20 appeal resolution coder jobs found

Job Title Required: Background in Inpatient with 3-5 years' experience in Coding or Auditing. Highly Preferred: Auditing experience with DRGs. Job Description Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and knowledge gaps. Job Responsibility Supports denial reviews and response processes; prioritizes and reviews cases denied by commercial payers. Reports program performance and/or corrective action to management on regular basis. Assists in monitoring inpatient denial types, volume and formulates responses to requesting agency; seeks additional resources (e.g. legal counsel) to resolve issues, as needed; develops case-specific written rationale to substantiate and communicate findings. Addresses coding issues and knowledge gaps; functions as a organization resource for litigation as related to coding denials. Maintains hospital...

GoTo Telemed seeks an exceptional Remote Medical Biller to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide.As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers--with new clients and provider networks added every month as our organization scales.In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management.Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory.This position...

Senior Inpatient Coder (REMOTE)Valhalla-NY-10595-United StatesJob Summary :The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the current International Classification of Diseases (ICD10 CM / PCS codes) and entering coded information into an automated grouper system.Technical guidance and acting in a lead role is expected.Does related work as required.Responsibilities :Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement.Interprets and applies American Hospital Association Official Coding guidelines to articulate and support principle and secondary diagnoses and selected procedures.Identifies and analyzes patterns in possible coding errors or other trends and reports to the the coding leadership team.Participates in mandated medical record review processes.Using current ICD10 CM / PCS coding systems, assigns and records an accurate code to all diagnoses,...

Certified Medical Coder (OBGYN or Ortho) FL, GA, IL, MD, NJ, NC, TX, VA, WV, IA, NY Nature & Scope: Positional Overview Are you a Certified Medical Coder ready to bring your expertise to a fully remote, contingent-to-hire opportunity? Join our client’s forward-thinking team and leverage your skills in accurate coding, compliance, and documentation to ensure seamless healthcare operations. We offer the flexibility of remote work, a collaborative virtual environment, and the chance to grow within a supportive organization. If you are detail-oriented, driven, and passionate about making a difference in healthcare, we want to hear from you! Apply today to take the next step in your coding career. Role & Responsibility Tasks That Will Lead To Your Success Review E/M, diagnostic and procedural documentation and assign correct CPT and diagnosis codes. Work with RCM team to identify patterns, trends and variations in coding and documentation practices. Prepare documentation...

Position Summary We are seeking a highly analytical and detail-oriented Certified Professional Coder (CPC) to join our team. This role is highly focused on Denial Management and Revenue Integrity. The ideal candidate is not just a coder but a problem solver who can investigate the root cause of unpaid claims, correct coding errors, and successfully appeal denials. While this role focuses on coding, candidates with a strong background in hard coding (coding directly from operative reports/medical records without relying solely on encoders) and end-toend medical billing will be given top priority. Key Responsibilities Denial Management & Coding Analyze and resolve complex claim denials resulting from coding errors (CCI edits, medical necessity, bundling issues, and modifier usage). Review medical records and "hard code" accurately from documentation to support appeals, ensuring the highest level of specificity for ICD-10-CM, CPT, and HCPCS levels. Draft and submit...

Medical Coder As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location: 2619 W Henrietta Rd, Rochester, New York, United States of America, 14623 Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education,...

Molina Healthcare, Inc. is seeking a full-time remote CPC Certified Coding Analyst to provide support for the investigation and resolution of provider appeals. In this role, you will review coding-related claims denials, conduct audits for billing accuracy, and communicate determinations to providers. Qualifications include at least 2 years of experience in medical coding or billing, an active CPC or CCS certification, and proficiency in Microsoft Office applications. #J-18808-Ljbffr

Overview RECOVRY is seeking a highly organized and detail-oriented Medical Biller to join our healthcare team. The ideal candidate will have Out-of-Network Physical Therapy experience and be responsible for ensuring accurate and timely billing and coding for patient services as well as oversee our billing operations. This role will include administrative patient services. This role is a crucial part of our medical office, and we are looking for someone who is passionate about providing excellent patient care while also ensuring the financial well-being of our organization. Responsibilities Utilize medical coding skills to assign accurate ICD-10 and CPT codes to patient records and submit claims to insurance companies Verify patient insurance coverage and obtain necessary authorizations for services Analyze and resolve billing discrepancies and denials in a timely and efficient manner Maintain accurate and up-to-date medical records, including patient demographics and treatment...

Job Description Job Description Benefits: 401(k) Dental insurance Health insurance Paid time off Vision insurance 401(k) matching Employee discounts RECOVRY is seeking a highly organized and detail-oriented Medical Biller to join our healthcare team. The ideal candidate will have Out-of-Network Physical Therapy experience and be responsible for ensuring accurate and timely billing and coding for patient services as well as oversee our billing operations. This role will include administrative patient services. This role is a crucial part of our medical office, and we are looking for someone who is passionate about providing excellent patient care while also ensuring the financial well-being of our organization. Duties: Utilize medical coding skills to assign accurate ICD-10 and CPT codes to patient records and submit claims to insurance companies Verify patient insurance coverage and obtain necessary authorizations for services Analyze and resolve billing...

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education,...

