38 denials coder jobs found

Hannibal Regional is seeking a hybrid opportunity coder- reviewer to perform a comprehensive review of denied visits, ensuring accurate billing, proper reimbursement, and complete data capture. You will collaborate with the coding and billing departments to stay compliant with all guidelines and regulations. The ideal candidate holds a high school diploma and a current coding certification (AHIMA/AAPC or RHIT/RHIA) with coding experience, and possesses strong analytical skills to interpret #J-18808-Ljbffr

Coder Reimbursement Specialist - Hospital The Coding and Reimbursement Specialist, CCS is responsible for coding and abstracting thoroughly, clinical data from the medical record. This includes both inpatient, outpatient, commercial, Medicare, Medicaid, and Illinois Public Aid, plus any other payor types. This accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis, grouped to the DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. Manages workload and assigns work to three inpatient and two outpatient coders and oversees the day to day workings of the coding/reimbursement area. Monitors various regulatory sources to keep HIM coding and other staff informed and trained on various coding rules, regulations and related issues. Works closely with patient financial services to resolve any...

Coder Reimbursement Specialist - HospitalThe Coding and Reimbursement Specialist, CCS is responsible for coding and abstracting thoroughly, clinical data from the medical record. This includes both inpatient, outpatient, commercial, Medicare, Medicaid, and Illinois Public Aid, plus any other payor types. This accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis, grouped to the DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. Manages workload and assigns work to three inpatient and two outpatient coders and oversees the day to day workings of the coding/reimbursement area. Monitors various regulatory sources to keep HIM coding and other staff informed and trained on various coding rules, regulations and related issues. Works closely with patient financial services to resolve any...

Coder Reimbursement Specialist - Hospital Full‑time position. The Coding and Reimbursement Specialist (CCS) is responsible for coding and abstracting clinical data from the medical record, including inpatient, outpatient, commercial, Medicare, Medicaid, Illinois Public Aid, and all other payor types. Accurate and timely coding is essential for reimbursement to the hospital, according to the appropriately selected principal diagnosis and DRG in accordance with rules and regulations and coding methodologies, resulting in reimbursement and billing compliances as set forth by the Office of Inspector General. The CCS manages workload, assigns work to three inpatient and two outpatient coders, and oversees day‑to‑day operations of the coding/reimbursement area. The CCS monitors regulatory sources to keep HIM coding and other staff informed and trained on coding rules, regulations and related issues, works closely with patient financial services to resolve claim denials, assists in...

Inpatient Coder II Remote - United States (Remote) Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time. The Inpatient Coder II is responsible for assigning ICD-10-CM and ICD-10-PCS codes for acute care inpatient, acute rehabilitation, swing bed, and LTACH services. This assignment is based on evaluation of the documentation in the medical record and utilization of coding guidelines, Coding Clinic knowledge of clinical disease processes and treatments. This position completes analysis and follow-up record reviews. Responsibilities Codes complex diseases, procedures, and diagnoses using the ICD-10-CM/PCS classification systems in accordance with Official Coding Guidelines, CMS guidelines, PPS guidelines,...

Hiring Department University Physicians Job Description This position is a dual post linked to Job ID 59698 - MCS-C and the department will be hiring for two positions. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records to identify potential problems with coding and reimbursement, such as edits, denials, and appeal letters. Act as liaison between third-party payers and assigned departments to coordinate all aspects of professional coding. Provide assistance to faculty, residents, and department staff in standards of medical record documentation and coding. Assist in the presentation of training sessions for faculty, residents, and staff to inform them of changes made to Medicare billing, federal laws and regulations, and other specific standards...

Hiring Department University Physicians Job Description #upjobs This is a dual posting with job ID 59698. The final title will depend on the qualifications of the final candidate. Review complex clinical documentation and diagnostic results timely to accurately assign codes for diagnoses (ICD-10-CM), procedures (CPT), and applicable modifiers for services provided to assure maximum reimbursement and regulatory compliance. Assist in the audit of medical records in order to identify potential problems with the coding and reimbursement process such as edits, denials, appeal letter, etc. Act as liaison between third party payers and assigned departments in order to coordinate all aspects of professional coding. Provide assistance to faculty, residents and department staff in the standards of medical record documentation and coding of medical records. Assist in the presentation of training sessions for faculty, residents and staff to inform them of changes made to...

Description Columbia Orthopaedic Group Fast-paced. Detail-driven. Team-focused. Every claim, code, and detail matters in delivering accurate, compliant, and timely patient care behind the scenes. If you take pride in precision and enjoy working in a collaborative healthcare environment, this role is for you. Why This Role Is Different This is not just a coding role-it is a key part of the revenue cycle that directly impacts the success of orthopaedic care delivery. Your work ensures providers are accurately represented, claims are clean, and reimbursement flows efficiently. You'll partner closely with physicians, billing, and administrative teams in a highly collaborative environment where accuracy, communication, and compliance are essential. About the Role The Medical Coder is responsible for accurately coding orthopaedic services to support timely and compliant claim submission. This role ensures documentation integrity, supports revenue cycle...

