24 denials coder jobs found

 Ophthalmology practice is seeking an experienced, organized Surgery Scheduler with strong medical billing and insurance knowledge. This is a full-time, onsite position in Las Vegas. Responsibilities: • Coordinate cataract, corneal, and oculoplastic surgeries from scheduling through postoperative appointments • Verify insurance eligibility, surgical benefits, deductibles, copays, and coinsurance • Obtain prior authorizations and required medical clearances • Prepare patient financial estimates and collect surgical payments • Coordinate with patients, physicians, surgery centers, and insurance companies • Maintain accurate surgery schedules, documentation, and follow-up • Assist with claim follow-up, denials, EOB review, and unresolved balances when needed Qualifications: • At least two years of surgery scheduling, medical billing, insurance verification, or related experience • Strong understanding of authorizations, CPT and ICD-10...

About the Role Wellness Direct LLC is an established behavioral health practice based in Cedar Grove, New Jersey, seeing patients remotely nationwide. This role, however, is hybrid and based out of our Cedar Grove office — see Location & Schedule below for the on-site expectation. This is one opening, filled at either the Specialist or Lead level depending on the experience the candidate brings; the level is determined during the interview process. The role owns full-cycle revenue cycle work in TherapyNotes: claims, ERA/EOB processing, denials, coding accuracy, patient billing support, and — at the Lead level — credentialing and oversight of the billing function. Specialist vs. Lead •     Specialist — Owns the day-to-day billing, coding, and claims work. Reports to the Billing Manager. No supervisory responsibility — a fit if you want to stay hands-on rather than manage people. •     Lead — Everything above, plus end-to-end credentialing and payer enrollment,...

APS Medical Billing, located in Toledo, Ohio, is seeking certified professional coders with experience in pathology 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. Requirements 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 preferred Experience in reviewing, resolving and preventing coding denials Understanding and application of CMS initiatives including NCCI Edits, MIPS and NCD/LCD polices Competitive wages; benefit package (Health, Health Savings Account, Dental, Vision, Personal Health Care Advisor, EAP, Life, 401k, Paid Holidays, Vacation & Earned Time Off (ETO). APS Medical Billing is an Equal Opportunity Employer....

* This is a hybrid position to be located in WI with travel required. * JOB SUMMARY The Coding and Billing Compliance Analyst plays a critical role in safeguarding the accuracy, integrity, and regulatory compliance of coding and billing operations across all service lines.  This position supports the organization’s revenue cycle and compliance initiatives by conducting detailed coding and billing reviews, identifying areas of risk, and contributing to the development of corrective action plans and educational programs.  The analyst ensures adherence to federal and state billing regulations, including Medicaid/Medicare guidelines, HRSA program requirements, and Office of Inspector General (OIG) guidance specific to Federally Qualified Health Centers (FQHCs).  The Analyst collaborates with providers, billing teams, compliance officers, and revenue cycle leadership, to improve clinical documentation, optimize reimbursement, and maintain full compliance with all applicable...

Job Summary The Medical Billing & Revenue Cycle Specialist will be responsible for managing and supporting the medical billing process from claim submission through payment and resolution. This individual will work closely with our administrative team, therapists, payers, and other team members to ensure accurate and timely billing, follow up on outstanding claims, resolve denials and billing issues, and support efficient revenue cycle processes. The ideal candidate is organized, detail-oriented, proactive, and comfortable working independently while also collaborating closely with a growing healthcare team. Responsibilities Prepare, review, and submit accurate claims to commercial insurance companies, Medicaid/managed Medicaid plans, and other applicable funding sources. Review claims and billing information for accuracy and completeness prior to submission. Monitor claim status and follow up on unpaid, denied, or rejected claims. Investigate and...

This is a non-remote position. We are seeking a detail-oriented, on-site Ophthalmology Coding Auditor to join our premier private practice. Under direct supervision of the Billing Manager, the Coding Auditor audits ophthalmology and optometry medical records for compliance with federal coding regulations and guidelines. Successful candidates will have extensive knowledge of auditing and education on CPT, ICD-10, and HCPCS codes and guidelines. In this role, you will work directly alongside our clinic team to review clinical documentation, surgical charts, and diagnostic reports, ensuring accurate coding, regulatory compliance, and optimal reimbursement. You will serve as our internal expert, identifying billing risk areas and providing face-to-face feedback and education to our providers and staff to support the financial health of our practice.   Key Responsibilities   Perform On-Site Audits: Conduct regular retrospective and prospective reviews of clinical...

Full-time    8-5 M-F Remote - must live in Texas Requirements Education:   High school diploma or equivalent  Certification :  Medical Coding certification through AAPC, AHIMA, RHIA or RHIT required Skills:   Computer literate, detailed oriented, demonstrates initiative, time management, able to multi-task, strong knowledge of medical terminology and anatomy, familiar with current insurance guidelines, understands payer coding denials, highly organized to work effectively and efficiently, goal driven, ability to multi-task, uses comprehensive and critical thinking for problem solving, effective verbal and written communication skills Experience:   Radiology coding required 2+ years current coding; 2+ years in medical office or related setting Job Description: CPT and ICD coding Radiology Procedures Assign “Merit-based Incentive Payment System” codes (MIPs) Maintain quality assurance standards for department Report any discrepancies...

Medical Appeals & Coding Specialist Job Summary University Medical Billing ( UMB )  is a fully remote department that is viewed as the premier billing office for the University of Utah School of Medicine, serving over 1,800 providers and 30 different specialties across Utah and surrounding states. We strive to be a great place to work while providing the best service to our customers. Our leaders and employees value collaboration, innovation, and accountability, and believe a successful candidate will exemplify these attributes too. We are looking for an experienced  Medical Appeals & Coding Specialist   to join our team. As the Medical Appeals & Coding Specialist, you will analyze and translate medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. Code records for use and planning by physicians, hospitals, research organizations, or insurance companies. Be knowledgeable of medical and clinical terminology,...

The Marwood Group is a healthcare advisory services firm headquartered in New York City with offices in Washington, DC, and London. The Healthcare Advisory Group advises and consults with the firm’s private equity and corporate clients on healthcare policy, strategy, and market analysis issues. Areas of focus include Medicare, Medicaid, commercial insurance, worker’s compensation, and clinical compliance. Marwood operates at the intersection of Wall Street and Washington, with experienced professionals from top banking, consulting, and healthcare operations firms, as well as senior political and governmental positions. The Advisory Group is currently accepting applications for an outpatient Certified Coding Auditor to work in its New York office or remotely. Principal duties and responsibilities: Perform remote billing and coding audits to ensure client coding practices are compliant with regulations and coverage policies for both government and commercial payors....

JOB SUMMARY: Support the Director of Health Information Management (HIM) by conducting comprehensive claim audits and reviewing hospital outpatient and professional fee (ProFee) claims for coding accuracy, revenue integrity, and billing compliance. Utilizing proprietary software, this role evaluates coding opportunities, identifies revenue cycle improvement recommendations, and assists clients in optimizing claim quality and reimbursement outcomes. The ideal candidate is an experienced outpatient facility coding professional with strong analytical skills, extensive knowledge of revenue cycle operations, and the ability to communicate complex coding concepts clearly to both clients and internal team members. This is a remote position ESSENTIAL DUTIES AND RESPONSIBILITIES:  Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of...

ASAAR Medical is seeking a HCC Coder & Provider Engagement Specialist ***This is NOT a REMOTE Position *** May require travel *** Duties: Reporting to the Director of MRA and Risk Adjustment Coding. The HCC / MRA Coder will offer real-time support and coordination for Primary Care Providers and Care Coordinators for MRA Risk Coding in a value-based care setting. Engages providers by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts ASAAR Medical's overall success first. Review patient charts and pursues excellence: Seeks out learning, strives to develop and expand personally, and continuously helps practices upgrade their capability to contribute to the ACO. Helps to educate clinician and non-clinician office staff on coding guidelines, documentation standards, and appropriate Medicare Risk Adjustment (MRA) procedures. Assists in education and transition with onboarding new providers, optimally within...

At this time, we are prioritizing candidates with at least one year of professional coding experience due to current training capacity.   Position Summary We are seeking detail-oriented Clinical Coding Specialists at all experience levels (entry, intermediate, and senior) to join our team. This role is designed as a unified opportunity for candidates with varying levels of coding expertise. Based on experience and qualifications, candidates will be aligned to the appropriate level within our coding structure. Clinical Coding Specialists are responsible for assigning accurate, compliant diagnosis and procedure codes across inpatient and outpatient services. This role works collaboratively with Health Information Management (HIM), Revenue Cycle, and clinical teams to ensure timely, high-quality coding that supports organizational, regulatory, and reimbursement requirements. Key Responsibilities Assign compliant, complete, and accurate codes based on clinical...

Prior Authorization Rep II Job Summary University Medical Billing ( UMB )  is a fully remote department that is viewed as the premier billing office for the University of Utah School of Medicine, serving over 1,800 providers and 30 different specialties across Utah and surrounding states. We strive to be a great place to work while providing the best service to our customers. Our leaders and employees value collaboration, innovation, and accountability, and believe a successful candidate will exemplify these attributes too.        We are looking for an experienced  Prior Authorization Representative  to join our team. As the Prior Authorization Rep, you will be responsible for ensuring accounts by performing insurance verification, obtaining benefit information, calculating patient estimates, and obtaining prior authorization before services are rendered. This position works with physicians, nurses, clinic managers and financial advocates to resolve issues that...

Coding Auditor AllCare Health | Quality Department | Grants Pass, Oregon We Are Seeking Qualified Candidates to Join Our Team! AllCare Health offers competitive wages and an excellent benefits package, including affordable healthcare, 401(k) retirement, wellness programs, and flexible scheduling options. Summary of the Position The Coding Auditor is responsible for developing, implementing, and maintaining auditing practices related to medical record coding and documentation to support accurate and complete risk adjustment outcomes for Medicare members. This position reviews medical records and coding for accuracy and compliance with Centers for Medicare & Medicaid Services (CMS) Risk Adjustment Data Validation (RADV) requirements, identifies coding and documentation trends, and works collaboratively with providers and internal teams to improve documentation, coding accuracy, and risk adjustment outcomes. Essential Duties Ensures the accuracy and...