8 coder edit denials jobs found

Datavant is the data collaboration platform trusted for healthcare. Guided by our mission to make the world's health data secure, accessible and actionable, we provide critical data solutions for organizations across the healthcare ecosystem - including providers, health plans, researchers, and life sciences companies. From fulfilling a single patient's request for their medical records to powering the AI revolution in healthcare, Datavanters are building the future of how data is connected and used to improve health. By joining Datavant today, you're stepping onto a driven and highly collaborative team that is passionate about creating transformative change in healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses high attention to detail and a depth of knowledge in medical terminology. This role is fully remote with a flexible schedule, allowing you to help shape the...

Coder APS Medical Billing located in Toledo, Ohio is seeking certified professional coders with experience in surgical pathology or diagnostic radiology to become part of our progressive team. This position works with clients to ensure proper documentation for charge capture and remains current with industry guidelines. $45,000.00 to $54,000.00 annually Qualifications Demonstrated ICD-10-CM proficiency Demonstrated understanding of the CPT guidelines for separate procedures, bundling, and add-on-codes Experience in abstracting medical records for accurate CPT code assignments Experience in surgical pathology or diagnostic radiology preferred Understanding and application of CMS initiatives including NCCI Edits, MIPS, and NCD/LCD policies Benefits Package includes Paid Time Off Medical plan Health Savings Account Alight Personal Health Care Advisor Dental, Vision, Life Insurance, 401K Paid holidays EAP - Employee Assistance Program We are an Equal Opportunity...

Job Description Job Description Description: About Primary Health Solutions Our Mission We meet people where they are and partner with them on their journey towards wellness. Our Vision The destination for servant leaders to provide comprehensive and exceptional care. Our Values R – Respect I – Innovation S – Stewardship E – Excellence Billing and Coding Specialist Summary Responsible for entering/auditing/coding patient services to ensure encounters transfer properly for submission to insurance payers. Analyze coding related claim issues, process gaps and denials to trend feedback for providers by location and/or specialty. A Day in the Life · Review provider documentation (including hospital procedures) and translate services into correct codes. Append payer specific modifiers and claim criteria when applicable. · Review incomplete encounters and code based on available documentation in EHR systems. · Know and understand several different...

GENERAL SUMMARY Works under the supervision of the HIM Manager (Operations & Auditing). The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting. Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately. Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines. Performs other duties as assigned. QUALIFICATIONS Education: High School Diploma or successful completion of an equivalent High School Exam Required Successful completion of the HIM Coder – Professional/HCC competency exam within 6 months of hire required...

Job Details Physician Office | Kettering | Full-Time | First Shift Responsibilities & Requirements Responsibilities & Requirements This position under the direction of the Manager of Professional Services Coding is responsible for coding compliance, HCC capture and EPIC WQ Reconciliation. KPN Pro Fee Coding Specialist Serves as the subject matter expert ensuring coding compliance, knowledge of CMS billing rules and regulations and serves as a professional fee coding resource to network service lines. Demonstrates knowledge of CPT, HCPCS, ICD-10 and CMS NCCI edits Reviewing the ambulatory records for the appropriate risk adjustment components Identify opportunities for the provider to have supplemental documentation to support the Hierarchical Condition Category (HCC) codes Accurately assess documentation in EPIC EMR to assign appropriate CPT, HCPCS and ICD-10 Reviews and researches pending and denied claims pertaining to professional fee...

HIM Coder - Professional Works under the supervision of the HIM Manager (Operations & Auditing). The primary function of the HIM Coder - Professional is to code and charge medical office visits for professional claims. Must be able to review and edit charges in Meditech as well as review leveling criteria for E/M charging accuracy, charge for procedures and other billable services provided in the clinic/office setting. Must be able to code ICD-10 diagnoses and CPT codes while ensuring they are assigned correctly and sequenced appropriately. Must apply HCC/risk coding concepts to ensure the appropriate risk score is assigned to each patient. Must understand the basic ICD-10 diagnosis and CPT procedure coding rules and guidelines. Performs other duties as assigned. Qualifications: Education: High School Diploma or successful completion of an equivalent High School Exam Required Successful completion of the HIM Coder – Professional/HCC competency exam within 6 months...

Inpatient Coder - Work at Home - Any State Bon Secours Mercy Health is dedicated to improving health care quality, safety and cost effectiveness. We are seeking an advanced inpatient coder to work at home in any state. Key Responsibilities Review medical record documentation and accurately assign ICD‑10 diagnoses and procedure codes, supporting correct Medicare Severity‑Diagnosis Related Group (MS‑DRG) or All Patient Refined Diagnosis Related Group (APR‑DRG). Verify patient discharge disposition and assign present‑on‑admission (POA) indicators for each code. Abstract required data per facility specifications and write appeals for DRG denials. Monitor and process inpatient accounts through the billing system, ensuring timely, compliant processing. Collaborate with Clinical Documentation Specialists and medical staff to ensure complete documentation and accurate coding. Maintain quality, productivity standards and key performance indicators for 3M 360 CAC for CRS and Direct...

University of Toledo Physicians' mission is to improve the human condition through excellence in patient care and medical discovery.Representing more than 200 physicians, UT Physicians are leaders in clinical care, research and education of the future physicians, providing care in a wide range of medical specialties from the most complex diagnoses and treatments to primary care for the entire family.The primary site of inpatient care services is at the University of Toledo Medical Center, but many of our physicians' practice at hospitals and medical offices throughout the region.University of Toledo Physicians offers competitive pay and benefits including:403B, Pension, health and tuition waiver at UT.POSITION SUMMARYThe Certified Coder is responsible for coding ICD diagnosis and CPT facility and professional codes.Assignment may include outpatient clinic visits, diagnostic procedures, outpatient surgeries, observation and inpatient encounters, and emergency room charges for the...