15 claims edit coder jobs found

Become a part of our caring community and help us put health first Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated claims that contain a code editing related denial or financial recovery. The Medical Coding Coordinator performs advanced administrative, operational, and customer support duties that require independent initiative and judgment. May apply intermediate mathematical skills. Where you Come In The Medical Coding Coordinator extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Decisions typically focus on methods, tactics and processes for completing administrative tasks/projects. Regularly exercises discretion and judgment in prioritizing requests and interpreting and adapting procedures,...

JOB SUMMARY This position will be functioning under minimal supervision while utilizing independent decision making. This position will assist the manager and supervisor in training new team members, coordinate inquiries from ancillary departments regarding DNFB and edit tasks. The Sr. Edit Coder will investigate and solve edit issues and communicate root cause data to management in order mitigate potential upstream and downstream impacts. Responsible for modifying and completing moderate to high complexity reviewing and resolving coding and charge edits using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations. Abides by the Standards of Ethical Coding as set forth by AHIMA. Abstracting required clinical information from the medical record. Working in billing editor systems as required. ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following. Others may be assigned. Performs claim edit...

Coding Specialist III Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). The Coding Specialist III can maintain up to two concurrent client assignments that are short-term in nature. For each client, the Coding Specialist III reviews documentation to code diagnoses and procedures for inpatient hospital-based claims and data needs. For both professional and technical claims and data needs, the Coding Specialist III reviews clinical documentation to code diagnoses, EM level, and surgical CPT codes. Additionally, this role also validates MS-DRG and APC calculations, abstracts clinical...

Revenue Integrity Analyst (Medical Coding) Job Family: Finance & Accounting Consulting Travel Required: Up to 25% Clearance Required: Ability to Obtain Public Trust What You Will Do: The Revenue Integrity Analyst (Medical Coding) supports accurate documentation, compliant coding, and optimized charge capture within MHS GENESIS, the Military Health System's enterprise EHR. The role ensures correct configuration of revenue cycle workflows and reduces revenue leakage through data analysis, system support, and cross-functional collaboration. Responsibilities of this role are as follows, to include but not limited to: System Configuration & Support: Validate and troubleshoot MHS GENESIS revenue cycle build, including coding workflows, charge capture, charge router logic, and billing integrations. Ensure accurate mapping of CPT, ICD-10, HCPCS, modifiers, and charge codes. Data Analysis: Analyze clinical and financial data to identify coding variances, charge gaps, and...

Business, Managerial & Finance UTMB Health Minimum Qualifications: Two years of medical billing or related experience, or related training from a non-accredited program or accredited agency. Preferred Qualifications: Knowledge of coding guidelines, anatomy and physiology, biology and microbiology, medical terminology and medical abbreviations. Required Licenses, Registrations, or Certifications: One of the following: CCA Certified Coding Associate (AHIMA) or CCS Certified Coding Specialist (AHIMA) or CCS-P Certified Coding Specialist Physician Based (AHIMA) or RHIA Registered Health Information Administrator (AHIMA) or RHIT Registered Health Information Technician (AHIMA) or CIC Certified Inpatient Coder (AAPC) or COC Certified Outpatient Coder (AAPC) or CPC Certified Professional Coder (AAPC) or CPC-A Certified Professional Coder Apprentice (AAPC) or CRC Certified Risk Adjustment Coder (AAPC) Job Summary: Properly codes and/or audits...

divh2Medical Coder Auditor/h2pRevenue Cycle Management is looking for a Medical Coder Auditor to join our team. Remote opportunity after 30-90 day in-person training./ppSUMMARY: The Medical Coder Auditor is responsible for reviewing coded encounters to ensure accuracy, compliance, and alignment with coding guidelines, payer rules, and organizational policies. This role provides feedback to coders, identifies trends in errors, and supports coding education and process improvement initiatives./ppESSENTIAL FUNCTIONS:/pulliConduct retrospective and prospective coding audits to ensure coding accuracy and compliance with regulations./liliReview coded documentation for completeness, accuracy, and adherence to ICD-10-CM, CPT, HCPCS, and/or ICD-10-PCS guidelines./liliIdentify coding trends, error patterns, and compliance risks and develop corrective action plans./liliProvide feedback and education to coders to improve accuracy and consistency./liliCollaborate with providers and clinical...

Job Description Job Description Certified Medical Coder (Remote Production Role) Our mission to change wound care and improve the lives of others isn’t easy, but it’s worth it! One in ten residents in a skilled nursing facility will develop a skin condition requiring expert medical care. We believe that every person deserves the very best wound care. Building and leading wound care teams is how we do it! Our wound care providers bring education and encouragement to the people who take care of our patients 24/7. When they get better at their jobs, our patient’s wounds heal faster and that is our goal! Main Responsibilities (may include but are not limited to): Meet minimum production goals while maintaining accuracy requirements Review provider medical coding of services rendered for medical claim submission Review and respond to medical coding inquiries submitted...

Job Description Job Description The Medical Billing Specialist is responsible for the timely and accurate submission of insurance claims, reviewing and updating denied claims for resubmission and performing reconciliations to ensure timely billing for services provided. The Medical Billing Specialist collaborates with patients, revenue cycle counterparts and work units, clinical staff, and insurance providers to drive the efficiency of the billing process and reduce the amount of denied claims. Essential Responsibilities: Reviews patient demographic and insurance information and confirms patient benefit details related to services provided by the clinic from insurance providers. Obtains necessary medical documentation from clinicians to provide to insurance companies as required for review and prior authorization of treatment. Documents authorization reference numbers in EMR and/or other systems. Updates and maintains EMR and/or other systems based on documentation...

