8 claims resolution coder jobs found

Lifeguard Pediatrics – Warner Robins, GA About Us Lifeguard Pediatrics is a trusted, physician-owned pediatric clinic serving families across Middle Georgia. We are dedicated to providing comprehensive, compassionate, and community-centered care. With a growing need for developmental and behavioral health services in our region, we are expanding our care team to include in-house autism diagnostic services. Position and Responsibilities The biller and coder is responsible for the accurate and timely submission of medical claims to insurance companies and other payors. The medical biller posts payments or adjudications as appropriate. Using knowledge of billing practices and standards including third party payor requirements, the medical biller will investigate denials to process appeals and collect payment. In addition, this position is responsible for reviewing coding for outpatient services for reimbursement and research compliance. Medical Billing Performs claim review,...

Job Description Job Description Description: Southeast Primary Care Partners is seeking a dedicated and detail-oriented Certified Coder to join our dynamic team. The successful candidate will play a crucial role in accurately coding healthcare claims for reimbursements, ensuring compliance with federal regulations, and contributing to the efficiency and effectiveness of our healthcare services. Certified Coder reviews medical records to assure proper billing. Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improve coding issues identified. Codes must meet QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Position Summary: Requirements: Key Responsibilities: Review patients' medical records to extract relevant information needed for billing and coding. Apply appropriate ICD-10, CPT, and HCPCS Level II code assignments to ensure accurate and timely billing. Work closely with healthcare...

Join to apply for the Coder-Certified I role at Southeast Medical Group . Position Summary: Southeast Primary Care Partners is seeking a dedicated and detail‑oriented Certified Coder to join our dynamic team. The successful candidate will play a crucial role in accurately coding healthcare claims for reimbursements, ensuring compliance with federal regulations, and contributing to the efficiency and effectiveness of our healthcare services. The Certified Coder reviews medical records to assure proper billing, participates in audits, and develops methodologies to improve coding issues identified. Codes must meet QA standards following Official Coding Guidelines and Risk Adjustment Guidelines. Key Responsibilities Review patients’ medical records to extract relevant information needed for billing and coding. Apply appropriate ICD‑10, CPT, and HCPCS Level II code assignments to ensure accurate and timely billing. Work closely with healthcare providers and billing teams to...

# Biller / CoderOcilla, GA 31774Education LevelHigh School## Biller/Coder Job Description***General Summary:***Performs work in accounts receivable and patient billing. This position identifies and codes patient professional fees for SCPCC. This position is dedicated to scrubbing and filing all commercial, Medicaid CMO, and Medicare claims. The position also follows up on lag times, electronic and paper denials. This position interacts with all levels of the organization to ensure cost-effective, accurate, and timely coding of professional services.***Employment Status:*** Hourly – FSLA Non-Exempt Status***Essential Duties and Responsibilities:**** Ensures timely and accurate problem resolution between the organization and its patients.* Ensures timely and accurate billing and collection of medical claims. Ensures that the billing and collection processes meet or exceed the organization’s financial and operational goals.* Ensures the billing processes and collection...

Lead Medical Coder and Auditor ProSidian Consulting is looking for a talented professional ready to deliver real value to clients in a fast-paced, challenging environment. ProSidian Consulting is a management and operations consulting firm with a reputation for its strong national practice spanning six solution areas including Risk Management, Energy & Sustainability, Compliance, Business Process, IT Effectiveness, and Talent Management. We help clients improve their operations. ProSidian seeks a Lead Medical Coder and Auditor (Full-Time) in CONUS - Fort Stewart, GA to support an engagement for a branch of the United States Armed Forces' Regional Health Command who's mission is to provide a proactive and patient-centered system of health with the focus on the medical readiness of all Soldiers and for those entrusted to the care for a medically-ready force. The Armed Forces' overall mission is "to fight and win our Nation's wars, by providing prompt, sustained, land...

We are seeking a detail-oriented and customer-focused Inbound Call Center Specialist to join our Revenue Cycle Management team. In this role, you will serve as the first point of contact for patients, guarantors, and insurance carriers, addressing inquiries related to account balances, billing statements, and payment concerns. The ideal candidate will possess strong communication skills, a basic understanding of medical billing processes, and a passion for delivering exceptional service while adhering to HIPAA and company policies. This position offers an opportunity to contribute to efficient revenue cycle operations in a dynamic healthcare environment. Key Responsibilities Answer incoming calls from patients, guarantors, and insurance carriers regarding account balances, statements, and billing concerns. Review and interpret Explanation of Benefits (EOBs), Electronic Remittance Advice (ERAs), and patient account activity to assist in resolving inquiries. Educate patients on...

You will be able to work from your home location within the United States PURPOSE AND SCOPE: Conducts data quality audits of outpatient encounters to validate coding assignment is in compliance with the official coding guidelines as supported by clinical documentation in health record. Validates abstracted data elements that are integral to appropriate payment methodology. Provides feedback and education to coders. Escalates compliance, risk-related issues to expedite mitigation. PRINCIPAL DUTIES AND RESPONSIBILITIES: Consults facility leaders and staff on best practices, methodology, and tools for accurately coding. Chart Analysis, OP Coding Data auditing and validation: Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Adheres to Standards of Ethical Coding (AHIMA/AAPC). Reviews medical records for the determination of accurate assignment of all documented diagnoses and procedures. Reviews claim to...

Qualifications High School Diploma or GED (Required) Vocational / Technical Degree (Preferred) 2 year / Associate Degree in Health Information Management (Preferred) Work Experience 2 - 3 years Diagnosis and CPT coding in a clinic, business, or revenue cycle environment or any combination thereof. (Preferred) 2 - 3 years Broad knowledge of medical terminology and anatomy. (Preferred) Licenses and Certifications Required Certifications/Licensures: Coding Certification (CPC or CCS) Preferred Certifications/Licensures: CPMA Essential Functions CODING SKILLS Review medical records to assign ICD-10-CM, CPT, and HCPCS Level II codes and modifiers for accurate primary and multi‑specialty billing. Provide analysis and education on coding trends and changes in payer policies to providers and staff. CODING REVENUE CYCLE SKILLS Review claim denials for coding issues, interpret payer guidelines, and assist insurance collectors with resolution for proper reimbursement. Prepare or...