17 coder edits denials jobs found

Edit & Denials CoderRequired Skills & Experience- 5 years minimum of Edit & Denials codingProfessional and facility coding.Ability to operate across multiple clients.Experience making changes in EHR systemsExperience reviewing and correcting coding edits.Strong communication and collaboration skills.Job DescriptionWe are seeking an Edit & Denials Coder to review medical records to determine appropriate billing codes and necessary documentation. This role is responsible for performing advanced coding and appeal activities; investigating payer issues, completing charge corrections, and for timely filing of appeals to insurance companies. Key Responsibilities: Reviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse. Creates appropriate letters to substantiate the validity of claims. Meets with facility liaison to review documentation, resolve...

Edit & Denials CoderRequired Skills & Experience- 5 years minimum of Edit & Denials codingProfessional and facility coding.Ability to operate across multiple clients.Experience making changes in EHR systemsExperience reviewing and correcting coding edits.Strong communication and collaboration skills.Job DescriptionWe are seeking an Edit & Denials Coder to review medical records to determine appropriate billing codes and necessary documentation. This role is responsible for performing advanced coding and appeal activities; investigating payer issues, completing charge corrections, and for timely filing of appeals to insurance companies.Key Responsibilities:Reviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse. Creates appropriate letters to substantiate the validity of claims.Meets with facility liaison to review documentation, resolve coding, and...

Insight Global is seeking an Edit & Denials Coder to review medical records and determine appropriate billing codes and necessary documentation. The role involves advanced coding and appeal activities, investigating payer issues, and timely filing of appeals to insurance companies. The candidate should have at least 5 years of experience in edit and denials coding across professional and facility settings, with proficiency in EHR systems and payor policies. #J-18808-Ljbffr

The Medical Billing & Coding Specialist will review completed encounters and claims prior to submission to identify coding, billing, demographic, payer, and claim-form errors. The goal of this position is to make sure claims are clean and accurate before they are submitted, reducing denials, rework, and payment delays. The position is expected to require approximately 1–2 hours per day, with flexibility in scheduling based on clinic volume. Key Responsibilities Include: Review completed encounters and claims for accuracy before submission Verify that appropriate CPT, HCPCS, ICD-10-CM, and applicable modifiers are used Review claims for common billing errors and missing information Ensure claims are submitted using the appropriate billing methodology for Rural Health Clinic (RHC) services Review payer‑specific requirements and identify potential claim issues before submission Assist with proper billing of Medicare, TennCare/Medicaid, Medicare Advantage,...

Who We Are Xtensys is a rapidly growing managed service provider delivering innovative technology solutions to health systems, beginning in New York and expanding nationwide. Owned by two industry leaders with a strong focus on advancing rural and community healthcare, Xtensys is executing several major initiatives and scaling quickly. With a team of more than 500 professionals, we are building a people-centered culture rooted in collaboration, innovation, and strategic thinking. How We Work East Coast Alignment: Our core operational and collaboration hours follow the Eastern Time Zone (ET), keeping our workflows synchronized with our primary clients and systems. Why Join Us? Mission-Driven Work: You are the "bridge" ensuring technology serves health systems and their patients when they need it most. Autonomy & Ownership: We trust you. You’ll lead projects, define success, and manage complexities with total support. A Culture of Innovation: Have a fresh perspective? We want it....

Job Summary The Outpatient Coder-Edits is responsible for daily review and resolution of outpatient (observation/surgical) coding-related alerts/edits by monitoring aging accounts and prioritizing, providing resolution, and identifying barriers preventing outpatient claims from being billed and reimbursed timely. This individual will be required to make independent decisions regarding accurate ICD-10-CMS & CPT/HCPCS code assignments which will play a key role in determining the reimbursement potential of CHS with adherence to compliant coding standards and corporate policies developed to ensure accurate billing. Essential Functions Modify and complete moderate to high complexity outpatient coding edits/errors using ICD-10-CM, CPT and HCPCS (All outpatient types) or another designated coding classification system in accordance with coding rules and regulations; missing and/or incorrect modifiers, CCI edits, payor medical necessity denials, etc. Work in Bill...

