Role Description Performs technical and administrative work reviewing, abstracting, and assigning accepted medical and surgical codes for inpatient and outpatient diagnoses, procedures, and services. Duties are performed in compliance with third party, state, and federal regulations according to standardized procedures. This position is eligible for the remote coding program. Qualifications - High school diploma or GED. - Successful completion of HIS Hospital Proficiency Test. - Must have AHIMA (American Health Information Management Association) certification and credential or AAPC (American Academy of Professional Coders) certification and credential. - Minimum of two years of coding experience. - Strong knowledge of ICD-10 CM/PCS and/or HCPCS/CPT coding with analytical and data mining skills. - Strong knowledge of coding rules and guidelines, Coding Clinic, and CPT Assistant. - Strong knowledge of Ambulatory Payment Classification (APC) system for outpatient cases and/or Medical Severity Diagnosis Related Groups (MS-DRG) system for inpatient cases. - Computer data entry skills required. - Possess balance or being highly productive and yet produce high quality work. - Strong communication skills, both written and verbal, and have extensive attention to detail. - Deliver outstanding customer service that upholds CarolinaEast's Standards of Excellence. Requirements - AHIMA or AAPC certification and credential. - Two years of coding experience. - Strong knowledge of coding systems and guidelines. - Computer data entry skills. - Strong communication skills. Benefits - Robust benefits package for full-time employees. - Benefits for part-time plus and part-time staff.

Title: Medical Records Coder III Outpatient (REMOTE) Business and Administrative Job Description: BayCare is currently in search of our newest Team Member who is passionate about providing outstanding customer service to our community. We are looking for an individual seeking a career opportunity with one of the largest employers within the Tampa Bay area. Position Details: - Location: Remote (must reside in the state of Florida, Georgia, North Carolina, or South Carolina) - Status: Full time (non-exempt) - Shift: 7:00 AM to 3:30 PM - Days: Monday through Friday The Medical Records Outpatient Coder III will work remotely on a full-time basis. Sign on bonuses available! Responsibilities: - The Medical Records Outpatient Coder III reviews short stay focused encounters to accurately assign diagnosis and procedural codes-using ICD-10-CM and CPT-4 coding systems. - Works in conjunction with various departments for missing documentation and monitors bill hold reports. - Strong utilization of medical terminology and anatomy. - Assists Manager/Director with mentoring/training of Coder I and Coder II team members and clinical practice students from various colleges. - Performs other duties as assigned. Required Coding Experience: - Emergency room (ED) - Same day surgery (ambulatory) - Observation cases Why BayCare? Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians. With the support of more than 30,000 team members, we promote a forward-thinking philosophy that is built on a foundation of trust, dignity, respect, responsibility, and clinical excellence. Our team members focus on tomorrow by achieving personal and professional success today. That is why you will thrive in our forward-thinking culture, where we combine the best technology with compassionate service. We blend high-tech with high touch in ways that are advancing superior health care throughout the communities we serve. BayCare offers a competitive total reward package including: - Benefits (Health, Dental, Vision) - Paid time off - Tuition reimbursement - 401k match and additional yearly contribution - Yearly performance appraisals and team award bonus - Community discounts and more - AND the Chance to be part of an amazing team and a great place to work! Certifications and Licensures: - Required: Certified Coding Specialist (CCS) - Preferred: RHIT (Health Information) Education: - Required: high school or equivalent - Preferred: associate degree in Health Information Management Experience: - Required 5 years of Outpatient Facility Coding - Strong CPT coding Equal Opportunity Employer Veterans/Disabled

