27 pro fee coder jobs found

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

Professional Coder The professional coder will be responsible for handling clinic charges, scrubbing charts for completeness, reviewing diagnoses codes, verifying procedures, and communicating with providers regarding missing information and working edits. We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. Skills and requirements: GED or High School Diploma CPC Certification 2 years of Pro Fee E/M Coding Experience Surgical coding experience

Professional Coder The professional coder will be responsible for handling clinic charges, scrubbing chart for completeness, reviewing diagnosis codes, verifying procedures, along with communicating with providers regarding missing information and working edits. We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form.

Coding Specialist III Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). JOB SUMMARY: The Coding Specialist III will review clinical documentation to assign and sequence diagnostic and procedural codes for specific patient types to meet the needs of hospital data retrieval for billing and reimbursement. Coding Specialist III validate MSDRG and/or APC calculations in order to accurately capture the diagnoses/procedures documented in the clinical record. Coding Specialist III performs documentation review and assessment for accurate abstracting of clinical data to meet regulatory and...

*Job Title:* Surgery Coder - Colorectal Specialty *Location:* Remote *Employment Type:* Full Time *Position Summary* We are seeking an experienced *Professional Fee Surgery Coder* with a strong background in *colorectal procedures*. The ideal candidate will have a minimum of *2 years of colorectal-specific coding experience* and a proven ability to handle high-volume coding efficiently and accurately. *Key Responsibilities* * Accurately code *colorectal surgical procedures* for professional billing (Pro Fee). * Maintain compliance with all applicable coding guidelines and payer requirements. * Review operative reports and assign appropriate CPT, ICD-10, and modifiers. * Ensure timely and accurate coding for approximately *30 cases per hour*. * Collaborate with clinical and billing teams to resolve coding discrepancies. * Stay current with industry changes and updates in colorectal coding. *Required Qualifications* * *CPC Certification* (Certified Professional Coder)...

In this high-impact Outpatient Pro-Fee Coding role, you will move beyond simple data entry to perform true clinical extraction, navigating complex operative reports across General Surgery, Plastics, ENT, and Neurosurgery to identify CPT and ICD-10-CM codes. Working within Epic, you'll master a shared work queue where you'll apply advanced logic-including modifiers, dummy codes, and Prop 99-to ensure seamless charge drops for high-dollar encounters. This is a position designed for the technical "detective" who thrives on a 95% quality benchmark and maintains a sharp pace of 12 surgical charts or 18 E/M visits per hour. You'll join a collaborative, remote environment that prizes technical accuracy and peer-to-peer knowledge sharing, offering a highly flexible "5-to-5" style schedule that empowers you to own your workflow while tackling the industry's most intricate surgical specialties. Schedule: Flex schedule. Can start as early as 5am in their timezone and be on as late as...

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures,...

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS 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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. We're focused on improving the health of our members, enhancing our operational effectiveness and reinforcing our reputation for high - quality health services. As Senior Inpatient Medical Coder you will provide coding services directly to providers. You'll play a key part in healing the health system by making sure our high standards for...

Outpatient Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this...

Outpatient Coder Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role...

Registered Nurse Clinical Coder DRG Audit Our client is seeking an experienced Registered Nurse Clinical Coder to support DRG audit activities for one of their major healthcare partners. This role focuses on reviewing inpatient medical records, validating DRG assignments, and ensuring coding accuracy from an insurance and payer-side perspective rather than the provider side. This is an excellent opportunity for an RN with coding experience who enjoys analytical work, documentation review, and collaborating with audit teams. Key Responsibilities: Perform DRG audits on inpatient medical records to validate ICD-10 coding accuracy and DRG assignment. Review clinical documentation to ensure compliance with payer guidelines and audit standards. Identify discrepancies, trends, and opportunities for coding improvement. Communicate audit findings clearly and professionally through written reports and outbound calls as needed. Collaborate with internal teams to support audit...