Experienced Multi-Specialty Surgery CoderOpportunities at Change Healthcare, part of the Optum family of businesses. We are transforming the health care system through innovative technology and analytics. Find opportunities to make a difference in a variety of career areas as we all play a role in accelerating health care transformation. Help us deliver cutting-edge solutions for patients, hospitals and insurance companies, resulting in healthier communities. Use your talents to improve the health outcomes of millions of people and discover the meaning behind: Caring. Connecting. Growing together.Job Description:The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process.Hours:...

NKC Health has a need for a Certified Coder to join our team! If you’re looking for a great opportunity to serve our community and be part of a growing team, join our NKC Health family where there is more for you! Here at NKC Health, as part of the coding team, you will have the opportunity to focus solely on coding processes. Your daily mission would be to review medical records for the correct ICD/CPT codes, posting charges and having meaningful communication with the practice team. Reasons To Join NKC Health Comprehensive Benefits (Medical, Dental, Vision, Life, FSA) Employer matched retirement plan Competitive wages Paid time off for personal/vacation/sick Six paid holidays per year Educational assistance Day shift schedules Job Responsibilities Review procedures, HCPCS, and diagnosis coding for accuracy. Assigns proper codes based upon medical record documentation. Works with denials team and central billing office to resolve claims denials, and billing issues. Posts...

Wipro Limited (NYSE: WIT, BSE: 507685, NSE: WIPRO) is a leading technology services and consulting company focused on building innovative solutions that address clients’ most complex digital transformation needs. Leveraging our holistic portfolio of capabilities in consulting, design, engineering, and operations, we help clients realize their boldest ambitions and build future-ready, sustainable businesses. With over 230,000 employees and business partners across 65 countries, we deliver on the promise of helping our customers, colleagues, and communities thrive in an ever-changing world. For additional information, visit us at www.wipro.com. Job Description Function Asks: We are seeking dedicated and detail-oriented specialists who possess a coding certificate and have a strong understanding of records review. They will be responsible for handling appeals for Medicare members, specifically working on NCD/LCD denials, Duplicate denials, and MUE denials. The role involves...

Overview This job reviews and accurately codes and abstracts the most complex hospital services, inpatient procedures, overnight/multi-night stay services, and all other complex medical services. The role utilizes appropriate coding guidelines to assign ICD and CPT codes, conforms to applicable Medicare, Medicaid, and other third-party payer guidelines to ensure accurate reimbursement, and collaborates with the Clinical Documentation Improvement team to ensure accurate DRG assignment. The coder works closely with management to resolve problems and meet deadlines. Education Required – High School diploma or equivalent. Preferred – Completion of an American Health Information Management Association (AHIMA) accredited coding program with certification. Work Experience Required – 3 years coding experience. Certifications Required – Certified Coding Specialist (CCS), Certified Inpatient Coder (CIC), Registered Health Information Administrator (RHIA), or Registered Health Information...

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...

Wipro Limited is seeking a detail-oriented specialist to review medical records for Medicare appeals, focusing on NCD/LCD denials, duplicates, and MUE denials. The role involves comparing findings to CMS guidelines and determining if conditions of coverage exist. If not met, provide uphold justifications and maintain thorough documentation. Domestic, 1 FTE, 300 cases per week with FACETS as primary workload and COSMOS as secondary. #J-18808-Ljbffr

Job DescriptionJob DescriptionDescription :HIRING REMOTE EXPERIENCED BILLERS IN THE FOLLOWING STATES :FL, GA, IN, KY, LA, MS, NC, SC, TN, TX, VA, & WVReady for a change? Are you an Experienced Medical Biller LOOKING FOR GROWNING COMPANY WITH ROOM FOR ADVANCEMENT?APPY NOW!Full Benefits after 30 Days!! PTO after 90 Days! and MORE!!!!NEW HIRE ORIENTATIONS START SEPT 10TH AND 24TH!The Medical AR Follow-up & Denial Specialist is primarily responsible for analyzing and resolving all insurance claim denials for DME Supplies.The individual in this position will generate effective written appeals to carriers using well-researched logic in order to recoup reimbursement on incorrectly denied claims.Appeal carrier denials through coding review, contract review, medical record review, and carrier interaction.Utilize a multitude of resources to ensure correct appeal processes are followed and completed in a timely manner.Demonstrate a high level of expertise in the management of denied...