Role Description The Risk Adjustment Specialist – Coding Compliance supports the organization’s delegated Risk Adjustment and Coding Compliance programs by performing specialized audit support, documentation review coordination, coding validation support, medical record analysis, and compliance activities to promote accurate and complete Hierarchical Condition Category (HCC) capture in accordance with Centers for Medicare & Medicaid Services (CMS), California Department of Managed Health Care (DMHC), National Committee for Quality Assurance (NCQA), Office of Inspector General (OIG), and contracted health plan requirements. - Supports coding compliance oversight activities related to Medicare Advantage Risk Adjustment, Risk Adjustment Data Validation (RADV), provider documentation integrity, and coding accuracy initiatives. - Assists with identifying documentation gaps, monitoring coding compliance trends, coordinating audit preparation activities, and supporting provider education efforts to ensure accurate Risk Adjustment Factor (RAF) scoring and regulatory compliance. - Collaborates closely with Coding Compliance leadership, certified coders, providers, population health teams, utilization management, care management, quality improvement, and health plans to support compliant documentation and coding practices, audit readiness, and delegated risk adjustment program performance. Qualifications - Minimum: High school diploma or GED equivalent required. - Preferred: Associate’s degree or higher in healthcare administration, public health, social services, or related field. - Minimum: At least one year of experience in one or more of the following areas: risk adjustment, coding compliance, medical record review, managed care, healthcare administration, managed care or MSO environment, medical office or provider operations. - Preferred: Experience supporting Medicare Advantage Risk Adjustment programs. Experience supporting CMS RADV audits or coding compliance audits. Experience in an MSO, IPA, health plan, delegated entity, or managed care environment. Experience working with electronic health records, coding software, or Risk Adjustment platforms. - Certification(s): Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or other coding certification preferred. - Knowledge of CMS Risk Adjustment methodology, HCC documentation requirements, and RAF score principles. - Understanding of Medicare Advantage Risk Adjustment, coding compliance, and documentation integrity requirements. - Familiarity with CMS RADV audit standards, DMHC regulatory requirements, NCQA standards, and delegated health plan oversight requirements. - Ability to identify documentation deficiencies, coding inconsistencies, compliance risks, and audit-related concerns. - Strong organizational, analytical, auditing, and data tracking skills with exceptional attention to detail and accuracy. - Ability to maintain accurate records, audit logs, compliance documentation, and reporting tools. - Proficiency with electronic health records, Risk Adjustment platforms, coding software, and Microsoft Office applications. - Strong verbal and written communication skills with the ability to communicate professionally with providers, coders, leadership, health plans, and interdisciplinary teams. - Ability to handle confidential and sensitive information in compliance with HIPAA and organizational policies. - Ability to manage multiple priorities, deadlines, and audit-related activities in a fast-paced managed care environment. - Ability to work independently while collaborating effectively within interdisciplinary operational and compliance teams. Requirements - The physical demands described here are represented of those that must be met by an employee to successfully perform the essential functions of this job. - Primarily sedentary work involving prolonged computer use. - Occasional standing, walking, and local travel may be required. - Ability to lift up to 20 pounds occasionally. - Requires strong attention to detail, data analysis capability, and effective communication skills. - Work is performed in an office or remote environment supporting electronic medical record and Risk Adjustment systems.

Title: Medical Coder Location: Eden Prairie United States Job Description: Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. The Medical Coder performs concurrent review of FFS coding rules within Epic, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. Schedule: Monday to Friday, 8 AM- 5 PM Location: Remote Nationwide You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes - Apply understanding of basic anatomy and physiology to interpret clinical documentation and identify applicable medical codes - Identify areas in clinical documentation that are unclear or incomplete and generate queries to obtain additional information - Follow up with providers as necessary when responses to queries are not provided on a timely basis - Utilize medical coding software programs or reference materials to identify appropriate codes - Apply post-query response to make final determinations - Apply relevant Medical Coding Reference, Federal, State, and Professional guidelines to assign and record independent medical code determinations. - Manage multiple work demands simultaneously to maintain relevant productivity and turnaround time standards for completing medical records (e.g., charts, assessments, visits, encounters) - Resolve medical coding edits or denials in relation to code assignment - Provide information or respond to questions from medical coding quality audits - Educate and mentor others to improve medical coding quality - Demonstrate basic knowledge of the impact of coding decisions on revenue cycle - Other duties as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications: - High School Diploma/GED - Coding certification from AAPC or AHIMA Professional Coding Association: (CPC, CPC-H, CPC-P, RHIT, RHIA, CCA, CCS, CCS-P etc.) - 2+ years of coding experience - 1+ years of family planning experience - 1+ years Rev Cycle experience - Advanced level of knowledge of ICD-10-CM, CPT, Modifiers & HCPCS coding classification and guidelines - Advanced level of knowledge of medical terminology, disease process and Anatomy and Physiology Preferred Qualifications: - Epic experience - All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN