• Review clinical documentation and assign accurate medical billing and procedure codes. • Process insurance claims and ensure compliance with payer guidelines and coding regulations. • Verify coding accuracy and resolve billing discrepancies or claim denials. • Maintain accurate patient billing records and documentation. • Collaborate with healthcare providers and administrative staff to support efficient billing operations. • Stay current on coding updates, payer policies, and industry regulations. • Assist with audits and implement best practices to improve billing accuracy and compliance.

Role Description CrewBloom is seeking a detail-oriented Medical Billing & Coding Specialist to support one of our US-based healthcare clients in a fully remote role. This opportunity is open exclusively to candidates currently residing in the United States. You will work closely with healthcare practitioners in private practices and medical clinics to accurately review, assign, and manage medical codes, ensuring compliant billing, timely reimbursements, and efficient revenue cycle operations. Job Responsibilities - Review clinical documentation and assign accurate medical billing and procedure codes. - Process insurance claims and ensure compliance with payer guidelines and coding regulations. - Verify coding accuracy and resolve billing discrepancies or claim denials. - Maintain accurate patient billing records and documentation. - Collaborate with healthcare providers and administrative staff to support efficient billing operations. - Stay current on coding updates, payer policies, and industry regulations. - Assist with audits and implement best practices to improve billing accuracy and compliance. Qualifications - Proven experience in medical billing and coding within a healthcare setting. - Strong understanding of medical coding standards, billing workflows, and insurance claim processes. - Experience working with private medical practices or outpatient clinics is preferred. - Familiarity with Eye Care Practice (ECP) code families and billing rules is highly preferred. - Certifications such as CPC, CCS, RHIT, or RHIA are a plus but not required. - Excellent attention to detail, analytical, and problem-solving skills. - Strong communication skills and the ability to work independently in a remote environment. Requirements - Minimum Technical and Work Environment Requirements: - Internet Connection: - Primary internet connection with a minimum speed of 15 Mbps. - Backup internet connection with at least 10 Mbps. - Backup connection must be capable of supporting work during a power outage. - Primary Device: - Desktop or laptop equipped with at least: - Intel Core i5 (8th generation or newer), Intel Core i3 (10th generation or newer), AMD Ryzen 5, or an equivalent processor. - A minimum of 8 GB RAM. - Backup Device: - Must meet or exceed the performance of an Intel Core i3 processor. - Must be functional during power interruptions. - Peripherals and Workspace: - A functioning webcam. - A noise-canceling USB headset. - A quiet, dedicated home office space. - A smartphone for communication and verification purposes. Benefits - Join Our Dynamic Team: Experience our fun, inclusive, innovative culture that values your unique contributions and supports your professional growth. - Embrace the Opportunities: Seize daily chances to learn, innovate, and excel. Make a real impact in your field. - Limitless Career Growth: Unlock a world of possibilities and resources to propel your career forward. - Fast-Paced Thrills: Thrive in a high-energy, engaging atmosphere. Embrace challenges and reap stimulating rewards. - Flexibility, Your Way: Embrace the freedom to work from home or any location of your choice. Create your ideal work environment. - Work-Life Balance at Its Best: Say goodbye to stressful commutes and hello to quality time with loved ones. Achieve a healthy work-life integration to perform at your best.

Role Description Are you looking for a rewarding career with a top-notch healthcare company? We are looking for a qualified Coder III like you to join our Texas Health Family. Work location: Remote Work hours: Monday through Friday from 8:00 to 4:30 pm (may have some flexibility after training/orientation) HIMS Coding Department Highlights: - 100% remote work - Flexible hours/scheduling - Terrific work/life balance Qualifications - H.S. Diploma or Equivalent (REQUIRED) - Completion or training in ICD-10-CM/PCS coding program (REQUIRED) - Associate's Degree in Health Information Management, Nursing, or other healthcare-related field (preferred) - Bachelor's Degree in Health Information Management, Nursing, or other healthcare-related field (preferred) Requirements - 3 Years Inpatient coding experience in a large, complex acute healthcare setting (REQUIRED) - CCS - Certified Coding Specialist Upon Hire (REQUIRED) - CIC - Certified Inpatient Coder Upon Hire (REQUIRED) - RHIT - Registered Health Information Technician Upon Hire (REQUIRED) - RHIA - Registered Health Information Administrator Upon Hire (REQUIRED) Skills - Ability to analyze and validate documentation that supports accurate code assignment for complex inpatient cases utilizing available coding technology appropriately. - Advanced knowledge and utilization of encoder software with usage of computer-assisted-coding software. - Ability to apply definition of principal diagnosis to arrive at correct code, MS-DRG and POA assignment. - Strong knowledge of ICD-10-CM/PCS diagnosis and procedure coding guidelines. - Expertise in the application of coding convention guidelines in all levels of inpatient coding from complex to simple. - Strong oral and written communication skills with the ability to initiate clear and concise queries to physicians. - Advanced MS Office suite skills and encoder software. - Moderate skills in computer-assisted-coding functions. - Acts as a resource/mentor to less experienced coders with the ability to assess coding accuracy and provide feedback. - Demonstrated strong decision making, problem solving and advanced critical thinking skills by applying coding concepts. What You Will Do - Provides critical assessment of the health record documentation to accurately identify pertinent primary and secondary diagnosis and procedures that require ICD-10-CM/PCS code and MS-DRG assignment for proper billing complex (Medicare, high dollars, long LOS and high CMI) inpatient records. - Abstracts and compiles clinical data elements such as attending physician, surgeon, consultants, ED physician, birth weight, etc. according to THR guidelines. - Queries the physician and takes initiative to collaborate with Clinical Documentation Specialist and other departments when documentation in the record is ambiguous, inadequate, unclear or incorrect for accurate coding and compliance. - Demonstrates and maintains adequate productivity and quality metrics as outlined in job description. - Demonstrates and maintains coding proficiency by staying abreast of coding guidelines as published in Coding Clinic. Benefits - Benefits include 401k, PTO, medical, dental, Paid Parental Leave, flex spending, tuition reimbursement, Student Loan Repayment Program as well as several other benefits. - A supportive, team environment with outstanding opportunities for growth. - Explore our Texas Health careers site for info like Benefits, Job Listings by Category, recent Awards we’ve won and more. - Do you still have questions or concerns? Feel free to email your questions to recruitment@texashealth.org.

