34 coder edit denials jobs found

Job Title: Specialty Physician Coder Job Location: Fountain Valley, CA Job Duration: 3 Months (possibility of extension) Payrate: $45.00 - $48.27/ hr. on w2 Job Summary: 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, ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. The Specialty Physician Coder will also collaborate with the Coding Compliance Manager to identify coding trends, irregularities, and required action items. Essential Functions and Responsibilities: Meet productivity standards established by management Meet quality standards established by management In adherence with standard work, analyze...

Our Client, a Healthcare company, is looking for a Specialty Physician Coder for their Remote, CA location. Responsibilities: Proficient in Microsoft Office suite. Proficient in Epic software. Strong analytical skills. Strong critical thinking skills. Detail oriented. The ability to anticipate, research, and resolve problems/strong problem-solving skills. Strong understanding of the healthcare revenue cycle. Excellent communication skills with the ability to communicate information accurately and clearly. The ability to manage interpersonal relationships and effectively communicate with clinical partners and fellow business center teams. Provide excellent customer service and address a moderate amount of incoming email and phone calls. Collaborative team player with the ability to adapt to the ever-changing healthcare environment. Professional demeanor at all times. The ability to handle complex and confidential information with...

Job Description Job Description Description: The Dermatology Medical Biller & Coder is responsible for accurately coding clinical services, submitting claims, posting payments, and ensuring timely reimbursement. This role plays a critical part in optimizing revenue cycle performance while maintaining compliance with payer guidelines, including Medicare and commercial insurance plans. Requirements: Medical Coding Assign accurate CPT, ICD-10, and HCPCS codes for dermatology services Review provider documentation to ensure coding accuracy and completeness Apply appropriate modifiers (e.g., -25, -59, -LT/RT ) Ensure compliance with NCCI edits and payer-specific policies Identify documentation gaps and communicate with providers Charge Entry Enter charges into the practice management system (e.g., EMA) Verify services align with documentation and scheduled visit type Ensure correct provider, location, and insurance selection Claims Submission...

Professional Fee Coder - Analyst II, under the direction of their Revenue Manager and Associate Director, will provide support in areas of revenue operations related to coding, auditing, and training for their designated areas. Responsibilities include providing education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines. Analyst II will perform an in-depth review of physician documentation and is responsible to present findings along with recommendations to the department on physician education. The incumbent should be familiar with all applicable billing and coding regulations and be able to effectively communicate these regulations to all levels of faculty, management and staff. This position will also assign codes based on a review of clinical charts, resolve coding issues based on denials, and Identify areas of improvement. Required Qualifications One (1) or more years of coding experience.Bachelor's degree in related...

Codes and abstracts documents such as patient charts and pathology reports utilizing diagnostic codes. Enters data into computer system(s). Essential Duties: Abstracts and assigns accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic). Reviews and edits previously submitted charges as needed due to identified billing errors and/or insurance requirement changes. Provides completed patient data to billing staff or designated personnel. Answer incoming calls from billers, front desk staff and clinical staff as needed assisting in what may be necessary to satisfactory resolution of the issues. Review and resolve insurance denials by examining the provider documentation. Consults with medical providers to clarify missing or inadequate record information and to determine...

Medical Coding Specialist Codes and abstracts documents such as patient charts and pathology reports utilizing diagnostic codes. Enters data into computer system(s). Essential Duties: Abstracts and assigns accurate Evaluation and Management (E&M) codes, ICD diagnoses, current procedural terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), modifiers and quantities derived from medical record documentation (paper or electronic). Reviews and edits previously submitted charges as needed due to identified billing errors and/or insurance requirement changes. Provides completed patient data to billing staff or designated personnel. Answer incoming calls from billers, front desk staff and clinical staff as needed assisting in what may be necessary to satisfactory resolution of the issues. Review and resolve insurance denials by examining the provider documentation. Consults with medical providers to clarify missing or inadequate record information and to...

Lead Outpatient Medical Coder The Lead Outpatient (OP) Medical Coder assists the HIM OP Coding Manager with administrative functions specific to all outpatient coding operations. Duties may be varied and may include many of the following: assisting the OP Coding Manager to organize work schedules, create work assignments, review timecards for accuracy, conduct quality assurance audits of production-coder performance, develop and implement quality improvement activities, train and mentor staff, provide feedback coding error findings and developmental needs, collect/analyze/report on data, prepare reports on performance and metrics, and other responsibilities of a similar nature and level. The Lead OP Medical Coder is responsible for serving as a subject matter expert in coding processes, providing advanced technical guidance, and ensuring coding accuracy, compliance, and productivity standards are met. The position supports coders and auditors through consultation, mentoring, and...

