31 denials coder jobs found

Physician Medical Coder Job Listing   PLEASE READ JOB DESCRIPTION    Profee coder to review coding denials and correct/validate CPT, ICD-10, HCPCS and modifiers for physician services.  Our coders will review medical records, research payer policy, and NCDs to make coding corrections and resubmit corrected claims in an accurate and timely manner. We work closely with other team members and management to translate clinical documentation consistently and accurately into ICD-10 and CPT codes with proper sequencing and modifiers. Through these efforts, the individual within this role will identify and report error patterns, resolve errors or issues associated with coding and billing processes, and when necessary, assist in the design and implementation of workflow changes to reduce billing errors.     Job Requirements     At least one active certification is required. Additional certifications a plus. Accepted certifications...

Job Summary Assigns appropriate ICD and CPT codes for reimbursement and statistical purposes. Follows ICD, CPT, CMS, and other regulatory coding guidelines. Abstracts clinical information from medical records for complete and accurate statistical documentation. Minimum Qualifications Minimum Education:   High School Diploma or Equivalent Minimum Years of Experience:   3 Years of Professional Coding Experience Covering Multiple Clinical and/or Surgical Specialties (Combination of Surgical, E/M, or other coding experience as approved by Director), which they Successfully Met Quality and Productivity Standards Substitutable Education & Experience (Optional):   None. Required Certifications/Licensure:   Active AAPC or AHIMA Coding Credential Required Training:   Experience working with CPT, ICD diagnosis coding; Experience with CCI edits; Experience with Medicare LCDs and NCDs; Understanding of state and federal regulations as well as payor...

JOB LOCATION:   Remote (Considering applicants residing in Georgia, Florida, Ohio, North Carolina, South Carolina, West Virginia, Utah, Arizona, and Missouri.) DEPARTMENT:   REVENUE CYCLE MEDICAL GROUP, SGMC Health SCHEDULE:   Full Time, 8 HR Day Shift, 8-5 Abstracts ICD-10 and CPT codes for Diagnosis and Procedures on professional services. Reviews and analyzes medical records verifying and coding the diagnosis, evaluation and management service, minor procedures, or other codes required for the completeness and accuracy of the record. Additionally, will code and/or review principal diagnosis, co-morbidities, complications, therapeutic and diagnostic procedures, any applicable supply, medication, and injectable drugs. Maintains communication with Management, Practice Manager, and Provider to ensure timely notification of identified documentation issues. Interact with other team members of the revenue cycle and provider clinics. Responsible for continuing education of...

Location : Remote Reports To:  Director of Revenue Cycle Employment Type:  Full-Time   Position Summary The RCM Account Manager is responsible for managing all aspects of the revenue cycle for a cardiovascular-focused Ambulatory Surgery Center (ASC), including  medical coding, billing, claims management, payment posting, and collections . This role ensures compliant, timely, and accurate reimbursement for cardiology and peripheral vascular procedures while providing high-touch service to internal stakeholders and physician partners. Key Responsibilities Coding & Charge Capture Accurately code cardiovascular procedures (e.g., peripheral interventions, pacemakers, stents) using CPT, HCPCS, and ICD-10 guidelines. Ensure documentation compliance with CMS and payer-specific policies. Stay current with cardiology-specific coding updates and NCCI edits. Billing & Claims Management Submit clean claims to Medicare, commercial payers, and...

Whether you are looking to expand your current knowledge or looking to share your extensive skills with us, this could be the start of something amazing. We are a small, close knit team that works together to accomplish tasks daily. Qualifications: Knowledge in Surgery Billing and Coding Coding Certification- CASCC or COC preferred Experience with Microsoft 365 products Minimum 3 years experience in surgical billing Knowledge in all aspects of RCM Insurance credentialling- preferred Job Requirements: Coding and Charge Capture Insurance Claims Billing Resolution of rejections Coding reviews of denials Appeal assistance Coding reviews of documentation in question by the coding team Management of payor chart audits Insurance overpayment reviews Issuance of disputes as needed Ability to assist in aging follow on unpaid claims Address physician documentation matters Month end closing Utilization of reports Knowledge of and adherence to...

