197 claims resolution coder jobs found

Coding Account Resolution Specialist-Outpatient Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. We are seeking a Coding Account Resolution Specialist-Outpatient for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply! The Coding Account Resolution Specialist-II (CARS-II) works outpatient coding related alerts/edits for SDC, OBV, and Wound Care, accounts, predominately post initial/final coding. The CARS-II performs the alert/edit resolution activities in the applicable systems. The...

Medical Coder As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location: Remote Work - New York Opening: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 Responsibilities General Purpose: Functions as an advanced coder in the abstraction and in-depth analysis of a variety of medical documentation and assigns appropriate procedural terminology and medical codes in accordance with applicable coding rules and policies. Analyzes, enters and manipulates database. Responds to or clarifies internal...

*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 *newly formed 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. *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 significant backlog of cases. *Note:* This is not a coding-heavy...

Coding Validation Coder I Cotiviti has multiple openings for full-time coders. These roles will focus on claims audits for appeals, checking for completeness and accuracy based on coding guidelines. Experience with EandM coding and auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule. Responsibilities: Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement. Apply client specific coding guidelines when applicable. Learns new appeal categories as production need requires. Stays current on coding guidelines appropriate to the position. Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards. Reviews quality feedback from QA. Submits questions for clarification as needed. Utilizes the 'QA Resolution' process when disagreement...

Coding Account Resolution Specialist-Outpatient Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. We are seeking a Coding Account Resolution Specialist-Outpatient for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply! The Coding Account Resolution Specialist-II (CARS-II) works outpatient coding related alerts/edits for SDC, OBV, and Wound Care, accounts, predominately post initial/final coding. The CARS-II performs the alert/edit resolution activities in the applicable systems. The...

Fair Haven Community Health Care For over 54 years, FHCHC has been an innovative and vibrant community health center, catering to multiple generations with over 165,000 office visits across 21 locations. Guided by a Board of Directors, most of whom are patients themselves, we take pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay. Our extensive range of primary and specialty care services, along with evidence-based programs, empowers patients to make informed choices about their health. As we expand our reach to underserved areas, our commitment to prioritizing patient needs remains unwavering. FHCHC's mission is to enhance the health and social well-being of the communities we serve through equitable, high-quality, and culturally responsive patient-centered care. Remote in New Haven, Connecticut Job Purpose Responsible for maintaining the professional...

Job Posting As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location: 905 Elmgrove Rd, Rochester, New York, United States of America, 14624 Opening: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 106 H Compensation Range: $21.36 - $29.90 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience,...

Coding Account Resolution Specialist-Outpatient Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. We are seeking a Coding Account Resolution Specialist-Outpatient for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply! The Coding Account Resolution Specialist-II (CARS-II) works outpatient coding related alerts/edits for SDC, OBV, and Wound Care, accounts, predominately post initial/final coding. The CARS-II performs the alert/edit resolution activities in the applicable systems. The...

Coding Account Resolution Specialist-Outpatient Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. We are seeking a Coding Account Resolution Specialist-Outpatient for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply! The Coding Account Resolution Specialist-II (CARS-II) works outpatient coding related alerts/edits for SDC, OBV, and Wound Care, accounts, predominately post initial/final coding. The CARS-II performs the alert/edit resolution activities in the applicable systems. The...

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 106 H Compensation Range: $21.36 - $29.90 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not...

Medical Coder As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location: Remote Work - New York Opening: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 Responsibilities General Purpose: Functions as an advanced coder in the abstraction and in-depth analysis of a variety of medical documentation and assigns appropriate procedural terminology and medical codes in accordance with applicable coding rules and policies. Analyzes, enters and manipulates database. Responds to or clarifies internal...

Coding Account Resolution Specialist-Outpatient Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. We are seeking a Coding Account Resolution Specialist-Outpatient for our team to ensure that we continue to provide all patients with high quality, efficient care. Did you get into our industry for these reasons? We are an amazing team that works hard to support each other and are seeking a phenomenal addition like you who feels patient care is as meaningful as we do. We want you to apply! The Coding Account Resolution Specialist-II (CARS-II) works outpatient coding related alerts/edits for SDC, OBV, and Wound Care, accounts, predominately post initial/final coding. The CARS-II performs the alert/edit resolution activities in the applicable systems. The...

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 106 H Compensation Range: $21.36 - $29.90 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not...

Coder - Full Time page is loaded## Coder - Full Timelocations: Attleboro, MAtime type: Full timeposted on: Posted Todayjob requisition id: R8288Working under the supervision of the Central Billing Department Supervisors will share the responsibilities of being accessible to physicians, staff and patients regarding billing questions; assures that all billing functions are completed in a timely fashion and develops billing goals. Responsible for accurately coding providers outpatient and inpatient visits based on the documentation provided and abstracting accurate and complete patient care data to ensure optimum and timely reimbursement. Applies knowledge of specialized information specific to coding and medical terminology according to all coding guidelines.**Required Qualifications and Skills:*** Minimum of 1-2 years of medical billing experience in either charge, payment or follow-up work* Minimum of 1-2 year of coding experience for primary care, medical and surgical specialties...

Medical Coder As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location: Remote Work - New York Opening: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 Responsibilities General Purpose: Functions as an advanced coder in the abstraction and in-depth analysis of a variety of medical documentation and assigns appropriate procedural terminology and medical codes in accordance with applicable coding rules and policies. Analyzes, enters and manipulates database. Responds to or clarifies internal...

