28 coder edit denials jobs found

Outpatient Surgery Coder Outpatient surgery coder with at least 2 years of experience coding in cardiology preferably cardiovascular, cardiology, IVR procedures. Must be experienced with edits and denials. Experience with bariatric cases a plus. Cerner experience is a plus. The project will be working denials and edits primarily in cardiology with some bariatric as well. This is short term project estimated to be 3 months. This is open to fulltime or parttime candidates. The preferred schedule is M-F with hours worked between 7a-5p CST. Required Experience: NCCI/CCI edits and modifier indicators Medically Unlikely Edits (MUEs) Medical necessity denials Modifiers 59, XE, XS, XP, and XU Looking up NCDs and LCDs Cardiac Caths Interventions (PCI, stents, atherectomy, thrombectomy) Electrophysiology studies and ablations Device procedures (pacemakers, ICDs, CRT, lead revisions, generator changes) Structural heart procedures (TAVR/TMVR, Watchman) Experience with...

Outpatient Surgery Coder Outpatient surgery coder with at least 2 years of experience coding in cardiology preferably cardiovascular, cardiology, IVR procedures. Must be experienced with edits and denials. Experience with bariatric cases a plus. Cerner experience is a plus. The project will be working denials and edits primarily in cardiology with some bariatric as well. This is short term project estimated to be 3 months. This is open to fulltime or parttime candidates. The preferred schedule is M-F with hours worked between 7a-5p CST. Required Experience: NCCI/CCI edits and modifier indicators Medically Unlikely Edits (MUEs) Medical necessity denials Modifiers 59, XE, XS, XP, and XU Looking up NCDs and LCDs Cardiac Caths Interventions (PCI, stents, atherectomy, thrombectomy) Electrophysiology studies and ablations Device procedures (pacemakers, ICDs, CRT, lead revisions, generator changes) Structural heart procedures (TAVR/TMVR, Watchman) Experience...

Benefits 401(k) matching Bonus based on performance Company parties Dental insurance Employee discounts Health insurance Opportunity for advancement Paid time off Parental leave Training & development Vision insurance The Medical Billing Specialist is responsible for the billing and collection of office visits, procedures, nurse procedures, and all other billing events as a result of practice activities. Additional responsibilities include keeping up to date with coding and billing regulations as well as maintaining an understanding and compliance with all Skin Wellness Physicians policies and procedures. Essential Duties and Responsibilities Develops and implements, with the Practice Administrator, procedures for all aspects of the billing process including charge entry, day end balancing, claims submission and edit, insurance follow up, patient balance follow up, denials, transfers to patient balance, cash collection, collection accounts, adjustments and...

Job Title Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Job Description Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and...

Overview Manages the daily operations of the patient financial services team to ensure accurate and efficient billing and collections. Coordinates with healthcare providers and insurance companies to resolve billing issues and expedite payments. Monitors patient accounts for compliance with financial policies, trains staff on handling inquiries and payment plans, and implements process improvements to optimize revenue cycle management. Requires reviewing financial reports to identify trends and collaborating with other departments to streamline patient registration and insurance verification, all while maintaining strict confidentiality and data protection standards. Responsibilities Manage and oversee all payer denial activities to support low denial rates and optimal reimbursement. Direct daily operations of the denial management process and identify opportunities for workflow and process improvements. Establish departmental goals, measure process effectiveness and...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Medical Billing Specialist -(Local Candidates Only) * LOCAL CANDIDATES ONLY Who We Are The Hirsh Center is a specialty healthcare practice committed to delivering exceptional care and building meaningful, long-term relationships with our patients. We take pride in providing a supportive and collaborative work environment where team members are valued, trained, and given opportunities to grow. Why Work Here At The Hirsh Center, we believe great care starts with a great team. This is a great opportunity for an experienced billing professional who enjoys working in a specialty practice, values teamwork, and wants a stable schedule with long-term growth potential. We offer a predictable weekday schedule, no nights or weekends, and we are closed for major holidays, supporting strong work-life balance. * This is an onsite based position located in Delray Beach, FL, Monday-Friday . No remote or hybrid candidates will be considered. Position Summary The Medical Billing Specialist...