Medical Coder - Multi-Specialty (Hospital & Clinic) Location: Kingwood-Hybrid Employment Type: Full-Time Reports To: Revenue Cycle Manager Position Summary We are seeking a highly skilled, detail-driven, and high-producing Certified Medical Coder with multi-specialty experience to join our growing healthcare organization. This role requires strong proficiency in both hospital and outpatient clinic coding, with specialty expertise in: • Cardiology • Urology • Dermatology • General Surgery • Pulmonology The ideal candidate has 2+ years of coding experience, maintains current certification (AAPC or equivalent), and consistently demonstrates accuracy, productivity, and strong clinical understanding across multiple service lines. This is a high-impact role within a performance-driven, collaborative organization focused on compliance, precision, and revenue integrity. Core Responsibilities Coding & Documentation Review • Accurately assign...

Overview Join our high?performing Billing team. As part of our team, you will make a positive impact by processing insurance and other third?party payor claims for patient visits. Responsibilities Enter facility charges as needed. Edit, build, and transmit electronic claims in a timely manner. Prepare paper claims as needed. Process monthly statements for patient accounts. Interpret Explanation of Benefits and other correspondence. Enter and update appropriate insurance information in each patient account. Keep appropriate logs, journals, and files to track patient accounts. Resolve problem claims including rejected billings, adjustments, re?billing, and unpaid claims. Post payments to patient accounts and monitor unpaid balances. Contact and assist patients in the process of obtaining information for billing issuesverifying totals, responding to and resolving client questions and problems, and delivering quality customer service. Qualifications To be a...

Job Description Job Description Westside Podiatry is searching for a confident professional that is adept at medical insurance billing, coding, and receivables recovery, with a strong background in Athena. The candidate must have proven productivity track record, great attitude, thrive in a fast paced production environment, be quality oriented, and possess the ability to adapt to a variety of technologies. You will work closely with patients, providers, insurance companies, and medical/surgical representatives to ensure the proper revenue for the practice. Skills Required: You must have at least 3 years of in-depth medical business office experience. This should include experience with coding, posting, electronic remittance filing, A/R, plus strong positive working relationships with patients and insurance companies. We will only consider candidates with medical billing experience. Critical and analytical thinking is key. Must be able to work independently and in a team...

Job Description Under direct supervision, responsible for conducting review of inpatient and outpatient coding, assuring coding compliance with federal regulations, and maintains up-to-date coding guidelines and coding policy changes. Performs all tasks required to facilitate medical billing to include abstracting complex patient related data from medical records and coding of diagnoses and procedures using the ICD-10 and CPT classification systems. This position will be a hybrid position working remote and/or on campus. Candidate being considered would need to live within commuting distance of UT Health San Antonio. Upon hire candidate will be required to be onsite for orientation and training. Transition to remote work is contingent on meeting productivity and quality standards as determined by supervisor. Remote Coders may be required to occasionally attend on campus training and meetings. Responsibilities Reviews, interprets, and assigns diagnostic and procedural...

Job Title :Gastroenterology ProFee Coder (E / M & Surgical) Company Description Vee Healthtek, Inc.delivers cutting-edge solutions that transform healthcare organizations.We offer a comprehensive suite of services that leverage our industry expertise to provide the best value to our clients.Through close collaboration and a deep understanding of market trends, we create customized strategies that deliver tangible outcomes.Our technology-driven services empower organizations to thrive in the evolving healthcare landscape, resulting in improved workflows, increased cost efficiency, and streamlined business processes.Learn more at www.veehealthtek.com.Job Summary The Gastroenterology ProFee Coder is responsible for accurate assignment of diagnosis, procedure, and Evaluation & Management (E / M) codes for physician professional services within a gastroenterology practice or health system.This role focuses exclusively on professional fee coding , ensuring compliance with CPT,...

Coding Specialist III Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). The Coding Specialist III can maintain up to two concurrent client assignments that are short-term in nature. For each client, the Coding Specialist III reviews documentation to code diagnoses and procedures for inpatient hospital-based claims and data needs. For both professional and technical claims and data needs, the Coding Specialist III reviews clinical documentation to code diagnoses, EM level, and surgical CPT codes. Additionally, this role also validates MS-DRG and APC calculations, abstracts clinical...

About Us MedAR is a dedicated medical billing company specializing in pathology, radiology and anesthesia services. We partner with healthcare providers to streamline their revenue cycle and ensure accurate reimbursement. We are currently seeking a meticulous and experienced Pathology Medical Coder to join our expert team. Job Summary The Pathology Medical Coder will be responsible for accurately applying billing codes to pathology reports for our client base. This role is crucial for ensuring compliance and maximizing revenue for our clients. The ideal candidate will have a deep understanding of CPT, ICD-10-CM, and HCPCS coding guidelines, with a specific focus on pathology services. Key Responsibilities Review provider documentation and accurately assign CPT, ICD-10-CM, and HCPCS codes to pathology and laboratory services, including surgical pathology, cytology, and molecular diagnostics. Apply correct modifiers and ensure NCCI edits, MUE , and payer...