WHY UT SOUTHWESTERN? With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report , we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career! JOB SUMMARY Works under moderate supervision to provide policy analysis and recommendations to management related to reimbursement projects and functions. BENEFITS UT Southwestern is proud to...

Professional Coder The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote. Essential Duties And Responsibilities Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes. Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role. Ensure established productivity and quality standards are met. Review denials, research and respond appropriately and timely. Perform audits as determined by management. Assist with all levels of application testing for...

Clinical Colorectal / Pathology Coder Top requirements: + Experience coding surgeries + Familiarity with PMD + Ability to complete auto notes (no leveling required) Role overview: You will code surgical procedures directly, ensuring accuracy in ICD-10 and CPT-4 assignment while adhering to national standards. Key responsibilities: + Abstract clinical and demographic info + Identify diagnoses with minimal error + Maintain 95% coding accuracy + Record procedures and obtain missing info from providers + Update coding procedures + Surgical coding experience preferred Additional skills: + Confident communicator + Strong team collaborator + Comfortable asking questions What they offer: + Growth opportunities within a scaling team + 100% remote + Flexible schedule (start between 79 AM CST) + Same eligible states as above + Same PTO restrictions and blackout days Placement: Contract-to-hire duration: 6 months Job type & location: This is a contract to hire position based out of...

Ceris Certified Coder III Ceris is seeking a certified coder. The Ceris certified coder reverse codes previously coded medical bills to determine coding accuracy. This is a remote position. Essential functions and responsibilities: Receives claim and processes based on state rules and regulations Determines validity and compensability of the claim using CorVel proprietary programs Makes recommendations to referring office Communicates claim status with referring office Reads and comprehends all medical reports Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Complies with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (IIPP), as well as, maintains HIPAA compliance Knowledge and skills: Ability to learn rapidly to develop knowledge and understanding of...

Medical Coder TekSystems is currently hiring for a medical coder that can sit anywhere in the US as it is fully remote, this position does work on EST time zone hours! Must have: 1-3 years of medical coding experience preferably outpatient experience but open to other medical coding experience, must have an active CPC license! These coders will be taking the work from the client coordinators. They will be looking at what the provider sends and coded for payment and what the payer sends and coded for payment. They will be reviewing the case to decide which one is correct, is the correct code being used, and make a determination of what code and payment is recommended by MCMC. Then they pass it off to QA for review. They will do these cases over and over again to push them through. All of the cases are going to be emergency services, so they would like for everyone to have experience in emergency services, inpatient coding, or DRG (diagnosis-related group) coding. This would allow...

CERIS is seeking a Certified Coder. The CERIS Certified Coder reverse code previously coded medical bills to determine coding accuracy. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim and processes based on state rules and regulations Determine validity and compensability of the claim using CorVel proprietary programs Make recommendations to referring office Communicate claim status with referring office Read and comprehend all medical reports Adhere to client and carrier guidelines and participate in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as, maintain HIPAA compliance KNOWLEDGE & SKILLS: Ability to learn rapidly to develop knowledge and understanding of claims practice...

Description The Coding Specialist performs all medical record coding activities. Assigns appropriate diagnostic codes to patient charts and reports as assigned. Skills Coding, Medical, icd-10, hcpcs, cpt-4, cpc, profee coding, communication and organization skills, writing skills Top Skills Details Coding,Medical,icd-10,hcpcs,cpt-4,cpc,profee coding Additional Skills & Qualifications Abstracts relevant clinical and demographic information from the medical record to assign ICD-10 and CPT-4 codes in accordance with coding and reimbursement guidelines. Identifies principal and secondary diagnosis with minimal error based on the national based standards. Codes with an accuracy of 95% based on QA internal reviews. Records all diagnostic procedures and assigns appropriate procedure codes. Requests diagnosis from physicians when information is not recorded. Determines and records the required medical information. Updates coding procedures and guidelines. Works with...

