11 claim edit coder jobs found

Job Summary The inpatient senior coder will thoroughly review inpatient record accounts to assign correct ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes per industry coding guidelines, utilizing the 3M computer assisted coding software application. Abstracts coded data from the Epic electronic medical record according to the established standard of work, while maintaining established quality accuracy and productivity standards. Works collaboratively with leadership, financial and clinical teams to ensure Diagnostic Related Groups (DRG) or All Patient Refined Diagnostic Related Groups (APR-DRG) accuracy. The outpatient senior coder will review multiple service lines of outpatient services (ambulatory surgery, observation, interventional radiology/cardiology, emergency) record accounts to assign correct ICD-10-CM diagnosis codes, CPT procedure codes, add modifiers, review claim edits, etc. per the industry coding guidelines, utilizing the 3M computer assisted coding...

Employment OpportunitiesProvides high level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments.Essential Functions:Knows, understands, incorporates, and demonstrates the Trinity Health Mission,...

Job Title Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD-10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross-training established coders in new specialties. Employment Type: Full time Shift: Day Shift Hours | Schedule: Remote...

Job Posting Candidates must have a primary address located within the state of Michigan or willing to move to Michigan to be considered. Candidate must have Denials experience to be considered. This position is responsible for coding all services including major and minor surgical cases performed in both the office and hospital setting for MyMichigan Medical Group, Family Practice Center and the MyMichigan Urgent Care locations. This position monitors compliance with third party payers guidelines while ensuring the maximum allowed reimbursement is attained. This position requires broad knowledge of current payer rules for all insurance companies we participate with, in addition to analytical skills to ensure all procedures are coded correctly for a timely and accurate reimbursement from all payers. This position must be able to work independently and make decisions based on their broad knowledge of current procedure terminology (CPT) and International Classification of Diseases...

Summary Candidates must have a primary address located within the state of Michigan or be willing to move to Michigan to be considered. This position is responsible for coding all services, including major and minor surgical cases performed in both the office and hospital settings for MyMichigan Medical Group, Family Practice Center, and MyMichigan Urgent Care locations. The role monitors compliance with third‑party payer guidelines to ensure maximum allowed reimbursement and requires broad knowledge of current payer rules and analytical skills to code procedures correctly for timely, accurate reimbursement. The coder works independently and makes decisions based on knowledge of CPT and ICD coding rules and regulations. Responsibilities Code visits and services performed in the office and hospital setting within 48 hours of receipt. (25%) Use Epic coding edits, CPT Assistant, and CMS coding guidelines to correct ICD, CPT, HCPCS codes, modifiers, and place of service for clean...

Job Summary The inpatient senior coder will thoroughly review inpatient record accounts to assign correct ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes per industry coding guidelines, utilizing the 3M computer assisted coding software application. Abstracts coded data from the Epic electronic medical record according to the established standard of work, while maintaining established quality accuracy and productivity standards. Works collaboratively with leadership, financial and clinical teams to ensure Diagnostic Related Groups (DRG) or All Patient Refined Diagnostic Related Groups (APR-DRG) accuracy.The outpatient senior coder will review multiple service lines of outpatient services (ambulatory surgery, observation, interventional radiology/cardiology, emergency) record accounts to assign correct ICD-10-CM diagnosis codes, CPT procedure codes, add modifiers, review claim edits, etc. per the industry coding guidelines, utilizing the 3M computer assisted coding...

Trinity Health: Coder IV Inpatient Coder (Remote) Employment Type: Full time Shift: Description: Provides high level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments. ESSENTIAL FUNCTIONS:...

Remote Experienced Billers Are you an experienced medical biller looking for a growing company with room for advancement? APPY NOW! Full benefits after 30 days!! PTO after 90 days! and MORE!!! New hire orientation starts July 22! The Medical AR Follow-up & Denial Specialist is primarily responsible for analyzing and resolving all insurance claim denials for DME Supplies. The individual in this position will generate effective written appeals to carriers using well-researched logic in order to recoup reimbursement on incorrectly denied claims. Appeal carrier denials through coding review, contract review, medical record review, and carrier interaction. Utilize a multitude of resources to ensure correct appeal processes are followed and completed in a timely manner. Demonstrate a high level of expertise in the management of denied claims and deploy an analytical approach to resolving denials while recognizing trends and patterns in order to proactively resolve recurring issues....

Remote Inpatient Coder - HIMJOB SUMMARYThe Health Information Management (HIM) Coder impacts Memorial's Healthcare quality initiatives and reimbursement through the assignment of the most accurate and optimal diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing.Under the direction of the Health Information Management (HIM) Coding and Clinical Documentation Integrity (CDI) Manager, this position will code and analyze physician documentation contained in health records (electronic, paper or hybrid) to determine the appropriate principal diagnosis, secondary diagnoses, and procedures codes to accurately capture MS-DRG assignment.Use the Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers in accordance with coding rules and regulations.The coding information is used to determine APC's (Ambulatory Payment Classification) for data...

Inpatient Coder - CPC Employer: Trinity Health Employment Type: Full time Shift: Day Shift Location: Remote Responsibilities Review all assigned charge review errors and claim edits for hospital-based services, including surgical procedures, ensuring correct charge capture and coding with CPT, HCPCS and ICD-10 codes and proper modifiers in accordance with local policies. Analyze medical documentation to verify primary and secondary diagnoses and procedures, assign diagnostic and procedural codes using CMS guidelines. Perform charge entry and discrepancy resolution, serving as liaison between Centralized Coding/Revenue Site Operations and physicians/clinical sites/departments. Assisting in orienting and training new employees in the coding and charge capture area and cross‑training established coders in new specialties. Qualifications Associate’s degree in an allied health field or equivalent education and experience. Certified Coding Specialist credential. One to...

3 days ago Be among the first 25 applicants Description Reviews all assigned charge review errors and claim edits for hospital-based services, including surgical procedures. Ensures correct charge capture and coding with proper CPT, HCPCS, and ICD‑10 codes, as well as proper modifiers, adhering to local ministry and Trinity practices and policies. May require analyzing medical documentation to verify principle and secondary diagnoses and procedures; assigning diagnostic codes, selecting the surgical/procedural codes and modifiers using coding guidelines established by the Centers for Medicare and Medicaid Services (CMS); performing charge entry; and performing discrepancy resolution. Serves as a liaison between Centralized Coding/Revenue Site Operations and physicians/clinical sites/departments. Assists in orienting and training new employees in the coding and charge capture area as well as cross‑training established coders in new specialties. Employment Type Full time Shift Day...