits, predominately post initial/final coding. You will also perform the alert/edit resolution activities in the applicable systems. The alerts/edits shall be worked according to the established procedures and thresholds and communicated as appropriate. What you will do in this role: + Compile daily work list from eRequest, CRT and/or other alert/edit systems + Takeaction and resolve alerts/edits daily following established procedures and thresholds + Enter detailed notes to update eRequest to provide details if the alert/edit cannot be resolved or must be rerouted to another responsible party for research/resolution + Escalate alert/edit resolution issues as appropriate to minimize final billing delays + Monitorthe aging of accounts held by an alert/edit, prioritizes aged accounts first, and reports to leadership + Work with team members in billing, revenue integrity and/or the Medicare Service Center to resolve alerts/edits + Assign interim DRGs for in-house patients at month end + Complete MOCK abstracts as necessary (e.g., combining the codes for outpatient and inpatient claims subject to the payment window) + Assist the Coding Leads and/or Coding Managers in resolving unbilled reason codes (URC)/Hold Reasons + Communicate coding revisions to the applicable party (e.g., CIS, lead, manager, international log) + Periodically works with manager to review individual work accomplishments, discuss work problems/barriers, discuss progress in mastering tasks and work processes, and discusses individual training needs and career progression What qualifications you will need: + RHIA, RHIT, and or CCS required OR in process of receiving certification + 1-year acute care inpatient coding experience required with 3 years experience preferred + Undergraduate (associate or bachelors) degree in HIM/HIT or related degree required Please visit our Parallon HCA Healthcare Coding Landing Page for more information on Coding Opportunities. CLICK HERE for more information on Parallon Coding (' Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities. HCA Healthcare has been recognized as one of the Worlds Most Ethical Companies? by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. ' The great hospitals will always put the patient and the patients family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual.- Dr. Thomas Frist, Sr. HCA Healthcare Co-Founder If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Inpatient Coding Resolution Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. To view full details and how to apply, please login or create a Job Seeker account

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the future of healthcare from your own workspace!

Preferred: SDS/OBV Coder. EPIC and 3M360 experience a plus. Observation coding requires I&I experience. SDS includes but not limited to Interventional radiology, transplant surveillance, gynecology, ophthalmology, ortho, ENT, EGD and colonoscopies, urology, pacemaker/AICD, Trauma, plastic surgery.

• Review medical records and assign accurate codes for diagnoses and procedures.
• Assign and sequence codes accurately based on medical record documentation.
• Assign the appropriate discharge disposition.
• Abstract and enter the coded data for hospital statistical and reporting requirements.
• Communicate documentation improvement opportunities and coding issues to appropriate personnel for follow up and resolution.
• Maintain a 95% coding accuracy rate and a 95% accuracy rate for APC assignment and meet site-designated productivity standards.
• Be responsible for tracking continuing education credits to maintain professional credentials.
• Attend Datavant Health sponsored education meetings/in-services.
• Demonstrate initiative and judgment in the performance of job responsibilities.
• Communicate with co-workers, management, and hospital staff regarding clinical and reimbursement issues.
• Function in a professional, efficient, and positive manner.
• Adhere to the American Health Information Management Association's code of ethics.
• Be customer-service focused and exhibit professionalism, flexibility, dependability, and a desire to learn.
• Handle a high complexity of work function and decision-making.
• Possess strong organizational and teamwork skills.
• Be willing and able to travel when necessary if applicable.
• Comply with all HIM Division Policies.

Preferred: SDS/OBV Coder. EPIC and 3M360 experience a plus. Observation coding requires I&I experience. SDS includes but not limited to Interventional radiology, transplant surveillance, gynecology, ophthalmology, ortho, ENT, EGD and colonoscopies, urology, pacemaker/AICD, Trauma, plastic surgery.

Excellent written and verbal communication skills

AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC or CRC).

Strong written and verbal communication skills, adeptness in remote work, and exceptional time management skills.

Experience in computerized encoding and abstracting software.

Required to take and pass annual Introductory HIPAA examination and other assigned testing to be given annually.

Proficiency with most or all of these coding specialties (Emergency Department, Same Day Surgery, Ancillary, Observation, Injections/Infusions, E/M leveling).

Must be able to communicate effectively in the English language.

2+ years of coding experience in a hospital and/or coding consulting role.

Experience in computerized encoding and abstracting software

Passing annual Introductory HIPAA examination and other assigned testing to be given annually in accordance with employee review.

Benefits for Full-Time employees: Medical, Dental, Vision, 401k Savings Plan w/match, 2 weeks of paid time off, and Paid Holidays, Floating Holidays

Free CEUs every year

Stipend provided to assist with education and professional dues (AHIMA/AAPC) If Applicable

Equipment: monitor, laptop, mouse, headset, and keyboard

Comprehensive training led by a credentialed professional coding manager

Exceptional service-style management and mentorship (we're in this together!)

Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $20 - $35 an hour.

To ensure the safety of patients and staff, many of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined on a case-by-case basis. Depending on the state in which you will be working, exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its components, pregnancy or pregnancy-related medical conditions, and/or religion.

This job is not eligible for employment sponsorship. Datavant is committed to a work environment free from job discrimination. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, or other legally protected status.