University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado. We are seeking a detail-oriented and highly motivated Surgical Coding Denial Specialist to join our AR Surgery team. This role plays a critical part in protecting and optimizing revenue for CU Medicine providers by ensuring surgical claims are accurately reviewed, appealed, and resolved. This position offers the flexibility of being 100% remote , and qualified...

CPC Expertise in medical record review to abstract information required to support accurate coding. Ability to identify documentation deficiencies and properly query providers for proper code capture. Expertise in assigning accurate CPT, HCPCS Level II, and ICD-10-CM medical codes for diagnoses and procedures. Proficiency across a wide range of services, including evaluation and management, anesthesia, surgery, radiology, pathology, and medicine. A sound knowledge of medical coding guidelines and regulations including compliance and reimbursement – allowing a CPC to better handle issues such as medical necessity, claims denials, bundling issues, and charge capture. CPB Proven knowledge of how to submit claims compliant with government regulations and private payer policies. Ability to follow up on claim statuses, resolve claim denials, submit appeals, post payments and adjustments, and manage collections. In-depth knowledge of...

Phoenix Behavioral Healthcare, LLC is seeking a highly skilled Executive   Director of Revenue Cycle Management (RCM) to oversee and optimize the full revenue cycle across multiple behavioral health facilities, clinics, laboratories, and E&M service lines. This onsite leadership role manages all aspects of RCM operations—including intake, UR/UM alignment, coding, billing, claims submission, collections, clinical documentation improvement, denial management, appeals, and compliance oversight. Key Responsibilities: Lead, manage, and optimize end-to-end revenue cycle operations for all Phoenix facilities Oversee billing and coding for inpatient, outpatient, lab, and professional services (UB-04 & CMS-1500) Direct UR/UM workflow integration to improve documentation quality and turnaround times Manage and mentor a full RCM support team (billers, coders, auditors, documentation trainers, compliance) Develop standardized...

Professional Coding Provider Educator & Reviewer RWJBarnabas Health Oceanport, NJ Full-Time Day Pay Range: $75,597.00 - $106,780.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The Professional Coding Provider Educator/Reviewer is responsible for preparing educational materials and delivering instruction to Medical Group physicians, Advance Practice Providers, and staff across all RWJBH medical centers, as directed by the System Professional Provider Education Coding Manager and Coding Leadership. Education may be provided in response to compliance reviews, physician onboarding, proactive training, or coding and regulatory updates. This role also conducts...

Coding Operations Manager is responsible for overseeing the medical coding team and ensuring the accurate and efficient coding of patient records for billing, compliance, and reimbursement purposes. Oversee insurance verification department.  Needs skills with operational leadership, compliance oversight, team management, and process improvement within the healthcare revenue cycle. Experience: Equivalent of an Associate’s degree and two to three years of relevant emergency department or general medical coding experience. CPC required, CEDC additionally preferred.  Strong expertise in all professional medical coding, including ICD-10, CPT and HCPCS coding.  Excellent organizational skills and ability to multi-task. This is a hybrid position.  (Two days remote and three days in-house.) JOB RESPONSIBILITIES Oversee day-to-day operations of the medical coding team, ensuring timely and accurate coding and allocation of duties Ensure that all codes (ICD-10, CPT,...

Help safeguard accuracy, integrity, and regulatory compliance across our organization. We are seeking a skilled Compliance & Coding Audit Specialist to support the Corporate Compliance Program through detailed auditing, monitoring, and provider education related to coding, billing, and clinical documentation practices. What You’ll Do Conduct ongoing coding, billing, and documentation audits to ensure compliance with hospital policies and federal and state regulations Interpret medical records and related documentation using advanced coding knowledge to assess accuracy and risk Execute compliance audit assignments with a high degree of independence, confidentiality, and professional judgment Analyze findings, prepare audit documentation, and identify trends or improvement opportunities Present audit results directly to physicians and providers, delivering clear feedback and education on documentation and coding best practices...

