33 denials coder 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...

Description This is a remote, advanced position functioning under general supervision and utilizing independent decision making. -The Coder Inpatient II correctly assigns ICD diagnosis and procedure codes and MS-DRGs for inpatient hospital services at Hospital, an academic, Level I Trauma Center. -The Coder Inpatient II codes a variety of medical and surgical specialties such as Neurology, Oncology, Urology, Transplant, OB/Newborn, Ortho, Cardiology, and Critical Care which can include complex trauma and acutely ill patients. -Coders in this role communicate with care providers when necessary mainly via the electronic query process. -In order to ensure the most appropriate DRG assignment, coders partner with clinical documentation improvement specialists with the goal of obtaining the most complete and accurate medical record documentation. -The coders in this position will apply all departmental coding quality guidelines and meet productivity standards, while maintaining a 95%...

Essential Duties and Responsibilities: - Abstract and code clinical data. - Audit medical records to ensure compliance with the organization's coding procedures and standards. - Accurately enter coded data in a system and validate data entered. - Research correct coding practices, clearly document and share findings with others. - Review denials and recommend billing corrections. - Train staff members on the coding process. Minimum Requirements - High School diploma or equivalent with 0 - 2 years of experience. - Additional clinical licensure may be required based on project. - Must be a Certified Medical Coder, Certified Professional Coder, or a Certified Coding Specialist. - Knowledge of Medical Billing and Coding Systems such as CPT and HCPCS is essential. - Ability to work a schedule between the hours of 8:00am - 5:00pm EST Monday - Friday required. Additional Skills and Experience: - Familiarity with retrospective payment reimbursement highly preferred....

The Medical Billing Specialist performs all functions as it relates to the billing and collections of accounts receivables for the billing for the Ambulatory Surgery Centers (ASC) for Twin Cities Orthopedics. This position will do training at the Golden Valley Business Center and then be fully remote. A $1,500 sign-on bonus will be offered, payable on first paycheck with a 12-month commitment. Internal applicants are not eligible for sign-on bonus. Essential Functions: Perform all daily functions as it relates to full accounts receivable management. Essential tasks include (but not limited to): Primary contact for all incoming receivable questions from both patients and insurances. Download and format SC Charge Entry Sheets using current software systems (Allscripts and Amkai) Responsible for timely action to claims populating the RCM queue in Amkai. Build relationships with ASC teams and supporting physician groups. Entry of Excel charges into Amkai and...

Senior Medical Coder Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The Senior Medical Coder performs concurrent review of FFS coding rules, ensuring all CPT and E/M codes are accurately coded and billed for maximum reimbursement and minimal denials. This position will support coding functions within charge review, claim edits, and denials and play a critical role in maintaining coding accuracy and supporting revenue cycle integrity....

Surgical Coder Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. The Surgical Coder reviews, analyzes, and codes professional/physician medical record documentation to include, but not limited to, medical diagnostic and procedural information for various practices. This coder works collaboratively with surgeons to ensure the accuracy of the code sets on the surgical case. There are currently two openings: The preferred candidate will have professional surgical coding experience in Urology and Gynecology. The preferred candidate will have professional...

Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient's quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and strengthen internal controls....

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Primary Responsibilities: Utilize resources and reference materials (e.g., on-line sources, manuals) to identify appropriate medical codes and reference code applicability, rules, and guidelines Apply understanding of relevant medical coding subject areas (e.g., diagnosis, procedural, evaluation and management, ancillary services) to assign appropriate medical codes Apply understanding of basic anatomy...

Job Overview Coder 4 provides inpatient coding utilizing ICD-10-CM and ICD-10-PCS coding classification systems. Utilizes an encoder and computer assisted coding (CAC) software to achieve accuracy and thorough coding. Researches complex coding scenarios and queries physicians on documentation for clarification. This is an inpatient coding position for an experienced, trained inpatient coder. A Coder 4 analyzes clinical documentation; assigns appropriate diagnosis, procedures, and abstracts the codes and other clinical data. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Assist in the resolution of clinical documentation and provide feedback to providers on the quality of their documentation. Responsibilities Code and abstract clinical and demographic data for inpatient...

Job Overview Are you an expert Coding Specialist looking to join an outstanding organization? We at M Health Fairview are looking for a Coder 2 to join our Hospital Based ED coding team! This is a fully remote position approved for a 1.0 FTE (80 hours per pay period) on the day shift. The Coder 2 analyzes clinical documentation; assigns appropriate diagnosis, procedure, and levels of service codes; abstracts the codes and other clinical data. Performs a variety of technical functions in the outpatient coding area, codes outpatient visits, sent-in labs, consolidated funding accounts, utilizing ICD-10‑CM, CPT‑4, and HCPCs coding classification systems. Utilizes electronic coding software to code to the highest level of specificity, ensuring optimal and appropriate reimbursement for services provided. Responsibility includes resolving medical necessity edits and extracting and entering data into the medical record. This information is then used to determine reimbursement levels,...

