35 coder edits denials jobs found

Job Description Job Description The ideal candidate would have thorough knowledge of not only CPT and preventive services but also versed in complex surgical procedures to assist in reviewing potential bundling issues and medical necessity concerns. Coder must have experience with different specialties (OB, Ortho, Gen Surg, Peds) as well as with coding denials and appeal processes with different payers. Must also have experience with GA Medicaid, if possible. Coder will help direct billers on how to correct edits or what is needed on coding denials. Primarily E/M, both office and facility Some procedures CPC required MUST be current on the Profee EM guidelines Current Epic experience is required

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary The Coder III is responsible for reviewing for physician services and interpreting physician documentation, CPT and diagnosis coding, coding claim edit, and coding denial management utilizing ICD-10-CM and CPT-4/HCPCS coding systems. Codes highly complex surgical, special procedures, observation records, inpatient records, medical, diagnostic, procedural, and/or recurring records within established productivity and coding accuracy guidelines. Highly complex surgeries may require research and reference checking to ensure accuracy of problematic coding. Extracts pertinent information from clinical notes, operative notes, radiology reports, laboratory reports, (including Pathology), procedure records, specialty forms, etc. Determines...

Job Description Job Description Medical Coding Specialist – Orthopedics Location: Atlanta, GA 30327 | Full-Time | In-Person Join Our Team at Ortho Sport & Spine Physicians Ortho Sport & Spine Physicians is seeking an experienced, highly detail-oriented Medical Coding Specialist to join our growing team. This position is responsible for reviewing clinical documentation, accurately assigning diagnosis and procedure codes, ensuring coding compliance, and supporting accurate and timely claims submission and reimbursement. The ideal candidate will have strong outpatient E/M and orthopedic coding experience, a thorough understanding of current CPT, ICD-10-CM, and HCPCS guidelines, and the ability to independently review documentation and determine the appropriate level of service. What You'll Do Medical Coding · Review provider documentation, medical records, operative reports, and clinical notes to accurately assign ICD-10-CM, CPT, and HCPCS codes. · Assign diagnosis...

Grady Health System Coding Position Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary The Coder II is responsible for coding and abstracting procedural (CPT) and diagnosis codes (ICD-10) for physician services, reviewing physician documentation in the electronic medical record for completeness and accuracy to ensure proper code assignment, providing physician feedback of discrepancies/trends, resolving edits and denials, and releasing encounters for billing. Utilizes intermediate problem-solving skills to address coding related tasks of detailed, medium complexity. Duties include procedural (CPT) and diagnosis (ICD-10) coding for all places of service, including, but not limited to ER, observation, inpatient, outpatient, ambulatory surgery, and other ancillary services. Responsible for...

Coder III The Coder is responsible for reviewing outpatient clinical documentation via Epic and 3M CAC for assignment of ICD-10-CM diagnoses and CPT-4/HCPCS procedure coding systems. Through knowledge of coding conventions and guidelines. Ability to address commonly applied modifiers for hospital outpatient accounts. Extracts pertinent information from clinical notes, operative notes, radiology reports, laboratory reports, (including Pathology), procedure records, specialty forms, etc. Determines complex code assignment pertinent to emergency visits and diagnostic workups. The Multispecialty Coder must possess a strong surgical specialty background in some of the following specialties: Neurosurgery, Trauma, Ortho, Plastic Surgery, etc. Codes complex surgical, special procedures, observation records, inpatient records, medical, diagnostic, procedural, and/or recurring records within. Highly complex surgeries may require research and reference checking to ensure accuracy of...

Location: Atlanta, Georgia, United States Company: NorthPoint Search Group Posted: Medical Coder – Orthopedics Who A growing orthopedic healthcare organization seeking an experienced Medical Coder with strong orthopedic coding expertise and a commitment to accuracy, compliance, and revenue cycle excellence. What An opportunity to manage accurate medical coding for orthopedic procedures, ensure documentation integrity, support reimbursement, and help minimize claim denials. When Immediate opportunity for a qualified Medical Coder looking to contribute to a growing healthcare organization. Where An established orthopedic healthcare organization with a collaborative and supportive team environment. Why Join a growing healthcare organization where your coding expertise will directly contribute to accurate reimbursement, operational efficiency, and quality patient care. Office Environment Full-time, in-office position. Salary Competitive compensation...

