552 coder edit denials jobs found

To support independent healthcare providers, the full-time Remote Coder, Edit and Denials will review medical records for appropriate billing codes, perform advanced coding and appeal activities, and investigate payer issues while working remotely. Key responsibilities Review documentation to identify facts for appealing denied claims and create substantiating letters Collaborate with facility liaisons to resolve coding issues and provide feedback on documentation for appeals Research payer policies and review clinical documentation to ensure accurate coding of diagnoses and procedures Required qualifications CCS, AHIMA, CCS-P, CPC, AAPC, CPC-A, or AAPC Credentials Three or more years of coding experience Knowledge of ICD-10 and CPT coding Proficiency in Microsoft Office, including Outlook, Excel, and Teams Experience working in a remote environment

Medical Records Coder II/III San Mateo County Health is seeking an experienced Medical Records Coder II/III to join Correctional Health and support the coding of CalAIM billable services, including clinic visits and ancillary services. This position plays an important role in ensuring accurate reimbursement while supporting continuity of care for justice-involved individuals. The successful candidate will perform billing functions related to the Department of Health Care Services (DHCS) Justice-Involved CalAIM Initiative. This initiative allows eligible incarcerated individuals to enroll in Medi-Cal prior to their release and enables reimbursement for covered healthcare services provided during the 90 days before reentry, helping support successful transitions back into the community. This position requires independent proficiency in ICD-10 and CPT coding, coding audits, physician education on coding practices, Evaluation and Management (E/M) coding, and identifying and...

Medical Records Coder II/III San Mateo County Health is seeking an experienced Medical Records Coder II/III to join Correctional Health and support the coding of CalAIM billable services, including clinic visits and ancillary services. This position plays an important role in ensuring accurate reimbursement while supporting continuity of care for justice-involved individuals. The successful candidate will perform billing functions related to the Department of Health Care Services (DHCS) Justice-Involved CalAIM Initiative. This initiative allows eligible incarcerated individuals to enroll in Medi-Cal prior to their release and enables reimbursement for covered healthcare services provided during the 90 days before reentry, helping support successful transitions back into the community. This position requires independent proficiency in ICD-10 and CPT coding, coding audits, physician education on coding practices, Evaluation and Management (E/M) coding, and identifying and...

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: 2619 W Henrietta Rd, Rochester, New York, United States of America, 14623 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: UR URG 106 H Compensation Range: $21.78 - $30.53 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,...

Professional Fee Coding Auditor & Educator We are seeking an experienced Professional Fee Coding Auditor & Educator to partner with physicians and APPs on coding accuracy, documentation improvement, compliance, and provider education. Must currently possess both the CPC and CPMA certifications in order to be considered for the role. The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or...

Medical Records Coder II/III San Mateo County Health is seeking an experienced Medical Records Coder II/III to join Correctional Health and support the coding of CalAIM billable services, including clinic visits and ancillary services. This position plays an important role in ensuring accurate reimbursement while supporting continuity of care for justice-involved individuals. The successful candidate will perform billing functions related to the Department of Health Care Services (DHCS) Justice-Involved CalAIM Initiative. This initiative allows eligible incarcerated individuals to enroll in Medi-Cal prior to their release and enables reimbursement for covered healthcare services provided during the 90 days before reentry, helping support successful transitions back into the community. This position requires independent proficiency in ICD-10 and CPT coding, coding audits, physician education on coding practices, Evaluation and Management (E/M) coding, and identifying and...

Remote Coding Specialist This position is open to remote candidates who reside in one of the following states only: Nevada, Texas, Arizona, Utah, Florida, Idaho, Oregon, or Washington. Due to business operations, tax registration, and employment compliance requirements, we are only able to hire individuals who currently live and work in these states. Applicants must maintain residency in one of the approved states as a condition of employment. Position Purpose To be responsible for accurately assigning diagnostic and procedural coding for all encounters associated with Renown Health Network and Ambulatory Services. This will also include translating patient information into alpha-numeric medical codes using patient treatment, health history, diagnosis, and related information. Assignment of ICD-10-CM and CPT codes must be consistent with CMS' Official Guidelines and any regulatory agency guidelines. Nature and Scope Incumbents must be proficient with CPT and ICD-10-CM coding...