$5,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. We're focused on improving the health of our members, enhancing our operational effectiveness and reinforcing our reputation for high - quality health services. As Senior Inpatient Medical Coder you will provide coding services directly to providers. You'll play a key part in healing the health system by making sure our high standards for documentation...

About Us Here at Baylor Scott & White Health we promote the well-being of all individuals, families, and communities. Baylor Scott and White is the largest not-for-profit healthcare system in Texas that empowers you to live well. Our Core Values are: We serve faithfully by doing what's right with a joyful heart. We never settle by constantly striving for better. We are in it together by supporting one another and those we serve. We make an impact by taking initiative and delivering exceptional experience. Benefits Our benefits are designed to help you live well no matter where you are on your journey. For full details on coverage and eligibility, visit the Baylor Scott & White Benefits Hub to explore our offerings, which may include: Immediate eligibility for health and welfare benefits 401(k) savings plan with dollar-for-dollar match up to 5% Tuition Reimbursement PTO accrual beginning Day 1 Note:...

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary: We are seeking two experienced inpatient DRG Auditors for an asneeded role offering flexible hours (8-40 hours per week). Candidates may already have fulltime jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews . Ideal candidates will have: 5-7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD10CM/PCS , MSDRG and APRDRG methodologies Understanding of Elixhauser scoring , HACs , PSIs , and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills Role Responsibilities: Perform...

DRG Coding Auditor Principal _Virtual: _ _ _ This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Carelon Payment Integrity is a proud member of the Elevance Health family of companies, Carelon Insights, formerly Payment Integrity, is determined to recover, eliminate and prevent unnecessary medical-expense spending. The DRG Coding Auditor Principal is responsible for auditing inpatient medical records on claims paid based on Diagnostic Relation Group...

Position Type Full Time Description Work Where You Matter! At St. Croix Hospice we guide patients and families through the end-of-life journey. Through compassionate care, we focus on our patient’s quality of life, empowering them to make the most of their time with dignity, comfort and respect. If you are ready to be part of an extraordinary team of caregivers, then come work where you matter. Position Overview The Compliance Auditor is responsible for assisting with the development and implementation of the compliance audit program to ensure regulatory adherence, risk mitigation and operational integrity. This role ensures that St. Croix Hospice complies with federal and state laws and regulations and internal policies by identifying potential risks and working cross-functionally to implement corrective actions. The Compliance Auditor will lead risk assessments, internal audits and compliance investigations while collaborating with leadership to mitigate risks and...

Description:Evaluates health record documentation and charges to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the outpatient visit.Ensures that data complies with regulatory and coding guidelines.Reviews medical information, such as diseases or symptoms and diagnostic descriptions and procedures for a given visit, to accurately assign and sequence the correct ICD-1 CM, HCPCS and CPT codes.Adheres to the quality and productivity standards set by the department.Education Qualifications :Successful completion or currently enrolled in a medical coding program which includes completed course work inICD-1-CM, HCPCS, CPT codes, medical terminology, anatomy and physiology and disease process AND a passing score on the ESSENTIA HEALTH coding skills assessment test.OR Credentialed as, or eligible for, Certified Coding Specialist (CCS), Certified Coding Specialist-Physician Based (CCS-P), Certified Professional...

Job Overview Are you an experienced inpatient coder looking to work fully remotely, with a team that values accuracy, continuous learning, and work-life balance? Fairview is hiring-you'll work Monday through Friday, handling 80 hours per pay period.What You'll Do Review and code inpatient clinical records using ICD-10-CM and ICD-10-PCS in alignment with coding guidelines, MS-DRG / APR-DRG reimbursement rules, and Fairview protocols.Validate computer-assisted coding (CAC) output and ensure thorough, accurate coding.Analyze clinical documentation and drill down on severity of illness (SOI), risk of mortality (ROM), HAC, and POA indicators.Collaborate with CDI (Clinical Documentation Integrity) staff to drive provider education and documentation quality.Assist in provider queries to improve documentation specificity.Partner with revenue cycle teams to support prompt claim submissions and optimize financial performance.Required Qualifications (must be met to be considered) :Certificate...

