84 denials management coder jobs found

San Mateo County Health is seeking an experienced Medical Records Coder II/III to join Correctional Health and support the coding of CalAIM billable services, including clinic visits and ancillary services. This position plays an important role in ensuring accurate reimbursement while supporting continuity of care for justice‑involved individuals. The successful candidate will perform billing functions related to the Department of Health Care Services (DHCS) Justice‑Involved CalAIM Initiative. This initiative allows eligible incarcerated individuals to enroll in Medi‑Cal prior to their release and enables reimbursement for covered healthcare services provided during the 90 days before reentry, helping support successful transitions back into the community. This position requires independent proficiency in ICD‑10 and CPT coding, coding audits, physician education on coding practices, Evaluation and Management (E/M) coding, and identifying and resolving billing edits. This assignment...

Shasta Regional Medical Group, affiliated with Shasta Regional Medical Center, is seeking a Billing Specialist to manage claims, authorizations, denials, and coding in a clinic setting. You will interact with patients and staff, ensuring compliance with Medi-Cal and Medicare requirements. The role requires prior clinic billing experience, familiarity with EMR/Practice Management software, and strong communication and analytical skills. A competitive benefits package is provided. #J-18808-Ljbffr

Shasta Regional Medical Group in California is seeking a Medical Biller to submit claims, ensure coding compliance with Medi-Cal/Medicare, obtain authorizations, and manage follow-ups and denials. You will input notes, work with EMR/Practice Management systems, and maintain reporting while delivering accurate, timely billing services in a community-focused setting. The role requires knowledge of ICD10, CPT, HCPCS, and strong communication skills to coordinate with care teams and payers. #J-18808-Ljbffr

Job Description Job Description Description The DRG Coder is responsible for reviewing inpatient medical records and accurately assigning diagnosis and procedure codes using ICD-10-CM and ICD-10-PCS to determine the appropriate Diagnosis-Related Group (DRG) assignment.  This role ensures coding accuracy, reimbursement integrity, and compliance with federal and state regulations, payer guidelines, and internal policies. In an Independent Practice Association (IPA) and Management Services Organization (MSO) environment, the DRG Coder partners with utilization management, care management, finance, and provider network teams to support accurate payment, risk adjustment, quality reporting, and medical expense analysis. What You'll Do Review inpatient hospital records and assign accurate diagnosis and procedure codes Determine the appropriate MS-DRG or APR-DRG assignment based on coding and clinical documentation Conduct coding validation and auditing to ensure compliance with...

JOB DESCRIPTION Job SummaryProvides support for medical coding activities, including ensuring that ICD-10 and CPT codes are reported accurately to maintain compliance, and minimize risk and denials. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties Performs on-going member medical chart reviews. Abstracts and reports ICD-10 and CPT diagnosis codes accurately and in compliance with established coding and billing principles - minimizing risk and denials. Demonstrates understanding of current provider office billing practices - ensuring that diagnosis and CPT codes are submitted accurately. Documents results/findings from chart reviews and provides feedback to leadership, providers and office staff. Provides training and education to provider network regarding risk adjustment and coding updates related to risk adjustment. Builds positive relationships between providers and the business by providing coding assistance as...

Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. T he Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is hybrid at our office in Playa Vista, CA Responsibilities: Supervise & Train: Lead the training and mentorship of new billing hires, ensuring rapid integration and consistent...

Biller/Coder LiaisonCommunity health is about more than just vaccines and checkups. It's about giving people the resources they need to live their best lives. At Neighborhood, this is our vision: a community where everyone is healthy and happy. We're with you every step of the way, with the care you need for each of life's chapters. At Neighborhood, we are Better Together.As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance.Since 1969, our employees have been making this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If this sounds like an organization...

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision: a community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together. As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance. Since 1969, our employees have been making this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If this sounds like an organization you would like to...

About Us We are a virtual-first primary care organization reimagining how people access and experience healthcare. Our mission is to deliver comprehensive, high-quality, and compassionate care that integrates technology, data, and human connection through a seamless digital platform complemented by in-person visits when needed. While our care is provided exclusively to patients in the United States, our team is distributed across the United States and Canada, bringing together clinicians, technologists, and operators who share a commitment to making high-quality healthcare delightful, personal, and accessible to everyone. More about us can be found on our website. Role Overview We are seeking an eager, detail-oriented Medical Biller and Coder to join our Revenue Cycle Team at Circle Medical Technologies. As we continue to grow, we constantly search for exceptional talent to join our team. What you will own Review patient claims for accuracy and completeness and proactively obtain...