Responsibilities Review adjudicated medical claims that have been denied and resubmitted by providers for reconsideration. Review medical documentation in support of Evaluation and Management in compliance with current CPT, HCPCS, ICD-10, and CMS guidelines, as well as company-specific reimbursement policies, competitor specific medical policies, reimbursement policies, and editing rules, as well as conducting clinical research, data analysis, and identification of legislative mandates to support draft development and/or revision of enterprise reimbursement policy. Analyze claim documentation, coding accuracy, and medical record details to determine if denial reasons are valid or if payment reconsideration is warranted. Conduct detailed coding audits to validate proper code assignment and adherence to medical necessity and billing regulations. Coordinates research and responds to system inquiries and appeals. Conducts research of claims systems and system edits to identify...

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary The Coder is responsible for reviewing outpatient clinical documentation via Epic and 3M CAC for assignment of ICD-10-CM diagnoses and CPT-4/HCPCS procedure coding systems. Through knowledge of coding conventions and guidelines. Ability to address commonly applied modifiers for hospital outpatient accounts. Extracts pertinent information from clinical notes, operative notes, radiology reports, laboratory reports, (including Pathology), procedure records, specialty forms, etc. Determines complex code assignment pertinent to emergency visits and diagnostic workups. CODER III The Multispecialty Coder must possess a strong surgical specialty background in some of the following specialties: Neurosurgery, Trauma, Ortho, Plastic...

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary Responsible for coding and abstracting procedural (CPT) and diagnosis codes (ICD-10) for physician services, reviewing physician documentation in the electronic medical record for completeness and accuracy to ensure proper code assignment, providing physician feedback of discrepancies/trends, resolving edits and denials, and releasing encounters for billing. Utilizes intermediate problem-solving skills to address coding related tasks of detailed, medium complexity. Duties include procedural (CPT) and diagnosis (ICD-10) coding for all places of service, including, but not limited to ER, observation, inpatient, outpatient, ambulatory surgery, and other ancillary services. Responsible for reviewing, analyzing, and interpreting physician...

Job InformationMedical Biller / Certified Coder & Auditor Presented by Symbiotic Services, LLC Location: Atlanta, GA Area | On-Site Employment Type: Full-Time (Pending Confirmation) Position Overview Symbiotic Services is seeking an experienced, detail-oriented Medical Biller / Certified Coder & Auditor for a confidential client in the specialty healthcare industry in the Atlanta, GA area. This position will be responsible for accurate medical coding, billing, and auditing across a complex, high-volume healthcare revenue cycle, with a particular emphasis on oncology, hematology, infusion services, and specialized treatment programs. The ideal candidate possesses extensive knowledge of medical coding guidelines, payer reimbursement policies, and compliance requirements, along with the ability to identify billing discrepancies, resolve claim issues, and optimize revenue cycle performance. This opportunity is well suited for a certified coding professional who thrives in a...

Brief Description SENTA Partners is a leading Management Services Organization (MSO) specializing in providing comprehensive support to ENT and Allergy private practices. Our mission is to help people Breathe better, Hear better, Live better. At SENTA, we focus on the operational efficiencies and financial performance of our partner practices, allowing physicians to focus on delivering exceptional patient care. We are committed to fostering a collaborative and supportive work environment where our employees can thrive and grow. Position Summary The Professional Coder is responsible for reviewing clinical documentation and accurately assigning CPT, HCPCS, ICD-10-CM, and applicable modifier codes for professional medical services. This role ensures compliance with established coding guidelines, CMS regulations, NCCI edits, payer policies, and organizational standards to support accurate reimbursement, clean claims, and regulatory compliance. The Professional Coder collaborates...

Medical Coder – OrthopedicsA growing orthopedic healthcare organization seeking an experienced Medical Coder with strong orthopedic coding expertise and a commitment to accuracy, compliance, and revenue cycle excellence.An opportunity to manage accurate medical coding for orthopedic procedures, ensure documentation integrity, support reimbursement, and help minimize claim denials.Immediate opportunity for a qualified Medical Coder looking to contribute to a growing healthcare organization.An established orthopedic healthcare organization with a collaborative and supportive team environment.Join a growing healthcare organization where your coding expertise will directly contribute to accurate reimbursement, operational efficiency, and quality patient care.Full-time, in-office position.Competitive compensation based on experience, with excellent benefits and generous paid time off (PTO).Position OverviewWe are seeking an experienced Medical Coder specializing in Orthopedics to join a...

