Role Description Acentra Health is looking for a Medical Coder to join our growing team. The Medical Coder is responsible for reviewing inpatient medical record documentation to ensure the accuracy, completeness, and clinical validity of reported diagnoses and procedures. This role evaluates coding accuracy, DRG assignment, reimbursement impact, and regulatory compliance in accordance with official coding guidelines, CMS regulations, payer policies, and organizational standards. The reviewer retrieves, analyzes, and documents medical record information to support appropriate reimbursement, documentation integrity, and audit outcomes for hospital inpatient services. Responsibilities: - Review medical record documentation and accurately code the primary/secondary diagnoses and procedures using ICD-9-CM and CPT-4 coding conventions. - Review inpatient medical records to validate the accuracy and appropriateness of reported primary and secondary diagnoses and procedures using ICD-10-CM/PCS guidelines. - Evaluate diagnosis and procedure sequencing to ensure compliance with official coding guidelines and payer requirements. - Review and validate MS-DRG assignment based on documented clinical conditions, procedures, and applicable coding rules. - Assess clinical documentation support for reported diagnoses, particularly those with reimbursement, quality, or compliance impact. - Conduct clinical validation reviews to determine whether diagnoses are supported by clinical indicators within the medical record. - Apply CMS regulations, including medical necessity criteria and the Two-Midnight Rule, when evaluating admission status and level of care. - Identify, document, and clearly communicate audit findings, including: - Coding discrepancies - Clinical validation concerns - DRG or reimbursement risk - Admission status issues - Abstract and compile audit data to support accurate reimbursement and compliance reporting. - Utilize coding software, encoder/grouper tools, and electronic medical record systems to complete reviews efficiently and accurately. - Meet productivity, quality, and contract deliverable standards in a production-driven environment. - Maintain compliance with all corporate policies, including HIPAA Privacy and Security Rules. - Serve as backup support for other administrative or audit-related functions as needed. Qualifications - High school diploma or GED. - Minimum of 2 years of progressive, hands-on acute care inpatient coding experience, including DRG auditing or review experience. - Active possession of one of more of the following certifications: - CCS or CCA or CDIP (AHIMA) - CPMA (AAPC) - CCDS (ACDIS) - Demonstrated proficiency in ICD-10-CM and ICD-10-PCS. - Strong working knowledge of inpatient coding guidelines, DRG reimbursement methodology, and CMS and payer regulations. - Proven ability to independently review inpatient medical records and validate diagnoses, procedures, as well as MS-DRG assignment. - Experience reviewing inpatient medical records. - Familiarity with electronic health records, encoder/grouper tools, and coding software. - Strong analytical skills with exceptional attention to detail. - Effective written and verbal communication skills. - Proficiency in Microsoft Office (Word, Excel, Outlook). - Ability to meet deadlines with accuracy in a fast-paced, production-focused environment. - Commitment to ongoing learning and professional development. Requirements - Advanced experience and knowledge of clinical validation audits, admission status, medical necessity reviews, and payer-specific audit processes. Benefits - Comprehensive health plans. - Paid time off. - Retirement savings. - Corporate wellness. - Educational assistance. - Corporate discounts. - And more. Company Description Acentra Health exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. Lead the Way is our rallying cry at Acentra Health. Think of it as an open invitation to embrace the mission of the company; to actively engage in problem-solving; and to take ownership of your work every day. Acentra Health offers you unparalleled opportunities. In fact, you have all you need to take charge of your career and accelerate better outcomes – making this a great time to join our team of passionate individuals dedicated to being a vital partner for health solutions in the public sector.

Role Description This position is responsible for the timely coding of professional services based on provider documentation, ensuring that all services are in compliance with the Tulane University Medical Group (TUMG) Guidelines. - Maintain knowledge base relative to billing functions, internal and external regulations, and documentation issues. - Work independently and process large quantities of data. - Communicate clearly and professionally with providers, administrators (DBON), and TUMG staff. - Respond timely and accurately to inquiries. Company Description Tulane University is an equal opportunity educator and employer committed to providing an education and employment environment free of unlawful discrimination, harassment, and retaliation. - Legally protected demographic classifications (such as a person’s race, color, religion, age, sex, national origin, shared ancestry, disability, genetics, veteran status, or any other characteristic protected by federal, state, or local laws) are not relied upon as eligibility, selection, or participation criteria for Tulane’s employment or educational programs or activities. - Tulane University is responsible for providing reasonable accommodations to individuals with disabilities throughout the applicant screening process. If you need assistance in completing an application or during any phase of the interview process, please contact the Office of Human Resources by phone at 504-865-4748 or by email at hr@tulane.edu.

Medical Coding Specialist Remote - Florida Remote - Georgia Full time R26_0000001370 Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best for our customers. Summary Reviews and completes the medical coding and pricing of the Allocation Worksheets and Calculation spreadsheets prepared by the Analysts. Essential Duties and Functions - Supports the preparation and review of the Allocation worksheet. - Prices DME, facility & medical procedures and surgeries and prescription medications. - Analyze and interpret Allocation worksheet to ensure accurate coding of diagnoses, procedures and services. - Apply appropriate ICD-10-CM, CPT, and fee schedules based on coding guidelines. - Enters the appropriate medical procedure code, NDC prescription drug code and price in the Case Management System. - Strictly adhere to company confidentiality policies and procedures, safeguarding sensitive information at all times. - Any other duties as may be assigned. Qualifications/ Requirements To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions. Required Qualifications - CPT, ICD-10, HCPCS coding, and a working knowledge of NDC codes – minimum 2 years of experience - Workers’ Compensation or Liability experience working with multiple jurisdictions - Working knowledge of the Medicare system, remittance and reimbursement policies - Strong knowledge of anatomy/physiology - Strong mathematics skills - Strong excel skills Preferred Qualifications - Experience coding and billing Orthopedic and Pain Management procedures and surgeries Preferred Certificates or Licenses - Certified Professional Coder and/ or Certified Professional Biller Teammate Benefits & Total Well-Being We go beyond standard benefits, focusing on the total well-being of our teammates, including: - Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance - Financial Benefits: ESPP; 401k; Student Loan Assistance; Tuition Reimbursement - Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services - Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more.

• The Consultant is seen as a senior level coding professional and provides knowledge, experience and mentorship to the team as well as other staff in the organization.