Coding Account Resolution Specialist-Outpatient Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: The Coding Account Resolution Specialist-II (CARS-II) works outpatient coding related alerts/edits for SDC, OBV, and Wound Care, accounts, predominately post initial/final coding. The CARS-II performs the alert/edit resolution activities in the applicable systems. The alerts/edits shall be worked and corrected according to the established procedures and thresholds, and communicated as appropriate. What you will do in this role: Compiles daily work list from eRequest, CRT and/or other alert/edit systems Takes action and resolves alerts/edits for the following patient types following established procedures...

Location: REMOTE any state Hours: Can start anytime between 6am-9am EST and work 8 hour day from there. Must be logged on during peak hours of 9am-2pm EST, other hours are flexible. MINIMUM REQUIREMENTS Education: High School Diploma or GED Experience: -Five years of coding experience, 3 years of Urology surgery coding experience. -Experience with APPs -Teaching Facility -Aware of the CPT codes for 2026 Licensure: Must be CPC through AAPC or CCS-P through AHIMA to qualify for all functional areas Plusses: -Epic Experience -3M and Encoder Pro Insight Global is seeking a profee urology surgical coder. This person assigns and reviews the accuracy of the diagnostic codes (ICD-10-CM) and CPT codes for providers' Evaluation and Management Services (E/M), procedures and diagnostic testing in all settings for purposes of billing, research and providing information to government and regulatory agencies. Incumbent may perform only certain of the following responsibilities depending on their...

If you are an existing employee of South Shore Health then please apply through the internal career site. Requisition Number: R-21766 Facility: LOC0014 - 549 Columbian Street549 Columbian StreetWeymouth, MA 02190 Department Name: SHS Physician Services Admin Status: Part time Budgeted Hours: 0 Shift: Day (United States of America) Under experienced leadership the Professional Surgical Coder is an advanced coding position that is responsible for accurate and timely assignment of codes to diagnoses and procedures for all outpatient and inpatient diagnostic and procedural coding. Using established department policies and procedures in conjunction with the current versions of ICD-10 and CPT-4, the Professional Surgical Coder will determine the proper diagnosis, assign co-morbidities and complications, secondary diagnoses and any HAC (Hospital Acquired conditions) documented. As well as both E/M codes and procedure codes. The Professional...

Coder 3 Hours of Work: 8 AM - 4:30 PM Days Of Week: M-F Work Shift: Job Description: Your Job: In this highly technical and fast-paced position, you will collaborate with multidisciplinary team members to provide the very best care for our patients. The Coder 3 performs pre-bill (secondary) audits on inpatient, ambulatory care and observation records to ensure accurate ICD10-CM, ICD10 PCS and/or CPT codes for optimal reimbursement and provide data and clinical information to management, medical staff and various hospital departments. The reviewer also codes and abstracts inpatient, ambulatory and observation records for diagnosis and procedures to determine optimal reimbursement. Your Job Requirements: Associate's degree in Health Information Management or Certification as a Coding Specialist; Bachelor's degree in Health Information Management preferred RHIA, RHIT, or CCS preferred Minimum of 3 years of DRG-based coding experience in an acute care hospital with...

Professional Coding Analyst II The Professional Coding Analyst II will be responsible for reviewing clinical documentation, assigning appropriate diagnosis, procedure, and in some cases level of service codes to resolve claim edits and denials. Ensures clinical documentation supports the charges posted, following the American Medical Association (AMA), Medicare, and Commercial coding guidelines on claims. Communicates trends and issues to leadership for investigation and resolution. This is a remote role working Monday-Friday, day shift hours. Responsibilities Reviews claims in assigned work queues in Cerner Revenue Cycle including CMG Review and Ambulatory Edit failure work items. Analyzes coding edits, reviews timeline notes, reviews clinical documentation, including provider orders, progress notes, surgical and test results thoroughly to interpret and ensure documentation supports the posted charges. Determines appropriate action needed to resolve coding edits/issues and...

Medical Coder IV, Complex The Medical Coder IV, Complex functions as an advanced coder in the abstraction and in-depth analysis of a variety of medical documentation for multiple specialties and assigns appropriate procedural terminology and medical codes in accordance with applicable coding rules and policies (e.g. ICD-10, CPT-4, HCPCS, DRG). Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Essential Functions: Uses thorough knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assign codes (ICD-10-CM, E/M, CPT, HCPCS and modifiers) through medical record documentation in accordance with universally recognized coding guidelines. Reviews and resolves coding denials. Resolves problems with claims having errors related to improper coding and provides feedback for correction and follow-up. Abstracts data and reviews codes for accuracy. Performs system edit checks and...

Join our team at Sixteenth Street Community Health Centers! We are dedicated to the highest quality health care. JOB RESPONSIBILITIES: Review, abstract, and code clinical data such as diseases, operations, procedures, and therapies into computer system for billing and data collection within the established time frame. Assign appropriate ICD-10, CPT, HCPCS and modifiers to accurately report and support the need for each physician service. Identify physician services provided but not adequately documented in the medical record. Advise coding auditor/educator or Manager of deficiencies. Code and abstract patient care records to provide information for insurance/billing and to establish accurate working indices. Perform void/re-enter of charges and changes to insurance as indicated by the medical record and insurance nuances. Perform follow-up claim duties as required and assigned. Comply with the Sixteenth Street TB Control Plan including PPD testing. Perform...

Assistant Coding Manager As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 110 Compensation Range: $60,431.00 - $84,603.00 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience,...