Supporting the Vice President & Chief Compliance Officer, the Compliance Specialist assists in carrying out the activities of the Frederick Health Compliance Program, including risk assessment, training & education, audits, policy development and internal investigations. Requirements: BA/BS required. MBA/MHA preferred. 5-10 years' experience in healthcare compliance and internal auditing. Certification preferred. Knowledge of laws, regulations, policies and procedures of governmental authorities and payers. Experience in developing and carrying out training and education of staff. Excellent oral and written communication skills. Strong organizational skills and ability to prioritize and manage multiple tasks. Ability to maintain a high level of confidentiality. The following experience & credentials are strongly preferred: Experience in healthcare revenue cycle or patient accounting (coding and/or billing) internal auditing and compliance....

Join Team Tidelands and help people live better lives through better health! Supervisor Provider Coding Specialist Are you passionate about quality and committed to excellence? Consider joining our Tidelands Health team. As our region's largest health care provider, we are also one of our area's largest employers. More than 2,500 team members at more than 70 Tidelands Health locations bring our healing mission to life each day. A Brief Overview The Supervisor, Provider Coding Specialist under the general supervision of the Coding Manager, is responsible for overseeing daily coding workflow in the assignment of ICD-10 CM, CPT, and HCPCS codes. Accountable for quality, timeliness, completeness, and accuracy of the coding team to ensure optimal reimbursement and goal attainment. The coding supervisor performs quality reviews and provides education and training when deficiencies are identified, or new processes are implemented. Incorporates initiatives that improve compliance...

General Summary: This role focuses on the Risk Adjustment process that supports the documentation of acuity diagnoses for the Managed Care (MC) patient population and required activities for submission of records to Medicare Advantage (MA) payers under established capitated contracts. It assists with medical record reviews for HCC diagnoses, correct usage of various coding guidelines (ICD-10-CM, CPT, HCPCS) and federal and MA payor regulations, as well as clinical validation of appropriate supporting documentation.   Supervisory Responsibilities: This position has no supervisory responsibilities.   General Requirements: All duties performed will be done accurately and in a timely manner.   1.        Assumes responsibility for maintaining clinical competencies according to Gonzaba Medical Group policy. 2.        Exercise tact and courtesy when dealing with patients, visitors, providers, and co-workers. 3.        Must...

Job Title: Manager Location: System Business Office Department Name: HIM - Professional Req #: 0000207266 Status: Salaried Shift: Day Pay Range: $110,681.00 - $156,337.00 per year Pay Transparency: The above reflects the anticipated annual salary range for this position if hired to work in New Jersey. The compensation offered to the candidate selected for the position will depend on several factors, including the candidate's educational background, skills and professional experience. Job Overview: The  System Professional Coding Provider Review and Education Manager  is responsible for onboarding, educating, and reviewing medical record documentation and coding processes of the Medical Group physicians, APNs and other billing providers across all medical centers within the RWJBH enterprise. This includes onboarding education, medical record reviews, targeted education to physician groups and individual physicians, annual and quarterly...

The Manager holds a key leadership role in ensuring the accuracy, compliance, and efficiency of provider coding and documentation practices. This position is responsible for directing all aspects of provider coding operations and clinical documentation improvement initiatives to support accurate reimbursement and maintain data integrity across the organization. The Manager leads a team of certified coders and charge coordinators, partnering closely with providers, compliance, and revenue cycle teams to enhance documentation quality, strengthen coding accuracy, and drive continuous improvement in clinical and financial performance. Required Knowledge & Skills Education: Associate Degree or 2 years of college coursework Experience: Five years of related experience. Requires broad knowledge of complex systems and procedures. Licenses and Certifications *CERTIFIED CODING SPECIALIST Qualifications *Associate or bachelor's degree. RN preferred. *Five...