Description Coding surgeries directly use PMD "do not level" Skills coding experience, colorectal coding experience, PATH experience Top Skills Details coding experience,colorectal coding experience,PATH experience Additional Skills & Qualifications Confident Good at collaborating with team Not afraid to ask questions Experience Level Intermediate Level Job Type & Location This is a Contract to Hire position based out of Dallas, TX. Pay and Benefits The pay range for this position is $25.00 - $28.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & vision - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions...

*Registered Nurse Clinical Coder - DRG Audit (100% Remote)* *Position Type:* Contract *Schedule:* Full-time, Remote *Experience Level:* Intermediate (5+ years) *Pay:* $90,000 *Overview* Our client is seeking an experienced *Registered Nurse Clinical Coder* to support DRG audit activities for one of their major healthcare partners. This role focuses on reviewing inpatient medical records, validating DRG assignments, and ensuring coding accuracy from an *insurance and payerside perspective* rather than the provider side. This is an excellent opportunity for an RN with coding experience who enjoys analytical work, documentation review, and collaborating with audit teams. *Key Responsibilities* * Perform *DRG audits* on inpatient medical records to validate ICD10 coding accuracy and DRG assignment. * Review clinical documentation to ensure compliance with payer guidelines and audit standards. * Identify discrepancies, trends, and opportunities for coding improvement. *...

Medical Coder - Independent Dispute Review (IDR) *Location:* 100% Remote *Pay Rate:* $25.00/hour *Schedule:* Monday-Friday | 8:00 AM - 4:30 PM CST *Duration:* Longterm contract (multiyear opportunity) About the Opportunity We are partnering with a nationally recognized medical review organization that supports state and federal agencies, healthcare payers, and employers by providing *independent, unbiased medical claim reviews*. Due to the *No Surprises Act* and a permanent increase in claim volume, this team is expanding and building out a *brandnew Independent Dispute Resolution (IDR) unit*. This is a *stable, longterm opportunity* with consistent work and strong training support-ideal for a CPC or CPCA professional looking to grow their career beyond traditional coding roles. What You'll Do In this role, you will *not be coding charts*. Instead, you'll use your coding knowledge to make *payment determinations* on disputed medical claims. Key responsibilities include: *...

*Description* * Assign CPT, ICD-10, and HCPCS codes for anesthesiology procedures. * Analyze medical records for accurate code assignment. * Apply appropriate modifiers for precise coding. * Generate and submit claims promptly. * Verify patient insurance information and resolve discrepancies. * Address denied claims, process appeals as needed. * Collaborate with providers for clear documentation. * Stay updated on coding regulations and compliance requirements. * Liaise with insurance companies and patients for billing inquiries. * Provide coding guidance to team members. *Additional Skills & Qualifications* Additional Skills & Qualifications * Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) desired. * 3-5 years of anesthesiology coding and billing experience preferred * Proficient in coding and billing claims software. * Thorough understanding of compliance and regulatory requirements. *Experience Level* Intermediate Level *Job...

Job Description Job Description Description: Under moderate supervision, responsible for reviewing, auditing, and data entry of medical bills for multiple states and lines of business within both Worker’s Compensation and Commercial Health arenas. This would include analysis for the fee schedule or usual and customary application, as well as PPO interface, while meeting contractual client requirements. Essential Job Functions: Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts Analysis and review of 1 or more assigned states having fee schedules Utilize Fee Schedules, Online Documents, Client instructions, and other training material to properly review medical bills Review medical bills for compensability and relatedness to injury Reprice medical bills to Workers’ Compensation Fee Schedule and PPO Network Research usual and customary/fee schedule applications and...

Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage. Functional Title: Medicaid Modernization Certified Clinical Coder - Program Specialist V (PS V) Job Title: Program Specialist V Agency: Health & Human Services Comm Department: Medical&Dental Benefits Policy Posting Number: 13598 Closing Date: 02/24/2026 Posting Audience: Internal and External Occupational Category: Healthcare Practitioners and Technical Salary Group: TEXAS-B-21 Salary Range: $4,523.16 -...