***HYBRID OPPORTUNITY (REMOTE 1-2 DAYS/WEEK)*** Minimum hourly rate $22.95, Maximum $36.66, based on experience Collaborates with coding and billing department to perform a comprehensive review of the denied visit. The comprehensive review should ensure accurate billing and reimbursement and completed data capture. Stays within departmental guidelines, rules, regulations and all billing requirements. High School Diploma or equivalent required Current coding certification through AHIMA (American Health Information Management Association) or AAPC (American Academy of Professional Coders), or RHIT/RHIA with coding experience required Thorough knowledge of the related prospective payments systems (PPS) Knowledge of ancillary testing (laboratory, x-ray, EKG) Knowledge of anatomy, physiology and medical terminology Understanding of ethical coding practices and guidelines Knowledge of applicable federal, state and laws and regulations Knowledge of all aspects of...

Hannibal-Regional-Healthcare-System is seeking a medical billing coder reviewer to collaborate with coding and billing teams. The role focuses on comprehensive reviews of denied visits to ensure accurate billing, reimbursement, and complete data capture while adhering to all guidelines and regulations. The ideal candidate will have a high school diploma and current coding credentials (AHIMA/AAPC or RHIT/RHIA) with PPS knowledge and strong analytical skills. #J-18808-Ljbffr

Our Medical Billing Specialists ensure efficient filing and resolution of insurance claims; acting as liaison between doctors, insurance companies, and patients.Essential Duties and Responsibilities include the following. Other duties may be assigned.Monitors and evaluates insurance reimbursements and requests review of questionable reimbursements on a claim-by-claim basis and by procedure code.Obtains accurate billing information from patients and insurance companies.Consults physicians and/or the coding department for assistance with the resubmission of claims requiring corrected diagnosis or procedure codes and as a resource for additional documentation or letters of inquiry and/or explanation, etc.Manages and researches status reports and the Aged AR to determine and resolve claim issues, denials, and overpayments.Works with insurance carriers and Privia to identify and address major claims issues and policy inconsistencies, escalating when necessary, for resolution.Provides...

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months • Online and in-person options available • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available...

Inpatient Coder IIRemote - United States (Remote)Candidates residing in the following states will be considered for remote employment: Alabama, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Minnesota, Missouri, Mississippi, Nebraska, North Carolina, Oklahoma, Texas, Utah, and Virginia. Remote work will not be permitted from any other state at this time.The Inpatient Coder II is responsible for assigning ICD-10-CM and ICD-10-PCS codes for acute care inpatient, acute rehabilitation, swing bed, and LTACH services. This assignment is based on evaluation of the documentation in the medical record and utilization of coding guidelines, Coding Clinic knowledge of clinical disease processes and treatments. This position completes analysis and follow-up record reviews.ResponsibilitiesCodes complex diseases, procedures, and diagnoses using the ICD-10-CM/PCS classification systems in accordance with Official Coding Guidelines, CMS guidelines, PPS guidelines, and...

Fully Remote Lake Park Building Full time R182990 Job Description: The Med Grp Professional Billing (PB) Coder II is responsible for accurately resolving coding edits in assigned Epic WQ’s and assigning ICD-10, CPT, and HCPCS coding classifications and modifiers based on clinical documentation and/or physician orders. This role ensures the integrity of data for both internal and external reporting, maintains work queues within processing timeframes, responds to inquiries related to billing codes, and adheres to compliance guidelines. Essential Functions Evaluates and resolves all types of coding edits in assigned Charge Review, Claim Edit, and Follow-up work queues in Epic. Assigns ICD, CPT, and HCPCS coding classifications based on clinical documentation and/or physician orders. Accurately evaluates and resolves assigned coding edits in Charge Review, Claim Edit, and Follow-up work queues in Epic within assigned timeframes. Appropriately...

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. The Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. The CPC must have the ability to determine correct coding and appropriate documentation during the review of medical records. The CPC must also ensure that the state, federal and company requirements are met and recognize any concerning billing patterns or trends. Conduct a...

Medical Coding Professional Shift: Monday Friday Days Department: Mizzou Therapy Services, Capital Region Medical Center Compensation: Base Pay Range: $19.25 - $30.23/hour, based on experience About The Job MU Health Care is looking for a detail-oriented and driven medical coding professional who thrives at the intersection of healthcare, compliance, and continuous learning. The ideal candidate is a critical thinker with a passion for accuracy, an eye for uncovering important details, and a commitment to supporting high-quality patient care through precise documentation and coding practices. We value professionals who enjoy collaborating with physicians, residents, and multidisciplinary teams while serving as a trusted resource on evolving regulatory and billing requirements. Success in this role requires strong analytical skills, integrity, and the confidence to navigate complex medical records and reimbursement processes with accuracy and professionalism. If you are...

Inpatient II CoderBJC is hiring for an Inpatient II Coder. We are looking for 2 years of Inpatient Hospital Coding experience. Must have one of the following certifications: CCS, RHIA, or RHIT. This is a remote position. Eligible remote states include Alabama, Kentucky, Oklahoma, Arkansas, Louisiana, South Carolina, Florida, Mississippi, Tennessee, Georgia, Louisiana, Texas, Indiana, North Carolina, Wisconsin, Iowa, and Ohio.BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental...