Outpatient surgery coder with at least 2 years of experience coding in cardiology preferably cardiovascular, cardiology, IVR procedures. Must be experienced with edits and denials. Experience with bariatric cases a plus. Cerner experience is a plus. The project will be working denials and edits primarily in cardiology with some bariatric as well. This is short term project estimated to be 3 months. This is open to fulltime or parttime candidates. The preferred schedule is M-F with hours worked between 7a-5p CST. Required Experience: NCCI/CCI edits and modifier indicators Medically Unlikely Edits (MUEs) Medical necessity denials Modifiers 59, XE, XS, XP, and XU Looking up NCDs and LCDs Cardiac Caths Interventions (PCI, stents, atherectomy, thrombectomy) Electrophysiology studies and ablations Device procedures (pacemakers, ICDs, CRT, lead revisions, generator changes) Structural heart procedures (TAVR/TMVR, Watchman) Experience with modifiers 51, 76 and 77 Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com AAP/EEO Statement Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories. Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com.

Role Description Hi, we're Oscar. We're hiring an Associate to join our Payment Integrity team. You will report into the Manager, Payment Integrity (Pre-Pay). Work Location: - This is a remote position, open to candidates who reside in: Atlanta, Georgia; Chicago, Illinois; Dallas, Texas; Louisville, Kentucky; Minneapolis, Minnesota; Philadelphia, Pennsylvania; Salt Lake City, Utah. - You will be fully remote; however, our approach to work may adapt over time. Future models could potentially involve a hybrid presence at the hub office associated with your metro area. Pay Transparency: - The base pay for this role is: $82,717 - $108,566 per year. - You are also eligible for employee benefits, participation in Oscar's unlimited vacation program, and annual performance bonuses. Responsibilities: - Perform line-by-line review of high-dollar facility itemized bills and corresponding claim forms (e.g., UB-04s). - Proactively identify and document potential billing errors, including duplicate billing of items, services, or procedures as improper unbundling of services (e.g., separating components that should be billed together) and charges for non-covered or non-rendered services. - Compare billed charges against both payor-specific contracts and industry guidelines to confirm appropriate billing practices. - Apply working knowledge of national coding systems (e.g., CPT, HCPCS, ICD-10, MS-DRGs) to validate the accuracy of codes used for services billed. - Review claims eligible under specific reimbursement scenarios: a percentage of charges or those exceeding stop-loss levels, ensuring the claim exceeds the minimum dollar threshold set by the payor. - Prepare clear, concise, and professional documentation of all findings, including savings identified, policy violations, and recommended claim adjustments. - Contribute to the refinement of internal audit processes and tools to enhance efficiency and accuracy in identifying claim inaccuracies. - Serve as a subject matter expert for internal and external stakeholders regarding complex billing issues, coding guidelines, and payor policies. - Provide subject matter expertise and in-depth understanding of Payment Integrity internal claims processing edits, external vendor edits and Oscar reimbursement policies. - Identify claims payment issues from data mining, process monitoring, etc., provide scoping and action steps needed to remediate the issue. - Respond to internal and external inquiries and disputes regarding policies and edits. - Document industry standard coding rules and provide recommendations on reimbursement policy language and scope. - Ideate payment integrity opportunities based on a deep knowledge of industry standard coding rules. Translate into business requirements; submit to and collaborate with internal partners to effectuate change. - Provide training and education to team members when necessary. - Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of progress, status changes, blockers, completion, etc.; field questions as appropriate. - Support Oscar run state objectives by providing speedy research, root cause analysis, training, etc. whenever issues are escalated and assigned by leadership. - Compliance with all applicable laws and regulations. - Other duties as assigned. Qualifications - A bachelor's degree or 4+ years of commensurate experience. - 2+ years of bill / coding audit experience with a focus on hospital or facility billing (UB-04). - 4+ years experience in medical coding. - Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA). - Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices. Requirements - 3+ years of experience working with large data sets using excel or a database language (bonus points). - Knowledge management, training, or content development in operational settings (bonus points). - Process Improvement or Lean Six Sigma training (bonus points). - Experience using SQL (bonus points). Benefits - Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. - Full-time employees are eligible for benefits including: medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

• Translate health care services and procedures into standardized codes on inpatient accounts • Work with Epic work quests to maintain timeliness of coding, billing and accounts receivable • Communicate with providers, coders and clinical documentation specialists as needed for comprehensive patient record documentation • Formulate, monitor and respond to all compliant documentation clarification requests to query the provider for resolution of incomplete documentation

Overview Where accuracy drives reimbursement and quality patient data. The Outpatient Coder is responsible for reviewing medical records and assigning accurate diagnostic and procedural codes using ICD and CPT classification systems in alignment with regulatory and organizational standards. This role ensures complete and compliant coding and charge entry, supports billing operations, and maintains the integrity of data for reimbursement and reporting. The coder collaborates with providers to improve documentation accuracy, identifies and resolves discrepancies within billing and abstracting systems, and contributes to continuous improvement through audits, training, and performance monitoring. Responsibilities Key Responsibilities - Reviews and analyzes medical records to assign accurate diagnostic and procedural codes - Ensures compliance with coding guidelines, regulatory requirements, and organizational policies - Collaborates with healthcare providers to clarify documentation and improve coding accuracy - Identifies and resolves coding discrepancies to maintain data integrity - Supports billing operations by providing accurate coded information for claims submission - Conducts audits of coded data and monitors productivity and quality metrics - Provides training and guidance to staff on coding procedures and updates Qualifications Minimum Qualifications - High school diploma or equivalent required - Three (3)+ years of medical coding or health information management experience preferred - Active coding certification required (RHIA, RHIT, CCS, CCA, CPC, or CPC-H) - Knowledge of ICD, CPT, and HCPCS coding standards - Understanding of medical terminology, anatomy, and physiology - Strong attention to detail with a focus on accuracy and compliance - Ability to review medical records and collaborate with providers to clarify documentation