Become a part of our caring community and help us put health first The Inpatient Medical Coding Auditor 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. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

Join Datavant, a transformative data collaboration platform redefining healthcare. We aim to enhance the security, accessibility, and actionability of health data for various organizations, including providers, health plans, researchers, and life sciences companies. By utilizing health data, we are shaping the future of patient care and health outcomes. In this role, you'll be part of a dedicated and passionate team committed to driving impactful changes in the healthcare landscape. We are currently looking for experienced outpatient coders to join our team. If you have a keen eye for detail and a strong grasp of medical terminology, this fully remote position with a flexible schedule could be the perfect fit for you! Preferred: Experienced PRN Outpatient Coder with a minimum of 3 years in SDS and Observation coding. Key Responsibilities: Review medical records and accurately code diagnoses and procedures. Assign and sequence codes based on medical record...

DRG auditor Location: Maplewood Mn Pay Rate: Negotiable Duration: 12 months potential for extension Summary: We are seeking two experienced inpatient DRG Auditors for an as-needed role offering flexible hours (8-40 hours per week). Candidates may already have full-time jobs, and the position is open to applicants on either the East or West Coast. The role will likely include two interviews . Ideal candidates will have: 5-7+ years of inpatient hospital coding/auditing experience Experience working in acute care hospitals, large hospital systems, or academic medical centers Strong expertise with ICD-10-CM/PCS , MS-DRG and APR-DRG methodologies Understanding of Elixhauser scoring , HACs , PSIs , and clinical validation Prior exposure to Clinical Documentation Improvement (CDI) preferred Ability to independently perform DRG audits with high accuracy Strong analytical, communication, and documentation skills...

Join Our Dedicated Team and Make a Difference in Healthcare! The Code Edit Disputes team is vital in reviewing and educating providers about claims denied due to coding errors. As a Medical Coding Specialist, you will undertake advanced administrative and operational tasks, showcasing your independent initiative and robust decision-making abilities. Your Role: In this position, you will extract key clinical information from various medical records to accurately apply procedural terminology and coding (such as ICD-10-CM and CPT) to patient documentation. You will analyze, input, and manage data within our systems while effectively addressing internal medical information queries. Your decision-making skills will be crucial in determining the best methods and processes to complete administrative projects successfully. Your expertise will help prioritize requests and adjust procedures as needed, often with minimal supervision. This Position is Fully Remote! What We...

Job Overview Coder 4 provides inpatient coding utilizing ICD-10-CM and ICD-10 PCS Coding Classification systems. Utilizes an encoder and computer assisted coding (CAC) software to achieve accuracy and thorough coding. Researches complex coding scenarios and queries physicians on documentation for clarification. This is an inpatient coding position for an experienced, trained inpatient coder. A Coder 4 analyzes clinical documentation; assign appropriate diagnosis, procedure, and abstract the codes and other clinical data. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Assist in the resolution of clinical documentation and provide feedback to providers on the quality of their documentation. Responsibilities Code and abstract clinical and demographic data for inpatient...

Job Overview The Coder 2 analyzes clinical documentation; assign appropriate diagnosis, procedure, and levels of service codes; abstract the codes and other clinical data. Performs a variety of technical functions within the Outpatient coding area, codes outpatient visits, sent-in-labs, consolidated funding accounts, utilizing ICD-10-CM, CPT-4, and HCPCs Coding Classification systems. Utilizes an electronic coding software to code to the highest level of specificity, ensuring optimal and appropriate reimbursement for the services provided. Responsibility includes resolving medical necessity edits and extracting and entering data into the medical record. This information is then used to determine reimbursement levels, assess quality of care, study patterns of illness and injuries, compare healthcare data between facilities and between physicians, and meet regulatory and payer reporting requirements. Coder 2's also resolves clinical documentation and charge capture discrepancies...

Job Overview Job Overview Fairview is looking for a seasoned Coder 3 who enjoys tackling complex outpatient cases and working at the top of their expertise. In this fully remote role, you'll use your advanced knowledge of ICD-10-CM, CPT-4, and HCPCS to confidently code specialty and hospital-based accounts, assign APC weights, resolve medical necessity edits, and navigate nuanced coding scenarios using encoder and CAC technology. Your precision will directly influence reimbursement, quality reporting, compliance, and the integrity of healthcare data across the organization. This is a full-time (1.0 FTE, 80 hours per pay period) day shift position with just one weekend day per month-offering meaningful, high-impact work with the flexibility of working from home. Responsibilities Maintains knowledge of, and complies with, all relevant laws, regulations, policies, procedures and standards. Actively participates in creating and implementing workflow...