Department/Unit: Physicians Billing Work Shift: Day (United States of America) Salary Range: $46,947.00 - $65,726.00 The Medical Billing Analyst is an intermediate billing position within the Hospital or Physicians Billing Offices for the Albany Med Health System (AMHS). This role is centered around the timely follow up needed on accounts that have already been billed but need re-billing, accounts in which the payer has not responded within the regulatory guidelines, or AMHS has received a denial that needs an immediate action and/or rebuttal. The denials assigned in this role are more intricate than others and the denial response may require a professional narrative accompanied by supporting documentation to be overturned. Some or all these areas may be the focus of the position depending on the resources needed. The incumbent must be able to prove that they have an ability to learn quickly and work independently. They will possess the ability to use payer websites to locate...

Senior Professional Coder The Senior Professional Coder will apply an advanced professional coding skill set to act as a service line coding team lead expert, working collaboratively to support all workflows related to professional fee coding/charging/denials follow-up. Coordinates with others as needed to ensure comprehensive and timely completion of professional coding processes. Audit CPT and ICD-10 diagnosis coding applied by providers and coding staff to assure compliance with federal and state regulations and insurance carrier guidelines. Provide education, instruction and training to providers and coding staff. Act as an expert for the HCC/Risk adjustment coding. This position is remote but does require onsite education to providers as needed. Essential Duties and Responsibilities Review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliance with federal and state regulations and insurance carrier guidelines. Ensuring...

To support accurate claims submissions, the full-time Certified Claim Denial Coder will review and resolve coding-related claims edits, rejections, and denials within Epic while collaborating with various teams. Key responsibilities Review and resolve coding edits, claim rejections, and payer denials for multiple specialties within Epic Validate coding elements by reviewing provider documentation and making necessary corrections in Epic Document denial findings and coding rationale while identifying trends for process improvement Required qualifications Minimum of 2 years of Medical Coding experience Certifications such as CCS, CCS-P, CPC, RHIT, or RHIA are required Experience using Epic for claim edit resolution and coding workflows is strongly preferred Proficiency in CPT, ICD-10, HCPCS, and Modifiers Experience with both Professional Fee Coding and Facility coding

Specialty Physician Coder Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing. This role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. The Specialty Physician Coder works with the Coding Compliance Manager on discovered coding trends, irregularities, and needed action items. Job Responsibilities: Achievement of productivity standards as established by management. Achievement of quality standards as established by management. Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical...

Senior Specialty Physician Coder Interventional Our client, a healthcare company, is looking for a Senior Specialty Physician Coder Interventional for their Fountain Valley, CA location. Responsibilities: Achievement of productivity standards as established by management. Achievement of quality standards as established by management. In adherence with standard work, analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient and/or outpatient medical records according to established coding guidelines, including the ability to review and natively code surgical operative and/or procedure reports. In adherence with standard work, follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing/coding improvements. Participate in developing, implementing, and reviewing programs for coding...

UPMC Corporate Revenue Cycle is hiring a Coder II to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. In this position, you will be working on edits. We are looking for individuals with a strong understanding of Evaluation and Management codes. As a Coder II, you will review all pertinent physician, nursing and ancillary documentation in the medical record. Depending on type of service and place of service, you will determine the level of acuity, procedure performed, billable supplies and diagnosis to substantiate medical necessity. You will review and sequence all codes to to maximize reimbursement and address any potential bundling issues. Apply modifiers as needed. LMRP/CCI edit and coding denial resolution. Responsibilities: Utilize computer applications and resources essential to completing the coding process efficiently. Meet and maintain charge lag and appropriate coding...

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: Time as Reported / Per Diem Scheduled Weekly Hours: As Scheduled Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.27 - $32.60 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...

It's more than a career, it's a calling. WI-REMOTE Worker Type: Regular Job Summary Coordinates, organizes and prioritizes the work flow activities for the coding area. Primary Responsibilities Leads and/or coordinates shift operations, work assignments and daily priorities of assigned activities, resources, and/or associates. Serves as a leader through modeling, mentoring and training assigned staff. Manages assigned charge review and coding-related claim work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plan follow-up steps. Reviews medical record documentation in the electronic health record and/or on paper. Identifies, enters and posts CPT-4 and ICD-10 codes to the electronic health record. Identifies need for medical records from outside the organization and follows established procedures to obtain. Ensures all coded services meet appropriate Medicare, National Correct Coding Initiative (NCCI) or payer‑specific...

