Clinical Policy Clinical Coder RN II
$132K - $163K/yr
Job Summary The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding ...
$132K - $163K/yr
Job Summary The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding ...
$132K - $163K/yr
Job Summary The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding ...
Assigns codes based upon clinical coding guidelines. * Assigns ICD-10-CM diagnostic, procedure codes with appropriate present on admission indicators to inpatient records, based upon the practitioner ...
Assigns codes based upon clinical coding guidelines. * Assigns ICD-10-CM diagnostic, procedure codes with appropriate present on admission indicators to inpatient records, based upon the practitioner ...
Description MaineHealth Corporate Professional - Nonclinical Req #: 69433 Summary: The Coder II - Ambulatory Surgery role is responsible for the accurate assignment of ICD and CPT coding of diagnoses ...
Description MaineHealth Corporate Professional - Nonclinical Req #: 69433 Summary: The Coder II - Ambulatory Surgery role is responsible for the accurate assignment of ICD and CPT coding of diagnoses ...
$18.25 - $24.25/hr
Job Title: Clinical Coder - Onsite ($5,000 hire-on bonus) Location: Johnson County Hospital, Tecumseh, Nebraska Department: Health Information Management Reports To: HIM Manager Work Schedule:
$18.25 - $24.25/hr
Job Title: Clinical Coder - Onsite ($5,000 hire-on bonus) Location: Johnson County Hospital, Tecumseh, Nebraska Department: Health Information Management Reports To: HIM Manager Work Schedule:
Tecumseh, NE · On-site
$16 - $32/hr
Job Title: Clinical Coder - Onsite ($5,000 hire-on bonus) Location: Johnson County Hospital, Tecumseh, Nebraska Department: Health Information Management Reports To: HIM Manager Work Schedule:
Tecumseh, NE · On-site
$16 - $32/hr
Job Title: Clinical Coder - Onsite ($5,000 hire-on bonus) Location: Johnson County Hospital, Tecumseh, Nebraska Department: Health Information Management Reports To: HIM Manager Work Schedule:
Manhattan, NY · On-site
$100K - $110K/yr
The Clinical Certified Coder will support the Plan in the detection, prevention and investigation of suspected fraud, waste, and abuse. The position reports to the Director of Special Investigations ...
Manhattan, NY · On-site
$100K - $110K/yr
The Clinical Certified Coder will support the Plan in the detection, prevention and investigation of suspected fraud, waste, and abuse. The position reports to the Director of Special Investigations ...
Manhattan, NY · Hybrid
$100K - $110K/yr
The Clinical Certified Coder will support the Plan in the detection, prevention and investigation of suspected fraud, waste, and abuse. The position reports to the Director of Special Investigations ...
Manhattan, NY · Hybrid
$100K - $110K/yr
The Clinical Certified Coder will support the Plan in the detection, prevention and investigation of suspected fraud, waste, and abuse. The position reports to the Director of Special Investigations ...
Scarborough, ME · On-site
Description MaineHealth Corporate Professional - Nonclinical Req #: 73025 Summary: The Outpatient Coder II role is responsible for the accurate assignment of ICD and CPT coding of diagnoses and ...
Scarborough, ME · On-site
Description MaineHealth Corporate Professional - Nonclinical Req #: 73025 Summary: The Outpatient Coder II role is responsible for the accurate assignment of ICD and CPT coding of diagnoses and ...
San Juan, PR · On-site
$18.50 - $23.25/hr
This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. Primary Responsibilities: * Sets team direction ...
San Juan, PR · On-site
$18.50 - $23.25/hr
This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. Primary Responsibilities: * Sets team direction ...
Cincinnati, OH · On-site
$18 - $22.75/hr
Job Summary Our corporate activities are growing rapidly, and we are currently seeking a full-time, office-based Clinical Data Coder to join our Clinical Coding & Support team in Cincinnati, OH. This ...