The Medical Billing & Coding Specialist will review completed encounters and claims prior to submission to identify coding, billing, demographic, payer, and claim-form errors. The goal of this position is to make sure claims are clean and accurate before they are submitted, reducing denials, rework, and payment delays. The position is expected to require approximately 1–2 hours per day, with flexibility in scheduling based on clinic volume. Key Responsibilities Include: ● Review completed encounters and claims for accuracy before submission ● Verify that appropriate CPT, HCPCS, ICD-10-CM, and applicable modifiers are used ● Review claims for common billing errors and missing information ● Ensure claims are submitted using the appropriate billing methodology for Rural Health Clinic (RHC) services ● Review payer-specific requirements and identify potential claim issues before submission ● Assist with proper billing of Medicare, TennCare/Medicaid, Medicare...

Outpatient CoderThe Outpatient Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS codes for outpatient services, including emergency department visits, outpatient surgeries, observation stays, interventional radiology, wound care, and ancillary procedures. This role ensures compliance with coding guidelines, regulatory requirements, and corporate billing policies, while contributing to accurate reimbursement and data integrity. The Outpatient Coder reviews medical records and applies appropriate codes within hospital coding systems.Essential FunctionsReviews and assigns appropriate ICD-10-CM, CPT, and HCPCS codes for outpatient records, ensuring compliance with coding and billing regulations.Codes a variety of outpatient encounters, including Cardiology: Cath, Stent/Angioplasty, IVUS, Pacemaker, Leadless Placement, AICD Placement, Vascular Surgery: Thrombectomy, Embolization, Angioplasty, Revascularization, A/V Fistula creation Interventional RAD/Spinal...

Outpatient CoderThe Outpatient Coder is responsible for accurately assigning ICD-10-CM, CPT, and HCPCS codes for outpatient services, including emergency department visits, outpatient surgeries, observation stays, interventional radiology, wound care, and ancillary procedures. This role ensures compliance with coding guidelines, regulatory requirements, and corporate billing policies, while contributing to accurate reimbursement and data integrity. The Outpatient Coder reviews medical records and applies appropriate codes within hospital coding systems.Essential FunctionsReviews and assigns appropriate ICD-10-CM, CPT, and HCPCS codes for outpatient records, ensuring compliance with coding and billing regulations.Codes a variety of outpatient encounters, including observation stays, outpatient surgeries, interventional radiology, cardiac catheterization, emergency department visits, wound care, and ancillary services.Applies correct coding guidelines and payer-specific policies,...

Multi-Specialty ProFee CoderRequired Skills & Experience: 3+ years of Professional Fee (ProFee) coding experience within a physician practice, hospital, or healthcare system. Minimum 3 to 5 years of recent coding experience (within the last 5 years) across multiple specialties, including: Primary Care, Orthopedics, Neurology, Emergency Department (ED), Urology. Hands-on experience with Charge Entry processes and revenue cycle workflows. Experience coding and charging for: Drug Administration services, Therapeutic Injections, Infusion Services, Hydration Services. Active coding certification through AAPC or AHIMA required. Active RHIT, RHIA, CPC, COC, CCS-P, CCS, CEDC, or equivalent credential required. Strong knowledge of CPT, HCPCS Level II, and ICD-10-CM coding guidelines. Experience reviewing physician documentation to ensure accurate code assignment and reimbursement. Working knowledge of Evaluation & Management (E/M) coding guidelines across multiple specialties....

Job Description Job Description Certified Medical Biller and Coder Position Summary Xpedited Care is seeking an experienced Certified Medical Biller and Coder responsible for accurate medical coding, claim submission, payment posting, denial management, accounts receivable follow-up, and overall revenue cycle support. The Certified Medical Biller and Coder must ensure that services are coded and billed accurately based on provider documentation, payer requirements, and applicable coding guidelines. This position requires strong attention to detail, knowledge of urgent care and primary care billing, and the ability to identify and resolve claim issues before they negatively affect reimbursement. Essential Duties and Responsibilities Medical Coding and Charge Review Review provider documentation for completeness and coding accuracy before claim submission. Assign and validate appropriate ICD-10-CM, CPT, and HCPCS Level II codes. Review E/M services and determine...

