9 claims edit coder jobs found

Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ's and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately escalates coding/denial trends and provider education...

Inpatient Coder 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. Position Summary: Responsible for charge capture process for professional...

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...

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...

Job Description Job Description Description: HIRING REMOTE EXPERIENCED BILLERS IN THE FOLLOWING STATES: AL,FL, GA, IN, KY, LA, MS, NC, SC, TN, TX, VA, & WV ***** MI RESIDENTS WITHIN 40 MILES OF 48393 WILL BE HYBRID New Year NEW CAREER! Are you an Experienced Medical Biller LOOKING FOR GROWNING COMPANY WITH ROOM FOR ADVANCEMENT? APPY NOW! - Full Benefits after 30 Days!! PTO after 90 Days! and MORE!!!! NEW HIRE ORIENTATION STARTS 2/18/2026! 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...

Summary **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...

JOB SUMMARY The 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 quantitative analysis,...

Employment Type: Full time Shift: Day Shift 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. Remote Position...

Employment Opportunities 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: Knows, understands, incorporates, and demonstrates the Trinity...