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary Responsible for coding and abstracting procedural (CPT) and diagnosis codes (ICD-10) for physician services, reviewing physician documentation in the electronic medical record for completeness and accuracy to ensure proper code assignment, providing physician feedback of discrepancies/trends, resolving edits and denials, and releasing encounters for billing. Utilizes intermediate problem-solving skills to address coding related tasks of detailed, medium complexity. Duties include procedural (CPT) and diagnosis (ICD-10) coding for all places of service, including, but not limited to ER, observation, inpatient, outpatient, ambulatory surgery, and other ancillary services. Responsible for reviewing, analyzing, and interpreting physician...

Medical Coding Specialist – OrthopedicsLocation: Atlanta, GA 30327 | Full-Time | In-PersonJoin Our Team at Ortho Sport & Spine PhysiciansOrtho Sport & Spine Physicians is seeking an experienced, highly detail-oriented Medical Coding Specialist to join our growing team.This position is responsible for reviewing clinical documentation, accurately assigning diagnosis and procedure codes, ensuring coding compliance, and supporting accurate and timely claims submission and reimbursement.The ideal candidate will have strong outpatient E/M and orthopedic coding experience, a thorough understanding of current CPT, ICD-10-CM, and HCPCS guidelines, and the ability to independently review documentation and determine the appropriate level of service.What You'll DoMedical CodingReview provider documentation, medical records, operative reports, and clinical notes to accurately assign ICD-10-CM, CPT, and HCPCS codes.Assign diagnosis codes based on documented clinical conditions, medical...

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary The Coder III is responsible for reviewing for physician services and interpreting physician documentation, CPT and diagnosis coding, coding claim edit, and coding denial management utilizing ICD-10-CM and CPT-4/HCPCS coding systems. Codes highly complex surgical, special procedures, observation records, inpatient records, medical, diagnostic, procedural, and/or recurring records within established productivity and coding accuracy guidelines. Highly complex surgeries may require research and reference checking to ensure accuracy of problematic coding. Extracts pertinent information from clinical notes, operative notes, radiology reports, laboratory reports, (including Pathology), procedure records, specialty forms, etc. Determines...

Description Medical Coding Specialist - Orthopedics Location: Atlanta, GA 30327 | Full-Time | In-Person Join Our Team at Ortho Sport & Spine Physicians Ortho Sport & Spine Physicians is seeking an experienced, highly detail-oriented Medical Coding Specialist to join our growing team. This position is responsible for reviewing clinical documentation, accurately assigning diagnosis and procedure codes, ensuring coding compliance, and supporting accurate and timely claims submission and reimbursement. The ideal candidate will have strong outpatient E/M and orthopedic coding experience, a thorough understanding of current CPT, ICD-10-CM, and HCPCS guidelines, and the ability to independently review documentation and determine the appropriate level of service. What You'll Do Medical Coding • Review provider documentation, medical records, operative reports, and clinical notes to accurately assign ICD-10-CM, CPT, and HCPCS codes. • Assign diagnosis codes based...

Overview Be inspired. Be valued. Belong. At Emory Healthcare At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more Description RESPONSIBILITIES: TheHospital Outpatient Coder Level II uses clinical coding knowledge, based on the Official Coding Guidelines and AHA Coding Clinic, to assign ICD-9/ICD-10 and CPT codes to the highest level of accuracy for each Ambulatory Surgery, Gastrointestinal, Infusion and Observation encounter. Works closely with physicians, clinical documentation improvement...

ProSidian is looking for “Great People Who Lead” at all levels in the organization. Are you a talented professional ready to deliver real value to clients in a fast-paced, challenging environment? ProSidian Consulting is looking for professionals who share our commitment to integrity, quality, and value. ProSidian 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. Linking strategy to execution, ProSidian assists client leaders in maximizing company return on investment capital through design and execution of operations core to delivering value to customers. Visit www.ProSidian.com or follow the company on Twitter at www.twitter.com/prosidian for more information. Job Description ProSidian Seeks a Medical Coder and Abstractor...

