Role Description This position is located in the Health Information Management Section (HIMS) of the Business Office at the VA Boston Health Care System (VABHCS). The Medical Records Technician (Coder) is responsible for performing a quality review of patient care documents and assigning codes specific for the type of care provided. Duties may include, but are not limited to: - Identifies the principal diagnosis and principal procedure (when applicable) for every inpatient discharge; also identifies significant complications and/or co-morbidities treated or impacting treatment to correctly determine the proper Diagnostic Related Group (DRG). - Conducts re-reviews of codes abstracted for patient encounters (inpatient and outpatient) identified by the VISN VERA committee to determine if based on the documentation the specific VERA coding requirements were followed; corrects coding as needed to ensure proper patient classification in the VERA program. - Codes inpatient professional fee services for identified inpatient admissions in support of the Medical Care Cost Recovery (MCCR) program. - Establishes the primary and secondary diagnosis and procedure codes for billable outpatient encounters following applicable regulations, instructions, and requirements for allowable reimbursement. - Codes all Operating Room procedures reported in the Surgical Package of the Vista hospital system. - Updates codes for current inpatient and Contract Nursing Home admissions for quarterly census and as directed for billable long stay admissions. - Reviews and codes assigned Fee Service patient encounters (inpatient and outpatient) using the paper or electronic documentation obtained from non-VA facilities. Qualifications - Experience: One year of creditable experience equivalent to the next lower grade level. - Demonstrated Knowledge, Skills, and Abilities: - Ability to analyze the health record to identify all pertinent diagnoses and procedures for coding and to evaluate the adequacy of the documentation. - Ability to accurately perform the full scope of outpatient coding, including ambulatory surgical cases, diagnostic studies and procedures, and inpatient facility coding. - Skill in interpreting and adapting health information guidelines that are not completely applicable to the work. Requirements - Citizenship: Citizen of the United States. - Experience and Education: - One year of creditable experience that indicates knowledge of medical terminology, anatomy, physiology, pathophysiology, medical coding, and the structure and format of health records. - An associate's degree from an accredited college or university with a major field of study in health information technology/management. - Completion of an AHIMA approved coding program or other intense coding training program. - Certification: Must have either Apprentice/Associate Level Certification or Mastery Level Certification through AHIMA or AAPC. - English Language Proficiency: Must be proficient in spoken and written English. Benefits - Competitive salary and regular salary increases. - 37-50 days of annual paid time off per year. - Up to 12 weeks of paid parental leave after 12 months of employment. - Child Care Subsidy for eligible employees after 60 days of employment. - Traditional federal pension and federal 401K with up to 5% contributions by VA. - Federal health/vision/dental/term life/long-term care insurance.

Role Description We are hiring a Medical Coder to accurately assign diagnosis and procedure codes for patient records. You will ensure coding compliance and support claims processing for healthcare providers. - Review clinical documentation and assign appropriate ICD-10, CPT, and HCPCS codes. - Ensure coding accuracy, completeness, and compliance with payer guidelines. - Query clinicians for clarification when documentation is insufficient. - Meet productivity and quality benchmarks. - Stay current with coding guidelines and payer updates. Qualifications - 2+ years of medical coding experience. - CPC, CCS, or RHIT certification required. - Proficiency with EHR systems and coding software. - Strong knowledge of medical terminology and anatomy. - Attention to detail and high accuracy rate. Company Description

