• Responsible for critical access hospital coding including emergency department, infusions, Critical Access Hospital Specialty Clinic, professional fees, and Rural Health Clinic • Ensure the timely and accurate coding of medical claims while maximizing reimbursement for services • Abstract clinical information; translate medical documentation into diagnoses and procedural codes while utilizing currently accepted coding and classification systems • Sequence codes according to established guidelines • Analyze and interpret medical information, medical diagnoses, coding/classification systems to ensure accuracy for prospective payment system reimbursement • Maintain current knowledge of coding rules and regulations as designated by the AMA, Centers of Medicare and Medicaid Services (CMS) and other payers • Communicate issues to management, including payer, system, or escalated account issues • Identify medical necessity denial trends and provide suggestions for resolution • Perform other billing functions including claim submission, unpaid claims follow-up, denial resolution • Participate in department meetings, in-service programs, and continuing education programs • Convey professional attitude with patients, visitors, physicians, office staff and hospital personnel

Manage the complete lifecycle of medical billing claims, ensure accurate processing and compliance, verify patient insurance eligibility, and generate detailed reports on billing activities and claim statuses to enhance financial operations.

Title: Outpatient Coder III Location: United States Department: HIM/Coding/Transcription Job Description: Description THIS IS A REMOTE POSITION The Coder III is responsible for coordinating, performing and completing Medicare compliancy. Coding consists of outpatient services in outpatient and inpatient services including procedures. To ensure coders provide technical aspects of the assignment diagnostic and carried out in accordance with established standards and in compliance NCQA and other regulatory agencies, and Tenet policy. Responsibilities - Performs all assigned billing in a timely manner - Communicates with the physician the documentation needed to complete job functions - Ensures accurate coding from the medical record regarding ICD-9 and ICD-10, appropriate evaluation and management CPT code - Updates patient record with patient’s current insurance, address and telephone numbers - Identifies primary care doctor and referral source with contact information and documents it in the medical record - Performs claims follow up and reviews with billing agent in a timely - manner - Protects patient confidentiality according to HIPAA guidelines - Maintains proper credentials and researches coding issues to ensure correct coding initiative per CMS guidelines - Identifies and attends one course/conference per specialty, per year to continue education in the coding field - Must have ortho billing experience Qualifications - AA Degree required - Bachelors Degree preferred - 5 years coding experience required - Healthcare background is required - CPT current competence with ICD- 10, ICD-9, CPT-4, and HCPCS required - Coding scheme and reimbursement practices required - RHIA, RHIT, CCS, CPC or COC certification is required - Office, and Excel required - Willingness to be flexible and adaptable in a complex, matrix environment #LI-JK1 About Us Embark on a rewarding career with Tenet Physician Resources. If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch. At Tenet Physician Resources, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include: - Medical, dental, vision, and life insurance - 401(k) retirement savings plan with employer match - Generous paid time off - Career development and continuing education opportunities - Health savings accounts, healthcare & dependent flexible spending accounts - Employee Assistance program, Employee discount program - Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance Note: Eligibility for benefits may vary by location and is determined by employment status About the Team The mission of the Paley Orthopedic & Spine Institute is to provide some of the most technologically advanced treatments to improve the lives of those who suffer from congenital, developmental and post-traumatic orthopedic conditions. Serving children and adults from the local community, the United States and the world, the Paley Orthopedic & Spine Institute offers comprehensive, coordinated care from an experienced team of professionalsdesigned for the specific needs of each patient. At the Paley Orthopedic & Spine Institute, our treatment philosophy focuses on reconstruction over amputation and a commitment to preserving limbs and joints and restoring function. Job Identification: 2603000400 Job Category: Administrative Functions Degree Level: Associate's Degree/College Diploma (±13 years) Job Schedule: Full time Job Shift: Day Locations The Paley Institute(Remote) Assignment Category: Full Time Pay Range: $24.92 - $37.39 hourly **Individual wages are determined based upon a number of factors including, but not limited to, an individual’s qualifications and experience

Title: Payment Integrity Professional Employee Type: Contract Remote: Yes Location: Louisville, KY, US Job Type: Date Posted: April 6, 2026 Pay Range: $22 - $23 per hour Job#: 3029181 Job Description: Payment Integrity Professional Location: Louisville, Kentucky (Remote) Employment Type: Contract Role Overview The Payment Integrity Professional contributes to cost reduction by improving the accuracy of provider contract payments and ensuring correct claims payment. This role supports investigations related to fraud, waste, and abuse. The position requires independent judgment to determine the appropriate course of action in ambiguous situations with minimal direction. This role does not involve clinical judgment or medical necessity determinations. Contract Details This role offers an opportunity for extension or conversion to full-time employment. Conversion is not guaranteed and is based on performance, evaluation, and business need. Key Responsibilities - Review and analyze Medicare appeal cases from a non-clinical and coding perspective. - Verify coding accuracy and ensure compliance with Centers for Medicare and Medicaid Services (CMS) guidelines. - Support the Medicare appeals process through detailed review and documentation. - Assist with the management and reporting of SIU grievances, appeals, Independent Review Entity (IRE) overturns, and Administrative Law Judge (ALJ) hearings. - Read, interpret, and analyze medical claims to ensure appropriate payment outcomes. - Apply coding guidelines, correct coding initiatives, national benchmarks, and industry standards. - Monitor compliance and manage assigned inventory. Required Qualifications - AAPC Coding Certification (CPC). - Minimum of two years of post-certification experience applying coding guidelines, preferably with Medicare claims. - Knowledge of CMS guidelines, correct coding initiatives, national benchmarks, and industry standards. - Experience with Medicare Appeals. - Experience reading and interpreting medical claims. - Experience with the Medicare Line of Business. - Experience with compliance monitoring. - Proficiency in CAS, CRM, MHK, Microsoft Word, and Excel. - Strong written communication skills. Preferred Qualifications - Experience working within a Special Investigations Unit (SIU). - Experience with Pareo or MOAT. - Experience leading people, projects, or processes. - Experience in a fast-paced operational setting. - Experience with STARs, G&A IRT, or Maximus. - Investigation experience. - Ability to work independently and manage multiple priorities. - Capacity to maintain confidentiality. - Experience using Strider or Co-Pilot. Work Arrangement This is a remote, work-from-home position. Occasional travel to company offices for training or meetings may be required. Work hours must align with Central or Eastern Time, Monday through Friday. Compensation and Benefits Pay Rate: $22.00/hr - $23.00/hr We are an equal opportunity employer and welcome applications from all qualified candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. Apex Systems is a world-class IT services company that serves thousands of clients across the globe. When you join Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico. Apex uses a virtual recruiter as part of the application process. Apex Benefits Overview: Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach. You can access a full list of our benefits, programs, support teams and resources within our ‘Welcome Packet’ as well, which an Apex team member can provide.