24 claim edit coder jobs found

Job Description Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT)...

Specialty Physician Coder Our client, a healthcare company, is looking for a Specialty Physician Coder for their Fountain Valley, CA location. Responsibilities: Achievement of productivity standards as established by management. Achievement of quality standards as established by management. Analyze and interpret medical information in the medical record and assign and sequence the correct ICD10CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines. Review and natively code surgical operative and/or procedure reports. Follow established workflow for working claim denials in the Follow Up work queues and identify opportunities for billing and coding improvements. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement...

Specialty Physician Coder | Onsite | Fountain Valley CA What You'll Do Review and analyze specialty coding and billing for charge processing. Review and accurately code office, hospital, and surgical/procedure services for reimbursement. Ensure accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. Work with the Coding Compliance Manager on discovered coding trends, irregularities, and needed action items. Achieve productivity standards as established by management, Achieve quality standards as established by management. Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes according to established coding guidelines. Review and natively code surgical operative and/or procedure reports. Follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing...

Western Growers Health — a part of Western Growers Family of Companies — provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65,668.50 with a rich benefits package that includes profit‑sharing. This is a remote position and can reside...

THE POSITION:  Under general direction this position is responsible for providing billing and coding support within the Ambulatory Care Clinic System. The clinic areas of specialization include ENT, plastic reconstruction, neurology, and urology.  Examples Of Duties: Duties may include but are not limited to the following: Reviews electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in accordance with Federal and State regulations in compliance with billing and coding guidelines. Effectively monitors assigned work queues and reviews claim errors, ensuring timely and accurate resolution of accounts.  Review, Analyze and validate medical records to ensure completeness and accuracy of code selections while identifying educational opportunities. Prepares educational materials to communicate with providers when identifying gaps in clinical documentation for the selection of appropriate...

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world’s health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient’s request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you’re stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. We’re looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day. Job Overview Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements, knowledge and expertise in reviewing and adjudicating coding services, procedures, and diagnoses on medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT codes into the NextGen system. Minimum Requirements A...

Are you in search of a fulfilling and meaningful position? Do you want to work for an organization that promotes growth and development? Here at Men's Health Foundation we envision a world where inequity and stigma do not separate people from healthcare. "Reimagining Healthcare" is our commitment to affirming the unique experience of every patient. We prioritize our patients' evolving needs and strive to help each patient feel comfortable, understood, and respected. Why Men's Health Foundation? Men's Health Foundation is seeking compassionate, mission-driven individuals. We believe that by reimagining how healthcare is delivered, we can help create greater health equity for those most at risk, breaking down barriers to care. We welcome all backgrounds, gender identities, and expressions. We recognize our staff as the heart of our organization and seek to provide a generous and competitive benefits package to support our employee's well-being. We offer the...

Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well‑being and inspire your best work. Job Summary Codes for cancer center encounters and maintains required quality and productivity standards while remaining compliant with third party, state and federal regulations. Reviews and resolves medical necessity edits that may apply for any outpatient surgical encounters, applying hospital and professional modifiers to CPT codes and processes any errors associated with the revenue cycle process. Assists in the design and implementation of workflow changes to reduce coding and billing errors. Uses knowledge of...

Coder The Coder reviews clinical documentation and diagnostic results and applies appropriate ICD-10-CM, ICD-10-PCS, and CPT codes to support diagnoses, procedures, and treatment results. Codes are used for billing, internal and external reporting, research, and regulatory compliance activities. Abides by the standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and adheres to all official coding guidelines. Verifies that all ICD-10-CM and CPT codes are correctly captured. Verify that physician is correctly abstracted. Keeps abreast of coding guideline changes by self-study, assigned education, coding meeting attendance or related in-services. Participates in internal and external quality review meetings. Performs other duties as assigned. Resolves billing related errors and assists with workflow changes and process improvement projects. Meets ongoing productivity and quality standard of 95% accuracy rate or better....