Title: Professional - Appeals Clinician I (B03724) Location: Remote, OR, US Job Description: Job#: 3027339 Professional - Appeals Clinician I Employment Type: Contract Employee Type: Contract Job Type: Pay Range: $25 - $28 per hour Role Overview The Appeals Clinician I utilizes clinical expertise to complete the clinical component of all appeal types to resolve member and/or provider appeals. This role applies nursing expertise and clinical judgment to ensure written appeal decisions are compliant with medical policy, medical necessity guidelines, reimbursement policies, federal regulations, and accepted standards of care. Key Responsibilities - Apply nursing expertise and clinical judgement to ensure written appeal decisions are in compliance with medical policy, medical necessity guidelines, and reimbursement policies. - Conduct clinical appeal reviews which adhere to member benefits and provider and hospital contracts. - Consult with physician advisers to ensure clinically appropriate determinations when required. - Advise and educate non-clinical appeals staff on clinical cases. - Prepare and present clear and concise written narratives and decisions. - Interpret medical records, patient data, and member benefits to communicate complex topics with clinical and non-clinical staff. Required Qualifications Education: Must have at least one of the following: - Bachelor’s degree (or higher) in a health or human services-related field. A psychiatric RN or Master's degree in Behavioral Health is preferred for behavioral health appeals management. - Registered nurse (RN) license with a current unrestricted RN license in Oregon, Washington, Idaho, or Utah. Experience: - Two years of experience in health insurance, Utilization Management, or Appeals Clinical review. - Three years (or full-time equivalent) of direct clinical care experience. - Demonstrated competency in claim review and experience using billing and claims forms. Skills and Knowledge: - Proven knowledge of medical and surgical procedures and other healthcare practices. - Familiarity with rules applied to appeals by accrediting bodies, state and federal governments, and employer groups. - Knowledge of personal computer software, such as Microsoft Word. - Knowledge of CPT, ICD-9, and HCPCS coding and Milliman Care Guidelines (MCG). Work Environment This is a remote position. Candidates must be willing to work Pacific Time Zone hours. The contractor will be provided with company equipment and must have a supported Internet Service Provider (CATV/Cable Modem, DSL, or Fiber). Satellite or mobile WiFi internet connectivity is not supported. 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. Click here for more details. 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.

About Our Company: At Infinx, we're a fast-growing company focused on delivering innovative technology solutions to meet our clients' needs. We partner with healthcare providers to leverage automation and intelligence, overcoming revenue cycle challenges and improving reimbursements for patient care. Our clients include physician groups, hospitals, pharmacies, and dental groups. We're looking for experienced associates and partners with expertise in areas that align with our clients' needs. We value individuals who are passionate about helping others, solving challenges, and improving patient care while maximizing revenue. Diversity and inclusivity are central to our values, fostering a workplace where everyone feels valued and heard.A 2025 Great Place to Work® In 2025, Infinx was certified as a Great Place to Work® in both the U.S. and India, underscoring our commitment to fostering a high-trust, high-performance workplace culture. This marks the fourth consecutive year that Infinx India has achieved certification and the first time the company has earned recognition in the U.S. Location: Remote Summary Description: The Profee Coder/Edits & Rejection Specialist supports the RW - Onshore department in various functions, including performing accurate professional fee coding, resolving edits and rejections, and ensuring pro-fee coding compliance. This role is critical in enabling onshore revenue cycle operations to optimize pro-fee billing and revenue capture. The Professional Fee Coder | Edits & Rejection Specialist will also code, audit, provide expertise, and identify process improvements. Job Responsibilities: - Accurately code professional fee services and procedures - Review and resolve coding edits, rejections, and denials - Stay up-to-date with coding guidelines and regulations - Collaborate with physicians and revenue cycle teams to ensure accurate coding - Provide training and education on coding best practices - Assist in other duties as assigned Skills and Education: - High School diploma or equivalent - Vocational school in healthcare or Associate's Degree preferred - Certified CCS, CCS-P, or CPC - 3+ years of experience in medical coding and auditing - Expertise in managing and resolving coding denials and rejections - In-depth knowledge of coding guidelines, regulations, and reimbursement methodologies in relevant speciality area - Proficiency with Epic - Ability to work independently and within a team atmosphere - Advanced and proficient knowledge of ICD-10 CM and ICD-10 - Self-motivated and passionate about our mission and values of quality work - Must have professional level skills in MS products such as Excel, Word, Power Point. - Must be able to type proficiently and with an effective pace - Proficient application of business/office standard processes and technical applications Company Benefits and Perks: Joining Infinx comes with an array of benefits, flexible work hours when possible, and a genuine sense of belonging to a dynamic and growing organization. - Access to a 401(k) Retirement Savings Plan - Comprehensive Medical, Dental, and Vision Coverage - Paid Time Off. - Paid Holidays - Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services If you are a dedicated and experienced ProFeeCoder with experience in Edits, Rejections, and Denials ready to contribute to our mission and be part of our diverse and inclusive community, we invite you to apply and join our team at Infinx.