5 coder professional jobs found in Pittsburgh, PA

UPMC Corporate Revenue Cycle is hiring a Coder II- Profee! This position will be a work-from-home position working Monday through Friday during business hours. This role will have the same responsibilities as a Coder I. The position will review all pertinent physician, nursing, and ancillary documentation. Depending on the type of service and place of service, you will determine the level of acuity, procedure(s) performed, billable supplies, and diagnosis to substantiate medical necessity. As well as review and sequence all codes to maximize reimbursement and address any potential bundling issues. The Coder II will apply modifiers as needed. The position will also handle LMRP/CCI edit and coding denial resolution. We are looking for coders with prior experience in ENT surgical coding to join the team. If you are ready to take the next step in your coding career, look no further! Responsibilities: Utilize computer applications and resources essential to completing the...

Job Description Job Description Description: About e4health At e4health, our vision is to Empower Better Health for our clients, our team, and the communities we serve. We live by five core values that guide everything we do: Embrace Change, Fun, and Learning: We maintain an unrelenting focus on quality, client success, and team member growth. Our PEOPLE Make the Difference: We build trusted relationships and celebrate wins every day. WE GROW: We believe in win/win outcomes—when our customers win, we win. GSD (Get Stuff Done): We say no to politics, drama, and egos, and yes to informed, agile decisions. Respectfully Listen, Challenge, & Support Each Other: We listen intently, challenge respectfully, and support fully. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. Our...

Purpose: OUTPATIENT SDS CODING, with IR/IC Experience: Coding diagnosis & procedure codes ICD10 & CPT codes and charging for injections, infusions, hydrations, and observation hours. Responsibilities: Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD-10-CM, CPT and DSM IV codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed. Adhere to internal department policies and procedures to ensure efficient work processes. Actively participate in monthly coding meetings and share ideas and suggestions for operational improvements. Maintain continuing education by attending seminars, reviewing updated CPT assistant guidelines...

Purpose: OUTPATIENT SDS CODING, with IR/IC Experience: Coding diagnosis & procedure codes ICD10 & CPT codes and charging for injections, infusions, hydrations, and observation hours. Responsibilities: Review coding for accuracy and completeness prior to submission to billing system utilizing CCI edits. Utilize standard coding guidelines, principles and coding clinics to assign the appropriate ICD-10-CM, CPT and DSM IV codes for all record types to ensure accurate reimbursement. (i.e. use of coding clinics, CPT Assistant, etc). Utilize the ACEP acuity level guidelines for assigning the correct acuity level for ED coding, or hospital specific acuity level module as needed. Adhere to internal department policies and procedures to ensure efficient work processes. Actively participate in monthly coding meetings and share ideas and suggestions for operational improvements. Maintain continuing education by attending seminars, reviewing updated CPT assistant...

ABA Billing Specialist Key Responsibilities: Submit accurate and timely claims for ABA services to private insurance, Medicaid, and other payers Verify insurance eligibility and benefits for new and existing clients Track and follow up on unpaid or denied claims; initiate appeals as needed Manage authorizations, re-authorizations, and documentation requirements for ongoing services Reconcile payments, post EOBs, and generate client invoices as needed Maintain compliance with HIPAA, payer guidelines, and ABA-specific billing codes (e.g., CPT 97151, 97153, 97155) Collaborate with BCBAs, administrative staff, and families to resolve billing issues and ensure smooth revenue cycle operations Requirements: 2+ years of medical billing experience, with a strong focus on ABA or behavioral health services Proficiency in billing software and clearinghouses (e.g., CentralReach, Office Ally, Kareo, SimplePractice) In-depth knowledge of ABA billing codes, modifiers, and...