Certified Medical Coder II - Surgical Coder - $2000 sign on bonus Hybrid - Remote. . Hourly Salary plus monthly bonus! As Mount Sinai grows, so does our legacy in high-quality health care. Since 1949, Mount Sinai Medical Center has remained committed to providing access to its diverse community. In delivering an unmatched level of clinical expertise, our medical center is committed to recruiting and training top healthcare workers from across the country. We offer the latest in advanced medicine, technology, and comfort in 12 facilities across Miami-Dade (including our 674-bed main campus facility) and Monroe Counties, with 38 medical services, including cancer care, 24/7 emergency care, orthopedics, cardiovascular care, and more. Mount Sinai takes pride in being South Florida's largest private independent not-for-profit hospital, dedicated to continuing the training of the next generation of medical pioneers. Culture of Caring: The Sinai Way Our hardworking,...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Job Requirements ** Candidate to be considered must reside in the state of Florida. This is a work from home opportunity with majority being remote work** Position Summary To be fully engaged in providing timely, complete, and accurate data collection for quality clinical analysis and revenue enhancement. PRIMARY ACCOUNTABILITES 1. Uphold regulatory compliance by assigning and sequencing accurate ICD 10 and CPT 4 codes to reference lab, ancillary, emergency room, endoscopy, ambulatory surgery, observation, and other outpatient records as per coding guidelines demonstrating behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. 2. Validate accuracy of codes assigned by the computer assisted coding software, recognizing inappropriate application of clinical coding rules/guidelines, and revising the codes assigned based upon expert subject matter knowledge and provider...

Become a part of our caring community 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, processes and techniques, and...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Front Desk Supervisor We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team. The Front Desk Supervisor, functioning under the supervision and guidance of the Center Operations Director and/or Clinical Dyad leader, is responsible for organizing and directing the work of the front desk staff, coordinating staff activities and schedules to ensure effective patient care services are provided, and ensuring quality standards are met. Trains, guides and supports Care Facilitators to ensure organizational front desk standards are met and that they have the tools and resources they need to effectively perform their duties. Leads front office center operations including, quality,...

Summary: Utilizing an electronic medical record and computerized encoder, assigns and sequences diagnosis and procedure codes and present on admission indicators for inpatient encounters based on medical record documentation in accordance with Official Coding Guidelines, CMS regulations, encoder software guidance and Health Information Management (HIM) policies and procedures. Responsibilities: Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements. Formulates physician queries for validation of pathological findings. Requests clinical validation queries for Clinical Documentation Integrity (CDI) review and follow-up. Seeks clarification from providers or other designated resources to ensure accurate and complete coding. Attends educational meetings and seminars to maintain certification and continuing education requirements. Reviews appropriate inpatient coding work queues daily to address coding edits and needed corrections...

Job Description Job Description Medical Billing & Revenue Cycle Specialist (Interventional Cardiology) Location: Stuart, FL (On-Site) Employment Type: Full-Time Position Overview A high-volume Interventional Cardiology practice is seeking an experienced Medical Billing & Revenue Cycle Specialist to support all aspects of the end-to-end revenue cycle (RCM). Reporting to the Practice Administrator, this role is responsible for charge capture, coding validation, claims submission, denial management, A/R follow-up, and reimbursement optimization across professional services including office, hospital, and telehealth encounters. The ideal candidate will demonstrate advanced knowledge of cardiology billing guidelines, payer policies, and regulatory compliance, with hands-on experience in EMR/PM systems such as Athenahealth (AthenaOne) or similar platforms. Key Responsibilities Perform accurate charge entry and reconciliation for CPT, HCPCS, and ICD-10-CM diagnosis...

Our promise to you Joining AdventHealth is about being part of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better. All the benefits and perks you need for you and your family Benefits from Day One: Medical, Dental, Vision Insurance, Life Insurance, Disability Insurance Paid Time Off from Day One 403-B Retirement Plan 4 Weeks 100% Paid Parental Leave Career Development Whole Person Well-being Resources Mental Health Resources and Support Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 900 HOPE WAY City: ALTAMONTE SPRINGS State: Florida Postal Code:...