Company Description Lin Health partners with payers and providers to help people reclaim their lives from chronic pain through human-led, tech-enabled, highly personalized care. The organization applies cutting-edge neuroscience to address a wide range of conditions, including migraines, IBS, and back and joint pain. By working closely with health systems, clinics, and payers, Lin Health offers an accessible, affordable, non-pharmacological solution for neuroplastic pain as an integral extension of the care team. Its clinically validated model blends multidisciplinary clinical guidance, frequent coaching, evidence-based digital tools, and proprietary technology to improve outcomes and satisfaction for patients and providers. Powered by a proprietary AI-based Care Platform and backed by experienced founders and leading investors, Lin Health has supported thousands of patients in the last year. MEDICAL BILLING SPECIALIST (Claims, Eligibility & Patient Billing) Type: Remote |...

Cardiology Medical Billing Specialist (U.S. Only) Remote Full-time $36k – $44k Location: Remote (U.S. residents only) About the Role We are seeking an experienced Medical Billing Specialist with expertise in claims submission and denial management specifically in Cardiology. This role is ideal for a detail-oriented professional who understands payer requirements and drives results by improving first-pass claim acceptance, denial resolution time, and accounts receivable (AR) performance. Key Responsibilities Submit clean, accurate claims for cardiology services. Manage and resolve denied, rejected, and underpaid claims, including appeals and payer follow-up. Review EOBs and remittance advice to identify denial trends and root causes. Work claims to resolution while meeting defined revenue cycle KPIs (e.g., first-pass acceptance rate, denial turnaround time, AR days). Utilize eClinicalWorks EMR for charge entry, claim submission, and payment posting. Verify insurance...

Benefits 401(k) 401(k) matching Dental insurance Health insurance Vision insurance Paid time off and holidays Employee discounts Competitive pay based on experience RECOVRY is seeking a highly organized and detail-oriented Medical Biller to join our healthcare team. The ideal candidate will have Out-of-Network Physical Therapy experience and be responsible for ensuring accurate and timely billing and coding for patient services as well as oversee our billing operations. This role will include administrative patient services. This role is a crucial part of our medical office, and we are looking for someone who is passionate about providing excellent patient care while also ensuring the financial well-being of our organization. Duties Utilize medical coding skills to assign accurate ICD-10 and CPT codes to patient records and submit claims to insurance companies Verify patient insurance coverage and obtain necessary authorizations for services Analyze and resolve billing...

Job Description Job Description Keith M. Blechman, M.D., P.C. Blechman Plastic Surgery d/b/a Breast Surgery Group Midtown Manhattan, New York | In-Office Medical Biller – Revenue Cycle Management Full-Time | In-Office (Midtown Manhattan) | Experienced Hire About the Practice Breast Surgery Group is a boutique plastic surgery practice in Midtown Manhattan specializing in breast reductions, breast lifts, and top surgery (chest masculinization and breast augmentation for transgender and non-binary patients). Our clinical team includes two board-certified plastic surgeons and two physician assistants. We are in-network with Cigna and accept out-of-network benefits for most other plans. Position Overview We are seeking an experienced Medical Biller to join our revenue cycle team. This role owns the full billing lifecycle — from claim submission and payer follow-up through payment reconciliation and AR management — with particular emphasis on out-of-network billing, No Surprises Act...

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): 2619 W Henrietta Rd, Rochester, New York, United States of America, 14623 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited...

Med Records Coder III, Complex page is loaded## Med Records Coder III, Complexremote type: Remotelocations: Remote Work - New Yorktime type: Full timeposted on: Posted Todayjob requisition id: R265604As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.**Job Location (Full Address):**Remote Work - New York, Albany, New York, United States of America, 12224**Opening:**Worker Subtype:RegularTime Type:Full timeScheduled Weekly Hours:40Department:900370 Health Info Mgmt-CodingWork Shift:UR - Day (United States of America)Range:UR URG 107 HCompensation Range:$23.06 - $32.29*The referenced pay range represents the minimum and maximum compensation for this job. Individual...

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location 905 Elmgrove Rd, Rochester, New York, United States of America, 14624 Job Details Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 106 H Compensation Range: $21.36 - $29.90 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience,...

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 108 H Compensation Range: $24.91 - $34.87 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not...

Medical Billing Specialist Position Overview: We are seeking a detail-oriented Medical Biller to accurately process medical claims, post payments, and follow up on outstanding accounts. This role requires strong organizational and problem-solving skills. The ideal candidate will be proactive in identifying and correcting claim issues, communicating effectively with internal teams, and ensuring timely reimbursement. Key Responsibilities: Submit claims for services through billing software and clearinghouses Apply PPS billing rules, including modifiers, value codes, and occurrence codes Investigate denials by reviewing remittance advice and identifying root causes Correct and resubmit claims efficiently Communicate recurring issues or system errors with supervisors for resolution Follow up on outstanding claims via payer portals or phone Draft professional appeals for denied claims, especially authorization-related issues Escalate missing or invalid...

Medical Records Coder III, Complex page is loaded## Medical Records Coder III, Complexremote type: Remotelocations: 2619 West Henrietta Roadtime type: Full timeposted on: Posted Todayjob requisition id: R268867As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive.**Job Location (Full Address):**2619 W Henrietta Rd, Rochester, New York, United States of America, 14623**Opening:**Worker Subtype:RegularTime Type:Full timeScheduled Weekly Hours:40Department:900370 Health Info Mgmt-CodingWork Shift:UR - Day (United States of America)Range:UR URG 107 HCompensation Range:$23.06 - $32.29*The referenced pay range represents the minimum and maximum compensation for this job....