4 appeal resolution coder jobs found

Medical Dental Coder Harlingen Annex - Harlingen, TX 78550 Description This position is vital in the health care delivery system in function with the fiscal aspect of the Clinic. Adhere to policies and procedures in conducting all clinical charges, payments, adjustments for proper billing and collections. Bills and submits claims to insurances/programs through AthenaOne EMR, follows up on claims statuses, resolves claim denials, submits appeals, post payments and adjustments, and manages collections. Great customer service and telephone etiquette, computer knowledge, professional appearance, attention to detail, able to multitask and work in a fast paced environment. Ability to work well under stress and maintain calm under pressure and work well with team members and willingness to cross-train. Functions as a member of a collaborative health care team to create and maintain a patient centered medical home. Essential Job Functions Communication: Communicates with outside...

About the Role Are you a newly certified medical coder looking to launch your career in a dynamic and fast-growing healthcare environment? Join a federally certified Independent Review Organization (IRO) that provides expert medical review services to government agencies, insurers, TPAs, and self-funded employers. This is a unique opportunity to be part of a team supporting a high-impact initiative driven by the No Surprises Act, with a mission to resolve complex claim disputes and ensure fair payment outcomes. **CANDIDATES WITH PREVIOUS MEDICAL CODING EXPERIENCE WILL NOT BE CONSIDERED** What You'll Do * Review and validate claim data to determine appropriate payment outcomes. * Analyze CPT codes and supporting documentation to identify the correct party in disputed claims. * Work primarily with emergency services claims, including ambulance and air ambulance cases. * Operate within a proprietary claims management system. * Collaborate with internal teams to clear a...

Job Description Job Description Our client is seeking a Certified Workers’ Compensation Coder to accurately review and code workers’ compensation claims in accordance with state regulations, payer guidelines, and official coding standards. This role requires strong knowledge of ICD10CM, CPT, HCPCS, and workers’ compensation billing rules, with a focus on claim accuracy, compliance, and reimbursement. The coder will review medical records and claims, identify coding or documentation issues, support denial resolution and appeals, and collaborate with billing, claims, and revenue integrity teams. Qualified candidates must hold an active coding CPC or CCS with 2+ years of workers’ compensation coding. Candidates should be highly skilled in interpreting statespecific workers’ compensation guidelines, payer policies, and fee schedules, and demonstrate strong attention to detail, analytical skills, and productivity. Experience with audits, denials management,...

Overview The Revenue Cycle Medical Billing Specialist is responsible for the overall account resolution of patient accounts within the revenue cycle management (RCM) process. Ensures timely billing of claims to payers and follow up of denials, appeals, recoupments and balance management. Ability to audit and provide feedback on the billing process and outcomes. Works cooperatively with other departments to ensure timely billing, reporting and patient account management. Supports the organization’s strategic plan and workplace inclusion initiatives. Abides by the organization’s mission in performing job duties. Demonstrates an understanding and commitment to PPGT’s culture of quality, safety and risk awareness. Responsibilities Reviews submission of claims by third party billing team to the clearinghouse to ensure accuracy. Processes reimbursements and payment adjustments with attention to detail, timeliness, and accuracy. Makes corrections and prepares appeals related to claim...