Cincinnati, OH · On-site
$18 - $22.75/hr
Job Summary Our corporate activities are growing rapidly, and we are currently seeking a full-time, office-based Clinical Data Coder to join our Clinical Coding & Support team in Cincinnati, OH. This ...
The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the ...
The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the ...
The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the ...
The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the ...
Cincinnati, OH · On-site
$18 - $22.75/hr
Job Summary Our corporate activities are growing rapidly, and we are currently seeking a full-time, office-based Clinical Data Coder to join our Clinical Coding & Support team in Cincinnati, OH. This ...
Cincinnati, OH · On-site
$18 - $22.75/hr
Job Summary Our corporate activities are growing rapidly, and we are currently seeking a full-time, office-based Clinical Data Coder to join our Clinical Coding & Support team in Cincinnati, OH. This ...
The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the ...
The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the ...
The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the ...
The Senior Clinical Coding Specialist plays a critical role in ensuring accurate and compliant coding of patient encounters, supporting timely billing and reimbursement processes, and maintaining the ...
Overview Supervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials Lead the frontline of revenue integrity--reducing denials, optimizing collections, and driving team performance.
Overview Supervisor, Revenue Cycle Clinical Coder Denials | Enterprise Denials Lead the frontline of revenue integrity--reducing denials, optimizing collections, and driving team performance.
Farmingdale, NY · On-site
$90K - $110K/yr
Ensure proper clinical coding and case-mix accuracy * Identify documentation gaps and coordinate corrections prior to billing * Support timely claim submission and reduce billing delays * Collaborate ...
Farmingdale, NY · On-site
$90K - $110K/yr
Ensure proper clinical coding and case-mix accuracy * Identify documentation gaps and coordinate corrections prior to billing * Support timely claim submission and reduce billing delays * Collaborate ...
Farmingdale, NY · On-site
$90K - $110K/yr
Ensure proper clinical coding and case-mix accuracy * Identify documentation gaps and coordinate corrections prior to billing * Support timely claim submission and reduce billing delays * Collaborate ...
Farmingdale, NY · On-site
$90K - $110K/yr
Ensure proper clinical coding and case-mix accuracy * Identify documentation gaps and coordinate corrections prior to billing * Support timely claim submission and reduce billing delays * Collaborate ...
Farmingdale, NY · On-site
$90K - $110K/yr
Ensure proper clinical coding and case-mix accuracy * Identify documentation gaps and coordinate corrections prior to billing * Support timely claim submission and reduce billing delays * Collaborate ...
Farmingdale, NY · On-site
$90K - $110K/yr
Ensure proper clinical coding and case-mix accuracy * Identify documentation gaps and coordinate corrections prior to billing * Support timely claim submission and reduce billing delays * Collaborate ...
Must reside in an authorized state (FL, GA, PA, NC, SC, TN, or TX) FTE: Full-Time (1.0 FTE) Manages the daily operations of the revenue cycle clinical denial coding team to ensure accurate, timely ...
Must reside in an authorized state (FL, GA, PA, NC, SC, TN, or TX) FTE: Full-Time (1.0 FTE) Manages the daily operations of the revenue cycle clinical denial coding team to ensure accurate, timely ...
$29K - $33.7K
4% of jobs
$33.7K - $38.4K
14% of jobs
$38.4K - $43K
4% of jobs
$46.3K is the 25th percentile. Wages below this are outliers.
$43K - $47.7K
4% of jobs
$47.7K - $52.4K
4% of jobs
$52.4K - $57.1K
12% of jobs
The median wage is $59.3K / yr.
$57.1K - $61.8K
17% of jobs
$61.8K - $66.5K
16% of jobs
$66.6K is the 75th percentile. Wages above this are outliers.