Job Description Job Description Lead Medical Biller Los Angeles, CA Job Description Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. The Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is hybrid at our office in Playa Vista, CA Responsibilities: Supervise & Train:...

Community health is about more than just vaccines and checkups. It’s about giving people the resources they need to live their best lives. At Neighborhood, this is our vision: a community where everyone is healthy and happy. We’re with you every step of the way, with the care you need for each of life’s chapters. At Neighborhood, we are Better Together. As a private, non-profit 501(C) (3) community health organization, we serve over 500,000 medical, dental, and behavioral health visits from more than 100,000 people annually. We do this in pursuit of our mission to improve the health and happiness of the communities we serve by providing quality care to all, regardless of situation or circumstance. Since 1969, our employees have been making this mission a reality. Regardless of the role, our team focuses on being compassionate, having integrity, being professional, always collaborating, and consistently going above and beyond. If this sounds like an organization you would like to...

Senior Specialty Physician Coder – InterventionalOur client, a healthcare company, is looking for a Senior Specialty Physician Coder – Interventional for their Fountain Valley, CA location.Responsibilities:Achievement of productivity standards as established by management.Achievement of quality standards as established by management. In adherence with standard work, analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient and/or outpatient medical records according to established coding guidelines, including the ability to review and natively code surgical operative and/or procedure reports.In adherence with standard work, follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing/coding improvements.Participate in developing, implementing, and reviewing programs for coding compliance...

1.0 FTE Full time Day - 08 Hour R2658919 Remote USA 108610021 Admin Compliance Business & Administration Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview Billing and Coding Compliance Auditors conduct audits and monitoring activities to identify and address compliance risks related to billing and coding practices. They review and evaluate healthcare regulatory compliance, focusing on the detection of documentation, coding, and billing errors. Responsibilities include assessing the adequacy and accuracy of documentation supporting billed services, including ICD, CPT, HCPCS, and other third-party payer codes, as well as adherence to Teaching Physician guidelines, Evaluation & Management criteria, DRG and APC assignments, medical necessity, and reimbursement accuracy. Auditors serve as a communication channel, partnering with Billing and Coding Compliance Educators to address compliance issues. They are responsible for conducting...

Specialty Physician CoderOur client, a healthcare company, is looking for a Specialty Physician Coder for their Fountain Valley, CA location.Responsibilities:Achievement of productivity standards as established by management.Achievement of quality standards as established by management.Analyze and interpret medical information in the medical record and assign and sequence the correct ICD10CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient medical records according to established coding guidelines.Review and natively code surgical operative and/or procedure reports.Follow established workflow for working claim denials in the Follow Up work queues and identify opportunities for billing and coding improvements.Participate in developing, implementing, and reviewing programs for coding compliance monitoring, benchmark comparisons, organizational policies and procedures, and physician clinical documentation improvement programs.Work in the...

Coding Compliance Auditor Riverside University Health System (RUHS) is seeking two skilled Coding Compliance Auditors (Administrative Services Manager I) to support the Health System's Compliance Department. Key Responsibilities Key responsibilities of this role include conducting thorough reviews of medical records to ensure compliance with coding regulations, while providing feedback and education to coders and physicians to enhance coding accuracy and documentation quality. The position involves performing annual, periodic, and focused audits of physician, inpatient, and outpatient coding as requested. It also requires effective communication with all RAC stakeholders to ensure timely and accurate responses to inquiries. Additionally, the role supports ongoing program development through training initiatives and process improvements, delivers coding presentations to diverse audiences including physicians and other staff. Ideal Candidate The ideal candidate will have at least...

MISSION, VISION, AND VALUES Our mission is to provide quality, comprehensive healthcare and supportive services to our community. Our vision is "Improving the Health and Well-Being of Our Community." Our core values are Integrity, Compassion, and Excellence. Employees are expected to demonstrate a strong commitment to the mission, policies, goals, and philosophy of Harbor Community Health Centers. JOB SUMMARY Reporting to the Revenue Cycle Manager (RCM), the Medical Biller II is responsible for the billing and collection activities for the clinic's primary care, pediatric, behavioral health, and dental services. This position works closely with providers, Front Office staff, and the Quality Improvement Department. ESSENTIAL DUTIES & RESPONSIBILITIES Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. An individual must be able to perform each essential duty satisfactorily to be successful in this role. The...

