4 claims resolution coder jobs found

Job Description Job Description Description: The Certified Professional Coder (CPC) – Primary Care (with Risk Code Review) is responsible for accurate and compliant coding of professional services, verification of demographic and insurance information, and timely resolution of front-end claim edits prior to submission. This role also includes reviewing encounters for accuracy of risk-related diagnosis codes to ensure proper documentation support in compliance with payer and CMS guidelines. The coder supports Southeast Medical Group’s goals for revenue integrity, compliance, and operational efficiency through close collaboration with providers, front-end staff, and billing teams. Requirements: Essential Duties and Responsibilities Coding and Charge Review Review provider documentation to assign accurate CPT, HCPCS, and ICD-10-CM codes for all primary care encounters, including preventive, chronic, and acute visits. Ensure all codes are supported by clinical documentation and...

Lifeguard Pediatrics – Warner Robins, GA About Us Lifeguard Pediatrics is a trusted, physician-owned pediatric clinic serving families across Middle Georgia. We are dedicated to providing comprehensive, compassionate, and community-centered care. With a growing need for developmental and behavioral health services in our region, we are expanding our care team to include in-house autism diagnostic services. Position and Responsibilities The biller and coder is responsible for the accurate and timely submission of medical claims to insurance companies and other payors. The medical biller posts payments or adjudications as appropriate. Using knowledge of billing practices and standards including third party payor requirements, the medical biller will investigate denials to process appeals and collect payment. In addition, this position is responsible for reviewing coding for outpatient services for reimbursement and research compliance. Medical Billing: Performs claim...

Lead Medical Coder and Auditor ProSidian Consulting is looking for a talented professional ready to deliver real value to clients in a fast-paced, challenging environment. ProSidian Consulting is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land...

Qualifications High School Diploma or GED (Required) Vocational / Technical Degree (Preferred) 2 year / Associate Degree in Health Information Management (Preferred) Work Experience 2 - 3 years Diagnosis and CPT coding in a clinic, business, or revenue cycle environment or any combination thereof. (Preferred) 2 - 3 years Broad knowledge of medical terminology and anatomy. (Preferred) Licenses and Certifications Required Certifications/Licensures: Coding Certification (CPC or CCS) Preferred Certifications/Licensures: CPMA Essential Functions CODING SKILLS: Review medical records to assign ICD-10-CM, CPT, and HCPCS Level II codes and modifiers for accurate primary and multi-specialty billing. Provides analysis and education on coding trends and changes in payer policies to providers and staff. CODING REVENUE CYCLE SKILLS: Review claim denials for coding issues, interpret payer guidelines, and assist insurance collectors with resolution for proper reimbursement....