Job Description Job Description Description: Coding & Documentation • Accurately code radiation oncology diagnoses and procedures using ICD-10-CM, CPT, and HCPCS coding systems • Code all radiation therapy modalities including IMRT, IGRT, 3D-CRT, brachytherapy, stereotactic radiosurgery, and other specialized treatments • Review and analyze clinical documentation to ensure accuracy and completeness for coding purposes • Assign appropriate evaluation and management (E/M) codes for physician services • Code both professional and technical components for radiation oncology services • Perform daily charge reconciliation for professional and technical charges Compliance & Quality • Ensure coding compliance with Medicare policies, LCD requirements, and payer-specific guidelines • Stay current with changes to CPT, ICD-10, and HCPCS codes, particularly those affecting radiation oncology • Review coding edits and resolve discrepancies in a timely manner • Maintain...

Introduction Do you want to join an organization that invests in you as a Trauma Surgical Profee Coder? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. Candidates with Trauma/Surgical Profee experience are strongly preferred. Benefits Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft...

Job Requirements Candidate to be considered must reside in the state of Florida. This is a work from home opportunity with majority being remote work Position Summary To be fully engaged in providing timely, complete, and accurate data collection for quality clinical analysis and revenue enhancement. Primary Responsibilities Uphold regulatory compliance by assigning and sequencing accurate ICD 10 and CPT 4 codes to reference lab, ancillary, emergency room, endoscopy, ambulatory surgery, observation, and other outpatient records as per coding guidelines demonstrating behavior that reflects integrity, shows a commitment to ethical and legal coding practices, and fosters trust in professional activities. Validate accuracy of codes assigned by the computer assisted coding software, recognizing inappropriate application of clinical coding rules/guidelines, and revising the codes assigned based upon expert subject matter knowledge and provider documentation. Literacy...

Front Desk Supervisor We're unique. You should be, too. We're changing lives every day. For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts? Do you inspire others with your kindness and joy? We're different than most primary care providers. We're rapidly expanding and we need great people to join our team. The Front Desk Supervisor, functioning under the supervision and guidance of the Center Operations Director and/or Clinical Dyad leader, is responsible for organizing and directing the work of the front desk staff, coordinating staff activities and schedules to ensure effective patient care services are provided, and ensuring quality standards are met. Trains, guides and supports Care Facilitators to ensure organizational front desk standards are met and that they have the tools and resources they need to effectively perform their duties. Leads front office center operations including, quality,...

Position Details Lakeland Regional Health is a leading medical center located in Central Florida. With a legacy spanning over a century, we have been dedicated to serving our community with excellence in healthcare. As the only Level 2 Trauma center for Polk, Highlands, and Hardee counties, and the second busiest Emergency Department in the US, we are committed to providing high-quality care to our diverse patient population. Our facility is licensed for 892 beds and handles over 200,000 emergency room visits annually, along with 49,000 inpatient admissions, 21,000 surgical cases, 4,000 births, and 101,000 outpatient visits. Lakeland Regional Health is currently seeking motivated individuals to join our team in various entry-level positions. Whether you're starting your career in healthcare or seeking new opportunities to make a difference, we have roles available across our primary and specialty clinics, urgent care centers, and upcoming standalone Emergency Department. With...

Job Summary As a Profee Coder, you will be responsible for reviewing and coding clinical notes and operative reports for a minimum of one specialty. You will provide feedback and documentation advice to the physician, practice management, and other coders. You will also work with the denials team to resolve coding-related denials. You will be a key promoter of Central Coding and responsible for setting the tone of the Coding Physician Service Center as a service organization, continuously seeking to understand, meet, and exceed customer expectations and needs. What you will do in this role: Reviews and codes clinical notes and operative reports for assigned specialty/specialties. Coordinates and reconciles multiple schedules to ensure complete charge capture. Charge entry of codes into billing system in a timely manner. Work in conjunction with A/R team on follow up and resolution of coding related denials and rejections, including recommendation of new/updated coding edits....