Clinical Policy Clinical Coder RN II Job Category: Clinical Department: Utilization Management Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $102,183.00 (Min.) - $163,492.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose. Job Summary The Clinical Policy Clinical Coder RN II is responsible for analyzing, interpreting, and operationalizing medical and utilization management policies to ensure accurate coding, appropriate...

divh2Medical Coder and Biller (Vascular Procedures)/h2pLocation: Sacramento, CA (or Remote)/ppSchedule: Full-Time and Part-Time positions/ppSalary: Competitive Salary Bonus Program/ppBenefits: Health, Dental, Vision, EAP, 401(k), FSA, Costco, AAA, etc./ph3About Us/h3pWith a growing network of locations, California Foot Ankle Centers (CALFAC) and the Vascular Institutes in Sacramento, Dallas, and Houston provide comprehensive care and surgery, including advanced wound care and amputation-prevention therapies, lower extremity peripheral nerve surgery, vascular surgery and endovascular procedures./ppWe have been serving patients for over 60 years, building a loyal patient base keeping our clinic locations busy with little to no marketing during that time. Our highly-competent doctors and medical staff all believe in giving a caring approach to each patient, as well as our utilizing the most modern technology available. Further, we conduct clinical trials and podiatric research at...

Job Description Job Description Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California. Qualifications: The successful candidate must have an excellent understanding of medical billing, which includes Insurance billing and payments processing: EOBs, ICD-10 and CPT coding. Candidates must have a strong understanding and working knowledge of the appeals and denials processes for Medicare, Medi-Cal and other commercial health insurances. Candidate is going to ensure all compliance and quality requirements are met. Candidate can efficiently communicate insurance company, clinical staffs and patients regarding billing issues. In addition, this position is the main link between our facility and our referring...

Salary : $105,597.80 - $145,114.92 Annually Location : Riverside Job Type: Regular Job Number: 26-74191-01 AL Department: RUHS-Medical Center Opening Date: 03/03/2026 Closing Date: Continuous For questions regarding this position, please contact the Recruiter listed in the Supplemental Information section. ABOUT THE POSITION Riverside University Health System (RUHS)is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to...

Job Description Job Description Victory Hematology and Oncology has a Medical Billing Specialist position available for a well-organized and knowledgeable Medical Billing and Coding Specialist with a Hematology and Oncology practice in Sherman Oaks, California. Qualifications: · The successful candidate must have an excellent understanding of medical billing, which includes Insurance billing and payments processing: EOBs, ICD-10 and CPT coding. · Candidates must have a strong understanding and working knowledge of the appeals and denials processes for Medicare, Medi-Cal and other commercial health insurances. · Candidate is going to ensure all compliance and quality requirements are met. · Candidate can efficiently communicate insurance company, clinical staffs and patients regarding billing issues. · In addition, this position is the main link between our facility and our referring clients. In this role, you will maintain a solid rapport with all our clients (case managers...

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. The ideal candidate will have at least five years of progressive...

Accredited CPC Medical Coding Specialist Anza, CA $52,089 - $67,099 a year Full Time Position Overview This role is responsible for accurately assigning codes to physician diagnoses and procedures, ensuring compliance with the latest medical billing and reimbursement policies. The specialist reviews medical records to identify all appropriate coding, adhering to CMS guidelines and current reimbursement standards. Duties include generating invoices for insurance and patient billing, managing paperwork, handling insurance claims, and performing collections. Collaboration with clinical teams and patients is essential to ensure precise and complete charge preparation for each visit. Key Responsibilities Maintain a safe and clean work environment, following unit safety and infection control protocols. Coding: Utilize electronic health records (EHR) to support claim coding. Assign ICD-10-CM, CPT-4, and HCPCS codes for surgeries based on current guidelines. Review...

Are you in search of a fulfilling and meaningful position? Do you want to work for an organization that promotes growth and development? Here at Men's Health Foundation we envision a world where inequity and stigma do not separate people from healthcare. "Reimagining Healthcare" is our commitment to affirming the unique experience of every patient. We prioritize our patients' evolving needs and strive to help each patient feel comfortable, understood, and respected. Why Men's Health Foundation? Men's Health Foundation is seeking compassionate, mission-driven individuals. We believe that by reimagining how healthcare is delivered, we can help create greater health equity for those most at risk, breaking down barriers to care. We welcome all backgrounds, gender identities, and expressions. We recognize our staff as the heart of our organization and seek to provide a generous and competitive benefits package to support our employee's well-being. We offer the...