Role Description This is a Full-Time Remote Position. Compensation Range: $61,214.40 to $91,832.00 yearly salary - paid biweekly. Exempt Position. Ensures interpretation and compliance with the appropriate credentialing and regulatory agencies, while developing and maintaining a working knowledge of the statutes and laws relating to credentialing. Responsible for the accuracy and integrity of the credentialing database systems and related applications. Essential Functions and Basic Duties Position-Specific Performance Expectations, Duties, and Responsibilities: - Leads, coordinates, and monitors the review and analysis of practitioner applications and accompanying documents, ensuring applicant eligibility. - Conducts thorough background investigation, research, and primary source verification of all components of the applicant’s file. - Identifies issues that require additional investigation and evaluation, validates discrepancies, and ensures appropriate follow-up. - Prepares credential files for completion and presentation to MRH and Medical Staff Committees, ensuring file completion within specified time periods. - Processes requests for privileges, ensuring compliance with criteria outlined in clinical privilege descriptions. - Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise. - Assists with internal provider file audits. - Monitors the initial, reappointment, and expired credentials process for all medical staff, Allied Health Professional staff, other health professional staff, and non-employed/delegated providers, ensuring compliance with regulatory bodies as well as Medical Staff Bylaws, Rules and Regulations, policies and procedures, and contracts. - Prepares meeting agendas and takes minutes for Medical Staff Committees. - Utilizes credentialing software to maintain current records, licensures, and certifications. - Organizes and facilitates the Peer Review process as needed. Maintains Peer Review documents in a locked file. - Prepares confidential reports for the Medical Executive Committee (MEC). - Establishes and maintains a professional relationship with all staff to resolve problems, working as a team. - Functions in a high-volume, multiple-task environment, while producing quality work. - Prioritizes workload and completes assignments within allotted time. - Able to work independently and problem-solve. - Must meet established productivity and quality guidelines. - Attends all applicable workshops. - Responsible for monitoring directed indicators. - Performs other duties as assigned. Organization-Specific Performance Expectations, Duties, and Responsibilities: - Demonstrates full commitment to the CHOICE values of MRH and consistently represents the organization in a positive, professional manner. - Establishes and maintains effective verbal and written communication, fostering positive working relationships with patients, staff, and vendors. - Adheres to the MRH attire and dress code in accordance with organizational policies and procedures. - Exhibits initiative and self-motivation; maintains a consistent level of productivity and manages time and responsibilities effectively. - Completes all required annual education, training, in-services, and licensure/certification updates; actively participates in departmental and organizational meetings or reviews meeting minutes as required. - Maintains strict patient confidentiality at all times. - Reports to work punctually and completes assigned duties within established timeframes. - Actively contributes to departmental and organization-wide performance improvement and continuous quality initiatives. - Ensures compliance with all regulatory requirements, maintaining adherence to departmental, hospital, state, and federal standards and policies. - Follows all infection control, safety, and risk management procedures to maintain a safe environment for patients, the public, and staff. Qualifications - Must be at least 18 years of age (21 for positions requiring driving, with a valid driver’s license). - Must be legally authorized to work in the United States. - Must successfully pass a background check. - Must successfully pass a pre-employment drug screen and breath alcohol test (if applicable). - Must complete an Employee Health meeting prior to starting employment. Education, Licensure(s), and Certification(s) - Required: Bachelor’s degree in Business Administration, Healthcare Administration, or related field. - Preferred: National Association Medical Staff Services (NAMSS) as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS). Experience - Required: One (1) year of experience directly related to hospital medical staff or managed care credentialing. Benefits - Medical - Dental - Life - Retirement - Paid Time Off