6 facility claims coder jobs found in Remote

Summary The Experienced Medical Billing Specialist provides best-in-class full RCM billing services for our private pediatric practice clients. Review claims for accuracy; oversee processing of claims to payers; resolve insurance company payments that are late, underpaid or denied; work closely with providers, practice managers and staff to implement best practice protocols. Responsibilities Learn and become proficient with the premiere pediatric system in the industry - Physician’s Computer Company (PCC) Billing. Efficiently analyze insurance claims throughout the submission process, insuring claims are accurately coded in a timely fashion, and for optimum reimbursement and compliance. Ensure that all claims reach the payers, and independently resolve any issues (underpayments, denials, etc.) with the claims so they are paid fully and on time. Post payments, organize processing of patient correspondence and statements. Answer phone inquiries from...

Job Summary:   The DRG Coding Validator integrates advanced clinical nursing knowledge with expert inpatient coding proficiency to perform comprehensive validation of Diagnosis-Related Group (DRG) assignments and associated inpatient medical record coding. Drawing on dual expertise as a Registered Nurse (RN) and a Certified Inpatient Coder (CIC or CCS), this role evaluates both the clinical validity of documented diagnoses and procedures and the accuracy of ICD-10-CM/PCS code assignments, DRG sequencing, and discharge dispositions. This position serves clients by identifying coding inaccuracies, unsupported clinical documentation, and DRG assignment errors across MS-DRG and APR-DRG reimbursement methodologies.     Why You'll Love Working at ClarisHealth   We believe our team deserves the best, and we’re proud to offer a comprehensive benefits package designed to support your success, both at work and in life. Here’s what you can look forward to:   Medical,...

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development. Summary: We are seeking a talented individual for a Clinical DRG Auditor who is responsible for performing DRG validation (clinical/coding) reviews of medical records and/or other documentation to validate the conditions that were documented in the medical record, the ICD-10-CM/PCS code assignments and determine the accuracy of DRG assignment that is clinically supported as defined by review methodologies specific to the...

Position Summary The Certified Medical Biller and Coder is responsible for accurately reviewing medical documentation, assigning appropriate diagnosis and procedure codes, and supporting the billing process to ensure timely and compliant reimbursement. This role plays a critical part in maintaining the integrity of the revenue cycle by ensuring claims are coded correctly, submitted efficiently, and compliant with payer and regulatory guidelines. The position requires strong knowledge of CPT, ICD-10-CM, HCPCS coding systems, payer requirements, and medical billing workflows. Essential Duties and Responsibilities Review provider documentation and assign accurate CPT, ICD-10-CM, and HCPCS codes Ensure coding compliance with Medicare, Medicaid, and commercial payer guidelines Verify documentation supports medical necessity and appropriate coding Apply correct modifiers and place-of-service codes Prepare and review claims prior to submission to ensure...