Job Description Job Description Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California. Qualifications: The successful candidate must have an excellent understanding of medical billing, which includes Insurance billing and payments processing: EOBs, ICD-10 and CPT coding. Candidates must have a strong understanding and working knowledge of the appeals and denials processes for Medicare, Medi-Cal and other commercial health insurances. Candidate is going to ensure all compliance and quality requirements are met. Candidate can efficiently communicate insurance company, clinical staffs and patients regarding billing issues. In addition, this position is the main link between our facility and our referring...

Job Description Job Description Lifekind Health is looking for a full-time Certified Coder II (CPC or CCS) to join our team. The Medical Coder II performs more complex coding assignments. This role requires independent judgment, strong knowledge of coding guidelines, and the ability to resolve more advanced coding issues. Our mission is to bring care that’s whole, human, and healing. Blending medical, behavioral, and lifestyle support into a single plan because restoring life takes more than a prescription. At Lifekind Health we strive every day to live up to that definition by providing the best care possible for our complex patient population. Our team of medical doctors, psychologists, chiropractors, acupuncturists, and dietitians work together within a revolutionary transdisciplinary model that addresses the quadruple aim of healthcare: enhancing patient experience, improving patient health, reducing healthcare costs, and increasing employee satisfaction. Learn more about...

AltaMed Health Services Corp. If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements, knowledge and expertise in reviewing and adjudicating coding services, procedures, and diagnoses on medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT codes into the NextGen system....

Certified Coder III (CPC or CCS) Lifekind Health is looking for a full-time Certified Coder III (CPC or CCS) to join our team. The Medical Coder III is a senior-level role responsible for highly complex coding assignments. This role serves as a subject matter expert and contributes to coding education and process improvement within the Coding Team. Our mission is to bring care that's whole, human, and healing. Blending medical, behavioral, and lifestyle support into a single plan because restoring life takes more than a prescription. At Lifekind Health we strive every day to live up to that definition by providing the best care possible for our complex patient population. Our team of medical doctors, psychologists, chiropractors, acupuncturists, and dietitians work together within a revolutionary transdisciplinary model that addresses the quadruple aim of healthcare: enhancing patient experience, improving patient health, reducing healthcare costs, and increasing employee...

CAREER OPPORTUNITY OFFERING: Bonus Incentives Paid Certifications Tuition Reimbursement Comprehensive Benefits Career Advancement This position will pay between $29 .75 and $ 3 2 . 7 0 / hr based on experience Specialized Coders Wanted -$3,000 Sign On Bonus Awaits We are seeking candidates with experience in Cardiology, Vascular or Thoracic Surgery specialties. This role is an onsite role located at Tower - Reading Hospital in West Reading, PA. The Specialized Coder is a certified coder with expert knowledge in physician coding for Cardiology, Cardiovascular Thoracic Surgery or Vascular Surgery . This position is responsible for reviewing physician charges to accurately code encounters, correct coding edits, and assist with research for denied claims. The Specialized Coder's role also includes tracking, trending coding issues, mentoring/training other coders, and supporting provider education. Job Responsibilities: Code claims directly from the medical...

Position: Medical Billing Specialist- Certified Coder Location: Los Angeles, CA Overview We are seeking a detail-oriented and experienced Medical Billing Specialist / Certified Medical Coder to join our team. The ideal candidate will have hands‑on experience in medical coding and billing, with strong knowledge of CPT, ICD‑10, and HCPCS coding guidelines. This role requires an individual who can work independently, maintain high accuracy standards, and ensure compliance with all applicable healthcare regulations and payer requirements. Key Responsibilities Medical Coding & Billing Review and accurately assign CPT, ICD-10, and HCPCS codes for medical procedures, services, and diagnoses. Ensure coding accuracy and compliance with federal, state, and payer-specific regulations. Submit insurance claims accurately and in a timely manner. Apply appropriate coding guidelines, reimbursement policies, and medical necessity requirements. Review, investigate, and resolve claim...