$66.5K - $71.1K
13% of jobs
$71.1K - $75.8K
6% of jobs
$75.8K - $80.5K
6% of jobs
$29K
$57.4K
$80.5K
A Clinical Coder is responsible for translating medical diagnoses, procedures, and treatments into standardized codes used for billing, healthcare records, and insurance purposes. They analyze patient records and apply classification systems such as ICD-10 and CPT to ensure accurate and consistent data entry. Clinical Coders work in hospitals, clinics, and healthcare organizations, playing a vital role in healthcare administration. Their work helps with reimbursement, research, and healthcare planning. Strong attention to detail and a thorough understanding of medical terminology, anatomy, and coding guidelines are essential for this role.
To thrive as a Clinical Coder, you need a solid understanding of medical terminology, anatomy, and clinical procedures, usually backed by a relevant qualification in health information management or medical coding. Familiarity with coding systems like ICD-10, CPT, and specialized medical coding software is essential, and certifications such as CCS, CPC, or equivalent are highly valued. Attention to detail, analytical thinking, and effective communication are important soft skills for success in this field. Mastering these skills ensures accurate translation of clinical data into standardized codes, which is critical for billing, compliance, and healthcare quality reporting.
Clinical Coders often encounter challenges such as deciphering incomplete or unclear clinical documentation, staying current with frequent updates to coding standards, and managing high volumes of records within tight deadlines. These professionals must constantly collaborate with healthcare providers to clarify details and ensure that codes accurately reflect the care delivered. Adapting to new coding software or changes in healthcare regulations can also be part of the job. However, these challenges offer valuable opportunities for growth and skill development, and strong problem-solving abilities can help you excel in this dynamic field.

$132K - $163K/yr
Other
Medical, Dental, Vision, Retirement, PTO
Posted 10 days ago
9.1
Based on 7 frontline employees who took The Breakroom Quiz
24th of 261 rated insurance
Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.)
Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight.
This position serves as a key clinical and coding resource, translating medical policy requirements into diagnosis, procedure, and service code logic, including determining which codes require prior authorization. Conducts in-depth research and analysis of legislation and regulatory requirements, clinical outcomes, utilization, claims, and financial data to identify utilization trends, fiscal risk, and opportunities for policy enhancement and cost containment.
This position works cross-functionally with internal teams to ensure policies are codified, consistently applied, and monitored through reporting and data analysis. This position collaborates closely with internal stakeholders and external entities to support standardized benefit administration, effective program implementation, and organizational compliance with state, federal, and accreditation requirements.
Required:
At least 8 years of experience in Clinical Nursing.
At least 3 years of experience with Medi-Cal and Medicare in a managed care environment.
Experience in performing and creating clinical documentation.
Experience in regulatory compliance for a health plan.
Experience with medical coding systems.
Preferred:
At least 1 year of experience in editing and writing clinical health services policies within a managed care health plan.
Required:
Proficient with clinical policy through skills in literature searching and clinical research analysis based on the best available evidence.
Working knowledge of clinical policies.
Working knowledge of CPT/HCPC codes and claims.
Ability to translate regulatory requirements into auditable tools.
Ability to perform independent research on complex medical topics.
Excellent verbal and written communication skills.
Strong analytical, problem solving, and team building skills.
Ability to work independently with strong self-direction.
Advanced proficiency in Microsoft Word, Excel, and PDF documentation tools.
Ability to work effectively with diverse teams in cross-functional work groups.
Ability to multitask, re-prioritize tasking, and streamline day-to-day operations.
Ability to identify discrepancies, assess risk, and recommend actionable solutions.
Knowledge of medical coding systems, including ICD-10-CM, CPT, and HCPCS, and their application in authorization and claims environments.
Strong organizational and time-management skills.
Preferred:
Advanced skills in assessing clinical policy deficiencies through literature searching and clinical research analysis based on the best available evidence.
Proficient in claims configuration, including claims adjudication workflows, configuration of claims edits and rules, and the translation of clinical and utilization management policies into system-based claims logic to support accurate, compliant payment outcomes.
Understanding of the managed care industry and market conditions.
Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
L.A. Care offers a wide range of benefits including
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Health care and social assistance
1,001 - 5,000 Employees
Los Angeles, CA, US
1997