Skilled Wound Care is looking for a Lead Medical Biller to join our rapidly growing company! We are a mobile surgical physician wound care group expanding into new markets of the United States. T he Lead Medical Biller is a critical leader responsible for ensuring the financial health of our organization by overseeing the daily operations of the billing team. This role requires advanced expertise in the end-to-end claims lifecycle, ensuring maximum revenue capture through accurate, compliant, and timely submission of medical claims across all payer types (private, government, and third-party). You will be the primary subject matter expert, driving team performance, resolving complex billing issues, and upholding strict adherence to all federal, state, and FQHC-specific billing regulations. Position is hybrid at our office in Playa Vista, CA Responsibilities Supervise & Train: Lead the training and mentorship of new billing hires, ensuring rapid integration and consistent...

Title: Specialty Physician Coder, OBGYN Location: Fountain Valley/Predominantly Remote Department: Document Improvement Status: Full Time Shift: Day Pay Range*: $33.79/hr - $49.00/hr MemorialCare is a nonprofit integrated health system that includes four leading hospitals, award-winning medical groups - consisting of over 200 sites of care, and more than 2,000 physicians throughout Orange and Los Angeles Counties. We are committed to increasing access to patient-centric, affordable, and high-quality healthcare; your personal contributions are integral to MemorialCare's recognition as a market leader and innovator in value-based and other care models. Across our family of medical centers, we support each one of our bright, talented employees in reaching the highest levels of professional development, contribution, collaboration, and accountability.Whatever your role and whatever expertise you bring, we are dedicated to helping you achieve your full...

Certified Coder and Biller We are looking for a certified coder and biller for our Highland clinic. The role is in‑person and involves coding, billing, claims, payer follow‑up, refunds, and billing queues. Coding visits and entering charges should occur within 48 hours of encounter completion. You will work Athena queues, handling missing slips, holds, messages, unpostables, denials, collections items, and related follow‑up. Other responsibilities may include insurance refunds, Medi‑Cal and normal overpayment cases, credentialing support, payer enrollment, and contract submissions. You will help keep billing spreadsheets updated for revenue, payments, fee‑for‑service, refunds, and reporting. The position may also answer billing questions from patients and staff, and assist with billing and chart audits. Qualifications CPC or equivalent coding certification Experience with medical coding, billing, charge entry, claims submission, and payer follow‑up Comfort working with...

Professional Fee Coder - Analyst II, under the direction of their Revenue Manager and Associate Director, will provide support in areas of revenue operations related to coding, auditing, and training for their designated areas. Responsibilities include providing education and training to physicians and clinical staff on documentation to ensure compliance with coding guidelines. Analyst II will perform an in-depth review of physician documentation and is responsible for presenting findings along with recommendations to the department on physician education. The incumbent should be familiar with all applicable billing and coding regulations and be able to effectively communicate these regulations to all levels of faculty, management and staff. This position will also assign codes based on a review of clinical charts, resolve coding issues based on denials, and identify areas of improvement and current work experience is essential. Note: The rate of pay starts at $45 per hour, and...

Vascular Surgery Medical Group is a busy and growing vascular practice specializing in minimally invasive vascular procedures, vascular ultrasound, and patient-centered care. Our mission is to help patients improve their quality of life through advanced vascular treatment and compassionate care. We are a collaborative, team-oriented practice focused on delivering exceptional patient outcomes while maintaining the highest standards of safety, professionalism, and clinical excellence. We are currently seeking an experienced Medical Billing Specialist to join our administrative team. Position Summary The Medical Billing Specialist supports the financial operations of the practice by ensuring accurate, timely billing and follow-up for vascular surgery services. This position is responsible for charge entry, claims submission, payment posting, insurance follow-up, denial management, account resolution, and maintaining accurate billing records in accordance with payer requirements and...

Job Description Job Description Hi! We are looking for a certified coder and biller for our Highland clinic. This is an in-person position for coding, billing, claims, payer follow-up, refunds, and billing queues. The job includes coding visits and entering charges within 48 hours of encounter completion. This person will also work Athena queues; missing slips, holds, messages, unpostables, denials, collections items, and related follow-up. We need someone who knows their stuff! Other work may include: insurance refunds, Medi-Cal and normal overpayment cases, credentialing support, payer enrollment, and contract submissions and related items. This position will also help keep billing spreadsheets updated for revenue, payments, fee-for-service, refunds, and reporting. If you have experience with these fields, please, apply! The person in this role may also answer billing questions from patients and staff, and assist with billing and chart audits.  --- We are looking...

Specialty Physician Coder Our client, a Healthcare company, is looking for a Specialty Physician Coder for their Fountain Valley, CA location. Responsibilities: Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing. This role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. The Specialty Physician Coder works with the Coding Compliance Manager on discovered coding trends, irregularities, and needed action items. Achievement of productivity standards as established by management. Achievement of quality standards as established by management. Analyze and interpret medical information in the medical record and assign and sequence the...