Position: Mid-Level Medical Coder Location: Full-Time Remote Clearance: No Secret Clearance Required Starting Salary: $37.00/Hour   “Candidates must hold valid credentials from either AAPC or AHIMA to be eligible to apply.” We cannot accept candidates with a CPC-A designation! Please indicate the position(s) you’re applying for. Include your  full mailing address (for equipment shipment), desired start date, and AAPC and/or AHIMA certification number(s) (with expiration date). Assessment Protocol The assessment is  strictly timed  and must be completed within  1 hour . Once the link is opened, the timer is automatically activated. The assessment  cannot be paused, reopened, or restarted .  Only the initial attempt  will be accepted for scoring. Candidates are provided with a  24-hour window  to complete the assessment upon receipt of the email from our team. Please ensure appropriate preparation and a suitable testing environment...

Planned Parenthood Association of Utah is looking for a bold, mission-driven  Director of Revenue Cycle  who is ready to make a powerful impact on the future of reproductive healthcare in our state. This is a dynamic leadership role for someone who thrives on solving complex challenges, elevating systems, and building strong, motivated teams. You will play a pivotal role in strengthening our financial foundation—ensuring every visit, every service, and every patient experience is supported by accurate, efficient, and forward-thinking revenue cycle operations. As a key collaborator across Health Services, Finance, and administrative leadership, you’ll bring fresh ideas, innovation, and strategic insight to identify new revenue opportunities and optimize the resources that keep our mission strong. If you’re passionate about protecting access to essential healthcare and want your work to truly matter, this is your opportunity to make a lasting difference at Planned...

Healthcare Coding and Consulting Services (HCCS) is hiring  multiple full-time, experienced, and certified Pro Fee and Pro Clinic Coders  across several outpatient specialties. These are fully remote, direct-hire W-2 positions offering long-term stability and consistent, specialty-aligned work. We currently have multiple Pro Fee and Pro Clinic openings supporting specialties such as  Family Medicine, Internal Medicine, Pediatrics, Orthopedics, and other clinic-based services.   One of the available positions specifically requires prior Georgia Medicare Pro Fee and Pro Clinic coding experience. We are seeking coders with strong E/M expertise who are comfortable in high-volume production environments and have recent hands-on Pro Fee and Pro Clinic coding experience. At HCCS, coders are assigned based on proven specialty expertise to ensure alignment with providers and chart types where they can perform at their highest level. Our Coding and Scheduling Managers work closely...

The Certified Professional Medical Auditor is responsible for performing comprehensive audits of medical records, coding, and billing to ensure accuracy, compliance with federal and state regulations, and alignment with payer policies. This role helps protect the organization from financial risk, supports accurate reimbursement, and promotes high standards of documentation and clinical integrity. Key Responsibilities Perform prospective and retrospective audits of medical records, coding, and billing across assigned service lines (e.g., outpatient, inpatient, behavioral health, SUD/MH, lab). Verify that documentation supports ICD‑10‑CM, CPT, and HCPCS coding; identify under‑coding, over‑coding, unbundling, and other compliance risks. Review claims for adherence to Medicare/Medicaid, commercial payer, and regulatory guidelines; ensure compliance with NCCI edits and payer‑specific policies. Prepare clear, detailed audit reports summarizing findings,...

Medical Coding Appeals Analyst Anticipated End Date: 2025-12-31 Position Title: Medical Coding Appeals Analyst Job Description: Sign On Bonus: $1,000 Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law This position is not eligible for employment based sponsorship. Ensures accurate adjudication of claims, by translating medical policies, reimbursement policies, and clinical editing policies into effective and accurate reimbursement criteria....