Lifekind Health is looking for a full-time Certified Coder II (CPC or CCS) to join our team. The Medical Coder II performs more complex coding assignments. This role requires independent judgment, strong knowledge of coding guidelines, and the ability to resolve more advanced coding issues. Our mission is to bring care that's whole, human, and healing. Blending medical, behavioral, and lifestyle support into a single plan because restoring life takes more than a prescription. At Lifekind Health we strive every day to live up to that definition by providing the best care possible for our complex patient population. Our team of medical doctors, psychologists, chiropractors, acupuncturists, and dietitians work together within a revolutionary transdisciplinary model that addresses the quadruple aim of healthcare: enhancing patient experience, improving patient health, reducing healthcare costs, and increasing employee satisfaction. Learn more about us at www.Lifekindhealth.com....

Insight Global is looking for an Orthopedic Surgery Coder. This person will primarily be responsible for reviewing and abstracting orthopedic surgical cases, handling a high volume of complex procedures at an expected rate of approximately 8 surgeries per hour. They will assign CPT, ICD-10, and modifiers while validating diagnoses, medical necessity, and LCD requirements. The coder will work through 10-12 edits per hour, ensuring claims are accurate before submission. Daily responsibilities also include returning charges to providers with clear documentation, supporting minimal denials work, and collaborating with physicians to clarify surgical documentation when needed. Orthopedic Case Types - Spinal surgeries (anterior and posterior approaches performed simultaneously) - Joint procedures and sports medicine cases - Podiatry cases - Trauma cases (e.g., motor vehicle accidents; high complexity) - Bone oncology procedures We are a company committed to creating diverse and...

Insight Global is looking for a Urology Surgery Coder for a academic medical center. This coder will spend the majority of their time reviewing and abstracting urology surgical cases, working through approximately 8 surgeries per hour. Surgeries will vary from simple to complex. They will assign CPT, ICD-10, and modifiers while validating diagnoses, LCDs, and medical necessity requirements. The role might include working through 10-12 clinic edits per hour, ensuring claims accuracy, and submitting finalized charges back to providers with clear documentation of coding decisions. While denials are minimal, the coder will support occasional claim corrections and may engage directly with physicians to clarify documentation and ensure accuracy. We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified...

Job Overview Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements, knowledge and expertise in reviewing and adjudicating coding services, procedures, and diagnoses on medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT codes into the NextGen system. Minimum Requirements A minimum of one year of college/trade school, or a minimum of two years of experience with medical record coding and charge edit review, and or billing edit review required. Certified Professional Coder (CPC) required, Certified Coding Specialist (CCS) preferred, depending on hiring department. Compensation $27.00 - $33.75 hourly Compensation Disclaimer Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation...

Job Description Professional Fee Coder – Analyst II, under the direction of their Revenue Manager and Associate Director, will provide support in areas of revenue operations related to coding, auditing, and training for their designated areas. Responsibilities include providing education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines, performing in‑depth reviews of physician documentation, presenting findings and recommendations to the department, assigning codes based on clinical chart reviews, resolving coding issues from denials, and identifying areas for improvement. Responsibilities Provide education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines. Perform in‑depth reviews of physician documentation. Present findings and recommendations to the department on physician education. Assign codes based on review of clinical charts. Resolve coding issues based...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements, knowledge and expertise in reviewing and adjudicating coding services, procedures, and diagnoses on medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT codes into the NextGen system. Minimum...

Western Growers Health — a part of Western Growers Family of Companies — provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65,668.50 with a rich benefits package that includes profit‑sharing. This is a remote position and can reside...

Pinnacle Claims Management Job Opportunity If you're looking for a career that provides affordable health benefit solutions to the people who support some of the most vital industries, we're looking for you. At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management. As part of the Western Growers Family of Companies, we are committed to providing our employees with everything they need to succeed and grow. We know that taking care of our clients starts with taking care of our employees. As a keystone of our philosophy, we recognize that every person on our team comes to us with a unique background, history and story that adds strength to our organization. Additionally, employees are encouraged to recognize that there isn't a work life and a home...