Salary Range: $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate authorization requirements, compliant claims processing, and effective utilization oversight. This position serves as a key clinical and coding...

Job Description Job Description Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California. Qualifications: · The successful candidate must have an excellent understanding of medical billing, which includes Insurance billing and payments processing: EOBs, ICD-10 and CPT coding. · Candidates must have a strong understanding and working knowledge of the appeals and denials processes for Medicare, Medi-Cal and other commercial health insurances. · Candidate is going to ensure all compliance and quality requirements are met. · Candidate can efficiently communicate insurance company, clinical staffs and patients regarding billing issues. · In addition, this position is the main link between our facility and our referring clients. In this role, you will maintain a solid rapport with all our clients...

Base Pay $19.6 - $35.00 / Hour Employee Type Nonexempt FT Come and join our team! We are a local growing private medical practice specializing in the diagnosis and treatment of patients with diseases of the retina and vitreous. We are looking for individuals who would like to establish a career in healthcare working for a company with nationally recognized physicians. We provide on the job training giving you the ability to grow and advance your skills along with gaining innovative knowledge. Established in 1977, we have locations all over Northern California including Sacramento, Grass Valley, Roseville, Stockton, Modesto, Merced, Fairfield, Elk Grove, Folsom, Yuba City and Chico. Our physicians are nationally known, and we continue to be on the leading edge of retina care by utilizing the latest equipment and both participating in and designing new clinical trials to advance the state of care for retinal diseases. Join 240+ other team members working for our nationally...

Overview The Professional Fee Coder is part of a team which has full responsibility for the efficient and accurate flow of coded charges. Applies the appropriate diagnoses, surgical and procedural codes to individual patient health information for data retrieval, analysis and claims processing. Works closely with departments to optimize reimbursement, ensure charge capture, reduce late charges and provide feedback to providers. Provides physicians routine feedback on documentation and compliance standards. Resolves pre-bill edits and appropriate follow-up. Exercises judgment within generally defined practices and policies in selecting methods and techniques for obtaining solutions. Receives no instructions on routine work and general instructions on new assignments. Locations Stanford Health Care What You Will Do Adheres to official coding guidelines. Applies CPT-4, ICD-9-CM, HCPCS and modifiers following coding guidelines. Code all documented professional services and submit...

Job Description Located in the metropolitan area of Sacramento, the Adventist Health corporate headquarters have been based in Roseville, California, for more than 40 years. In 2019, we unveiled our WELL-certified campus - a rejuvenating place for associates systemwide to collaborate, innovate and connect. Whether virtual or on campus, Adventist Health Roseville and shared service teams have access to enjoy a welcoming space designed to promote well-being and inspire your best work. Job Summary: Codes for cancer center encounters and maintains required quality and productivity standards while remaining compliant with third party, state and federal regulations. Reviews and resolves medical necessity edits that may apply for any outpatient surgical encounters, applying hospital and professional modifiers to CPT codes and processes any errors associated with the revenue cycle process. Assists in the design and implementation of workflow changes to reduce coding and billing...

Grow HealthyIf you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day.Job OverviewAssigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements, knowledge and expertise in reviewing and adjudicating coding services, procedures, and diagnoses on medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT codes into the NextGen system.Minimum RequirementsA minimum...

The medical biller is responsible for the timely submission of professional medical claims to various payors.Prepare, review, and transmit claims for electronic and/or paper claim submission from the PM system.Responsible for resolving claim edits and clearinghouse rejections via the PM system.Responsible for processing all secondary claims via electronic and/or paper claim submission.Responsible for submitting claims with required documents, per payor guidelines or as requested (i.e., medical records).Review patient statements for accuracy and completeness prior to billing.Maintain a current understanding of local coverage determinations, payor and coding guidelines to ensure claims are consistently billed properly.Perform charge reconciliation from the daily appointment schedule.Perform posting of charges, electronic and/or manual to the PM system.Keep abreast with medical coding updates and educate team members of changes in a timely manner.The specialist will maintain...