Inpatient Facility Coder LaSalle Network is partnering with Amplify to hire an Inpatient Facility Coder to support complex inpatient coding for Level II trauma cases. This contract-to-hire opportunity offers a fully remote work environment and the potential for long-term employment. The ideal candidate is an experienced, credentialed inpatient coder with a strong understanding of ICD-10-CM and ICD-10-PCS coding, DRG validation, and complex community hospital cases. This role is well suited for someone who can balance productivity and accuracy while navigating challenging clinical documentation in a fast-paced environment. Responsibilities Review inpatient medical records and assign accurate ICD-10-CM and ICD-10-PCS codes while meeting established productivity and quality standards. Validate MS-DRG assignments and ensure accurate coding and grouping outcomes. Abstract clinical data to support accurate inpatient facility claims and reporting. Review and resolve coding-related...

Coder III Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you. Job Summary The Coder III is responsible for reviewing for physician services and interpreting physician documentation, CPT and diagnosis coding, coding claim edit, and coding denial management utilizing ICD-10-CM and CPT-4/HCPCS coding systems. Codes highly complex surgical, special procedures, observation records, inpatient records, medical, diagnostic, procedural, and/or recurring records within established productivity and coding accuracy guidelines. Highly complex surgeries may require research and reference checking to ensure accuracy of problematic coding. Extracts pertinent information from clinical notes, operative notes, radiology reports, laboratory reports, (including Pathology), procedure records, specialty forms, etc....

Medical Coder - Edit and Charge Review Focus Hourly Compensation: $21.00 - $25.00 per hour (based on experience) + Bonus Plan Eligibility FLSA Classification: Nonexempt, Full-Time, Benefit Eligible Location: Remote. East Coast and SC Upstate area candidates strongly preferred. The Opportunity: The Certified Medical Coder is responsible for reviewing clinician-entered charge suggestions, resolving coding edits, validating charge accuracy, and managing coding queues within obstetric and GYN services. This role supports accurate charge capture by reviewing suggested CPT, HCPCS, and ICD-10 coding and making coding corrections when documentation review identifies discrepancies or opportunities for improvement. This role is primarily focused on coding validation and edit resolution rather than routine chart abstraction or full medical record coding. OBHG is a great place to work, offering remote work opportunities, a monthly bonus program, health and 401(k) benefits, generous paid...

Emory Healthcare Be inspired. Be valued. Belong. At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: Comprehensive health benefits that start day 1 Student Loan Repayment Assistance & Reimbursement Programs Family-focused benefits Wellness incentives Ongoing mentorship, development, leadership programs And more LOCATION: Remote This position is remote; however, applicants must be physically located and authorized to work in one of the following states: Alabama, Arkansas, Florida, Georgia, Illinois, Louisiana, Michigan, New Hampshire, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Wisconsin Description RESPONSIBILITIES: The Hospital Outpatient Coder Level II uses clinical coding knowledge,...

Oncology Coder LaSalle Network is partnering with our client to hire an Oncology Coder. This contract-to-hire Oncology Coder opportunity is fully remote and offers the chance to make an immediate impact by ensuring accurate, compliant coding across complex surgical, procedural and E&M professional services. In this Oncology Coder role, you will leverage your expertise in ICD-CM and CPT-4 coding, quality standards and reimbursement guidelines to support clean claims, accurate charge capture and strong compliance outcomes. This is an exciting opportunity to join a growing team and contribute to high-visibility coding and validation initiatives. Responsibilities Analyze medical records and accurately code diagnostic and procedural information in alignment with nationally recognized coding guidelines and reimbursement requirements. Assign ICD-CM and CPT-4 codes for appropriate APC assignment and address NCCI edits and charge reconciliation as needed....

Inpatient Facility Coder LaSalle Network is partnering with Amplify to hire an Inpatient Facility Coder to support complex inpatient coding for Level II trauma cases. This contract-to-hire opportunity offers a fully remote work environment and the potential for long-term employment. The ideal candidate is an experienced, credentialed inpatient coder with a strong understanding of ICD-10-CM and ICD-10-PCS coding, DRG validation, and complex community hospital cases. This role is well suited for someone who can balance productivity and accuracy while navigating challenging clinical documentation in a fast-paced environment. Responsibilities Review inpatient medical records and assign accurate ICD-10-CM and ICD-10-PCS codes while meeting established productivity and quality standards. Validate MS-DRG assignments and ensure accurate coding and grouping outcomes. Abstract clinical data to support accurate inpatient facility claims and reporting. Review and resolve...