Outpatient Coder-EditsThe Outpatient Coder-Edits is responsible for daily review and resolution of outpatient (observation/surgical) coding-related alerts/edits by monitoring aging accounts and prioritizing, providing resolution, and identifying barriers preventing outpatient claims from being billed and reimbursed timely. This individual will be required to make independent decisions regarding accurate ICD-10-CMS & CPT/HCPCS code assignments which will play a key role in determining the reimbursement potential of CHS with adherence to compliant coding standards and corporate policies developed to ensure accurate billing.Essential FunctionsModify and complete moderate to high complexity outpatient coding edits/errors using ICD-10-CM, CPT and HCPCS (All outpatient types) or another designated coding classification system in accordance with coding rules and regulations; missing and/or incorrect modifiers, CCI edits, payor medical necessity denials, etc.Work in Bill Scrubber...

Community Health Systems - 4000 Meridian Boulevard - Responsibilities: Reviews and assigns ICD-10-CM, CPT, HCPCS codes for outpatient records; Codes outpatient encounters including ED visits, outpatient procedures, interventional radiology; Ensures compliance with LCD/NCD and payer policies; Resolves edits/denials and collaborates with CDI/billing; Maintains coding productivity and accuracy standards

Overview Medical Biller Remote Position: Southeast U.S. (Eligible states: TN, KY, NC, GA, AL, VA, MS, AR, MO) Full Time , 80 Hours Per Pay Period, Day Shift Covenant Health Overview: Covenant Health is the region’s top-performing healthcare network with 10 hospitals (http://www.covenanthealth.com/hospitals/) , outpatient and specialty services (http://www.covenanthealth.com/services/) , and Covenant Medical Group (http://www.covenantmedicalgroup.org/) , our area’s fastest-growing physician practice division. Headquartered in Knoxville, Covenant Health is a community-owned integrated healthcare delivery system and the area’s largest employer. Our more than 11,000 employees, volunteers, and 1,500 affiliated physicians are dedicated to improving the quality of life for the more than two million patients and families we serve every year. Covenant Health is the only healthcare system in East Tennessee to be named a Forbes “Best Employer” seven times. Position Overview:...

## Coder, OutpatientApply: Ovation Healthcare - Remote CST: Full time: Posted 5 Days Ago: R2784# **About the Job** **Welcome to Ovation Healthcare!**At Ovation Healthcare (formerly QHR Health), we’ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions.The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare’s vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership,...

Job Details Job Location: Midtown Plaza (PLZ) - Nashville, TN 37203. Position Type: Full Time. Job Shift: Day. Job Category: Finance. Summary The Charge Entry Specialist captures and reviews all billing codes prior to electronic claims filing, for accuracy and adherence to payer specific coding guidelines, for a multi-specialty physician group practice. Essential Duties and Responsibilities Captures and reviews daily charges from the Electronic Health Record’s Charge Passing System to ensure standard coding and billing guidelines are followed correctly. Utilizes CPT, ICD-10CM, and HCPCS coding as well as correct Modifier usage during daily reviews of Primary Care services. Other specialties may be added based on performance level. Communicates effectively and respectfully, both in verbal and written form, with providers or clinical staff to obtain missing or incomplete information. Audits the imported encounters against the daily appointment schedule to ensure all encounters have...

Remote Op CoderThe Op Coder works outpatient coding related alerts / edits for Same Day Surgery, Observation, and Wound Care, accounts, predominately post initial / final coding.The CARS-II performs the alert / edit resolution activities in the applicable systems.The alerts / edits shall be worked and corrected according to the established procedures and thresholds, and communicated as appropriate.Position Duties :Compiles daily work list from eRequest, CRT and / or other alert / edit systemsTakes action and resolves alerts / edits for the following patient types following established procedures and thresholds :Same Day Surgery (SDC)Observation (OBV)Wound CareOutpatient Cardiac CathProvides back up / coverage as needed for :Emergency Dept (ED)Recurring (RCR)Clinical (CLI)Provider Office Visit (POV), as applicableEnters detailed notes to update eRequest to provide details if the alert / edit cannot be resolved or must be rerouted to another responsible party for research /...