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Coding • baltimore md

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Medical Coding Specialist

Medical Coding Specialist

Cynet SystemsBaltimore, MD
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Acts as an internal expert to ensure that as value-based reimbursement and medical policy models are developed and implemented. Provides advanced knowledge to support effective partnership with prov...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Coding Manager - Practice Operations- Remote Opportunity

Coding Manager - Practice Operations- Remote Opportunity

University of MD Faculty Physicians Inc.Baltimore, MD, US
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Manages the day to day operations of the certified coders for the UM clinical departments.Provides advanced level auditing and teaching skills, assist with auditing medical records to determine if ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Coding Specialist / PB Coder (Trauma / Surgical )

Coding Specialist / PB Coder (Trauma / Surgical )

Omm IT SolutionsLinthicum Heights, MD, us
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It is an 100% Remote position but the candidates MUST Reside on CST / EST.M-F 8AM-5 PM (Flexible start date).Equipment : Facility will NOT provide equipment. Contractors must have their own equipment f...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
CODING COMPLIANCE AUDITOR

CODING COMPLIANCE AUDITOR

University of Maryland Medical SystemBaltimore, Maryland
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Accurately audits hospital Inpatient, Ambulatory Surgery, Observation, and any other outpatient encounter visit for the purpose of appropriate reimbursement, research and compliance with federal an...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
HCC Coding Education Lead Analyst - Cigna Healthcare - Hybrid (Mid-Atlantic)

HCC Coding Education Lead Analyst - Cigna Healthcare - Hybrid (Mid-Atlantic)

The Cigna GroupBaltimore, MD
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Incumbent candidate must reside in assigned territory and have the ability to travel to the local office and provider offices in the territory. Candidate can be based out of Baltimore, MD office or ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Coding Educator

Coding Educator

VirtualVocationsBaltimore, Maryland, United States
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A company is looking for a Coding Educator to develop and facilitate coding education programs for coders.Key Responsibilities Administer and update the coding education program for inpatient and...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
Medical Billing and Coding - Entry Level Training Program

Medical Billing and Coding - Entry Level Training Program

Dreambound Inc.Baltimore, Maryland
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This is an educational program, not a job offer.Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market.Looking to s...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Coding Education Auditor Inpatient, CCS

Coding Education Auditor Inpatient, CCS

Johns Hopkins MedicineBaltimore, MD, US
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Employee and Dependent Tuition Assistance.Diverse and collaborative working environment.Affordable and comprehensive benefits package. You can explore the details of our benefits offering by visitin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Senior Manager, Risk Adjustment Coding Management (Medicare)

Senior Manager, Risk Adjustment Coding Management (Medicare)

Kaiser PermanenteBaltimore, MD, US
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Senior Manager, Risk Adjustment Coding Management (Medicare).The Senior Manager role, reporting to the Senior Director in Risk Adjustment, will manage 3-4 direct reports in the Medicare risk adjust...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Coding Specialist III

Coding Specialist III

Johns Hopkins UniversityMiddle River, MD, United States
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Federal payer documentation guidelines.Works closely with departmental management and coordinates with Clinical Practice Association, Office of Billing Quality Assurance to include review of docume...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
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Carelon Medical Coding / Auditing Manager - Behavioral Health

Carelon Medical Coding / Auditing Manager - Behavioral Health

Elevance HealthElkridge, MD, US
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Carelon Medical Coding / Auditing Manager - Behavioral Health.Supports Payment Integrity & Behavioral Health.This role requires associates to be in-office 3-4 days per week, fostering collaboration a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
Medical Coding Specialist

Medical Coding Specialist

Cynet SystemsBaltimore, MD
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Job Description :

Pay Range : $30hr - $35hr

  • Acts as an internal expert to ensure that as value-based reimbursement and medical policy models are developed and implemented.
  • Provides advanced knowledge to support effective partnership with provider entities and guidance on the appropriate quality measure capture and proper use of CPT and ICD 10 codes in claims submissions.
  • Utilizes extensive coding knowledge, combined with medical policy, credentialing, and contracting rules knowledge to help build the effective guides and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity.
  • Consults on proper coding rules in value-based contracts to ensure appropriate quality measure capture and proper use of CPT and ICD10 codes.
  • Provides input on various consequences for different financial and incentive models. Supports to use of alternatives and solutions to maximize quality payments and risk adjustment.
  • Translates from claim language to services in an episode or capitated payment to articulate inclusions and exclusions in models.
  • Serves as a technical resource / coding subject matter expert for contract pricing related issues.
  • Conducts business and operational analyses to assure payments are in compliance with contract; identifies areas for iimprovement and clarification for better operational efficiency.
  • Provides problem solving expertise on systems issues if a code is not accepted.
  • Troubleshoots, make recommendations and answer questions onmore complex coding and billing issues whether systemic or one-off.
  • Supports and contributes to the development and refinement of effective guides and resources for providers on the expected methodologies for billing and code submissions to maximize quality and STARs outcomes while not compromising payment integrity.
  • May interface directly with provider groups during proactive training events or just in time on complex claims matters.
  • Consults with various teams, including the Practice Transformation Consultants, Medical Policy Analysts and Provider Networks colleagues to interpret coding and documentation language and respond to inquiries from providers.
  • Keeps up-to-date on coding rules and standards.
  • To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
  • The requirements listed below are representative of the knowledge, skill, and / or ability required.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education Level :

  • High School Diploma.

    • Experience :

  • 3 years experience in risk adjustment coding, ambulatory coding and / or CRC coding experience in managed care; state or federal health care programs; or health insurance industry experience.

    • Preferred Qualifications :

  • Bachelor's degree in related discipline.
  • Experience in medical auditing.
  • Experience in training / education / presenting to large groups.
  • Experience in revenue cycle management and value-based. reimbursement / contracting models and methodologies.
  • Knowledge, Skills and Abilities (KSAs) Proficiency.
  • Knowledge of billing practices for hospitals, physicians and / or ancillary providers as well as knowledge.
  • about contracting and claims processing Proficient.
  • Knowledge and understanding of medical terminology to address codes and procedures Advanced.
  • Excellent communication skills both written and verbal Proficient.
  • Detail oriented with an ability to manage multiple projects simultaneously Proficient
  • Demonstrated ability to effectively analyze and present data Proficient
  • Experience in using Microsoft Office (Excel, Word, Power Point, etc.) and demonstrated ability to learn / adapt to computer-based tracking and data collection tools Proficient.
  • Responsibilities will include reviewing provider claims with medical records for SIU prepayment team.
  • The role is to ensure properly coded claims in accordance with AMA, industry standards, and identification of FWA indicators.

    • Accreditations Include :

  • CPC, CPMA, COC through AAPC.