ELLIS HOSPITAL POSITION DESCRIPTION TITLE: Accounts Receivable Representative/ Coder II DEPARTMENT: Physician Revenue Cycle REPORTS TO: Manager Patient Financial Services SECTION I BASIC FUNCTION: The Accounts Receivable Representative/ Coder will be responsible for achieving accurate and timely accounting for professional accounts receivable as set by policies and procedures. Responsible for reviewing and posting charges, payments and adjustments to the patient accounting system on a daily basis, and ensuring outgoing data is accurate. Review and resolve outstanding accounts receivable with insurance companies and patients. In addition to AR responsibilities this position will be responsible for coding review, resolving coding edits and denials with the focus on ensuring that the account is resolved in a timely and appropriate manner. SECTION II EDUCATION AND EXPERIENCE REQUIREMENTS: Education: High School Diploma or Equivalent...

Senior Outpatient Coder Position Details: Full-Time Remote Reports to Coding Operations Manager You must reside in one of these states to be eligible for this position: Arkansas California Kentucky Massachusetts Nevada New Mexico Oregon Utah Tennessee Texas Wyoming Job Summary: The Senior Coder supports assigned inpatient and/or outpatient coding operations through day-to-day workflow leadership and may provide oversight of coding quality, coding edits, auditing, and staff education. Assigned functions may include inpatient, observation, emergency department, ambulatory surgery, ancillary, clinic, and other hospital-based coding services. The position supports Revenue Cycle Operations with special projects, including denial review, appeals, discharge-not-final-billed management, regulatory and payer edit review, and process improvement efforts designed to meet organizational goals while promoting accurate, complete, and compliant coding and billing....

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: Time as Reported / Per Diem Scheduled Weekly Hours: As Scheduled Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.27 - $32.60 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,...

To support accurate claims submissions, the full-time Certified Claim Denial Coder will review and resolve coding-related claims edits, rejections, and denials within Epic while collaborating with various teams. Key responsibilities Review and resolve coding edits, claim rejections, and payer denials for multiple specialties within Epic Validate coding elements by reviewing provider documentation and making necessary corrections in Epic Document denial findings and coding rationale while identifying trends for process improvement Required qualifications Minimum of 2 years of Medical Coding experience Certifications such as CCS, CCS-P, CPC, RHIT, or RHIA are required Experience using Epic for claim edit resolution and coding workflows is strongly preferred Proficiency in CPT, ICD-10, HCPCS, and Modifiers Experience with both Professional Fee Coding and Facility coding

Professional Fee Coding Auditor & Educator We are seeking an experienced Professional Fee Coding Auditor & Educator to partner with physicians and APPs on coding accuracy, documentation improvement, compliance, and provider education. Must currently possess both the CPC and CPMA certifications in order to be considered for the role. The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or...

Coding Auditor And Educator At Anne Arundel Dermatology we give exceptional care - to our patients and to eachother. Patient First | Caring | Accountability | Trust | One Team | Growth The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or activities, typically under supervision. An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and...

Remote Coding Specialist This position is open to remote candidates who reside in one of the following states only: Nevada, Texas, Arizona, Utah, Florida, Idaho, Oregon, or Washington. Due to business operations, tax registration, and employment compliance requirements, we are only able to hire individuals who currently live and work in these states. Applicants must maintain residency in one of the approved states as a condition of employment. Position Purpose To be responsible for accurately assigning diagnostic and procedural coding for all encounters associated with Renown Health Network and Ambulatory Services. This will also include translating patient information into alpha-numeric medical codes using patient treatment, health history, diagnosis, and related information. Assignment of ICD-10-CM and CPT codes must be consistent with CMS' Official Guidelines and any regulatory agency guidelines. Nature and Scope Incumbents must be proficient with CPT and ICD-10-CM...

UPMC Corporate Revenue Cycle is hiring a Coder II- Profee to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. This role will have the same responsibilities as a Coder I. The position will review all pertinent physician, nursing, and ancillary documentation. Depending on the type of service and place of service, you will determine the level of acuity, procedure(s) performed, billable supplies, and diagnosis to substantiate medical necessity. As well as review and sequence all codes to maximize reimbursement and address any potential bundling issues. The Coder II will apply modifiers as needed. The position will also handle LMRP/CCI edit and coding denial resolution. We are looking for coders with prior experience in ENT coding to join the team. If you are ready to take the next step in your coding career, look no further! Responsibilities: Utilize computer applications and resources...

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 Job Details 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 limited to, market data, education, experience,...