14 edits coder jobs found

Position Summary The Revenue Cycle Auditor - Credentialed Coder is responsible for end to end auditing of professional and facility claims to ensure accurate, complete, and compliant coding and billing. This role partners closely with revenue cycle leadership, coding teams, and clinical providers to identify root causes of denials, drive best practices in claims resolution, and deliver targeted education that improves documentation quality and reimbursement accuracy. The ideal candidate brings deep working knowledge of ICD 10 CM/PCS, CPT®, and HCPCS Level II, along with hands on experience using NCCI/CCI edits, MUEs, and payer policies across inpatient, outpatient, and professional settings. Key Responsibilities Audit & Compliance • Perform prospective and retrospective audits of medical records and associated charges to validate code selection, modifiers, medical necessity, and documentation sufficiency across inpatient, outpatient, ED, and professional services. •...

SPECIALTY SCOPE FOR THIS CODER II POSITION TO INCLUDE BUT NOT LIMITED TO: Upper Extremity: - Shoulders: Total/Hemi Arthroplasty, Arthroscopy, Rotator cuff repair, Biceps tenodesis, Acromioplasty, Distal claviculectomy, Superior Labrum Anterior to Posterior tear (SLAP) repair - Elbows: Cubital tunnel release, Bursectomy, Arthroplasty - Wrist: Carpal tunnel release, Carpectomy, TFCC debridement/repair, 4-corner fusion, De Quervain (1st dorsal compartment) - Hands: Trigger fingers, Ganglions, Mallet fingers, Carpometacarpal (CMC) arthroplasty, , Dupuytren's (Palmar fascial fibromatosis), Amputations Lower Extremity: - Hips: Dislocation reductions, Total/partial Arthroplasty, Femoral fracture treatments, Arthroscopy - Pelvis: Fracture repairs - Femur: ORIF neck fractures, Trochanteric repairs, shaft fracture repairs - Knees: Dislocation repairs/reductions, Total/hemi arthroplasty, Meniscal repairs, Ligamentous reconstructions and repairs,...

This position is responsible for the timely abstraction and coding of professional surgical services based on provider documentation, ensuring that all services are in compliance with the Tulane University Medical Group Guidelines. Responsibilities also include providing ongoing education to all physicians and their employees relative to billing functions, internal and external regulations and documentation issues. This person must be able to work independently and demonstrate leadership qualities. Must demonstrate the ability to communicate clearly and professionally, act as a liaison among providers, administrators (DBON) and the coding staff and respond timely and accurately to inquiries.• Excellent oral and written communication skills • Ability to work independently, to demonstrate initiative and good organizational skills • Tactful and professional interpersonal relationships with others. • Experience with basic PC skills (i.e., Email, Word, Excel) required • Knowledge...

GENERAL SUMMARY OF DUTIES: Provides coding, audit, and compliance support for all clinical services rendered by the organization. This role ensures accurate code assignment, adherence to FQHC billing and reimbursement regulations, and supports risk mitigation efforts through provider education and ongoing audit activities. SUPERVISION EXERCISED: None ESSENTIAL FUNCTIONS: Conduct routine and targeted provider coding audits to ensure compliance with FQHC billing requirements, Medicare, Medicaid, and commercial payer policies. Analyze audit findings and communicate results to Providers, including corrective action recommendations and education as needed. Serve as a liaison to Providers regarding coding updates, new services, documentation standards, and regulatory changes; must be able to present effectively to physician groups. Review all coding-related denials to identify trends, root causes, and systemic risks; recommend preventive strategies to reduce future...

About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for health systems, providers, and payers. MedKoder delivers accurate, efficient, and ethical coding, aiming to ensure accurate payment and financial peace for clients. With a team of certified coders throughout the United States, MedKoder emphasizes coding excellence, remote-work flexibility, and a positive workplace culture, earning high employee satisfaction ratings and awards with Best Places to Work in Modern Healthcare and City Business Best Places to Work. Position Location: 100% Remote Position Classification: Full-time, 40 hour work week  that offers a flexible schedule Description: Physician Coding Auditor is responsible for reviewing and accurately coding all professional multi-specialty services including evaluation and management, diagnostics, surgeries, and procedures in compliance with applicable...

Job Description Job Description Local, fast-paced, growing specialty practice looking for a Full-Time Medical Coder / Biller. Northlake Gastroenterology Associates is comprised of 6 physicians, 5 NPs, 3 offices and 2 Ambulatory Surgical Centers. We are continuously advancing and making strides to keep up with the modernization of the medical field and industry standards as a whole.  Experience:  Minimum of 5 years of medical billing required, CPC certification required General skills and knowledge: General experience working with insurance carriers and representatives, patients, and staff on meeting/communicating billing & documentation concerns or requirements for billed services. Standard industry policy and procedure in a medical office setting (i.e. billing, front desk, eligibility verification, PAs, scheduling, referrals, etc.) Working reports and queues such as A/R, aging, collections, failed scrub, invalid, rejected, etc. HIPAA compliance and guidelines...

divh2Physician Coding Auditor/h2pEnsemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference!/ppThe Physician Coding Auditor develops and implements strategic needs analyses and training plans for coding leadership; coordinates and evaluates curriculum development and conducts the preparation and delivery of training for Medical Coders employed by Ensemble and providers that are contracted/employed and outlined in the client...

Your job is more than a job The Intern HIM Coding pursues a career in medical coding for hospital inpatient/emergency/outpatient and professional/provider services. Assists the team with assigning appropriate codes, reviews coding claim and edits or performs any other duties as assigned. Responsible for applying the appropriate ICD-10-CM/PCS and CPT (including charging) diagnostic and procedural codes for emergency, outpatient and/or inpatient encounters and ancillary encounters ambulatory/provider-based clinics. Utilizes knowledge and experience gained with a goal to serve as a coding specialist. Your Everyday GENERAL DUTIES Gains/Implements basic knowledge of ICD-10-CM and PCS, IPPS and DRG payment methodology, CPT and HCPCS coding principles in the work. Assigns ICD-10, CPT and HCPCS codes to reflect services provided. Also implements knowledge of software programs related to EHR coding and billing. Implements knowledge of federal, state and local laws, accreditation...

This position is responsible for the timely abstraction and coding of professional surgical services based on provider documentation, ensuring that all services are in compliance with the Tulane University Medical Group Guidelines. Responsibilities also include providing ongoing education to all physicians and their employees relative to billing functions, internal and external regulations and documentation issues. This person must be able to work independently and demonstrate leadership qualities. Must demonstrate the ability to communicate clearly and professionally, act as a liaison among providers, administrators (DBON) and the coding staff and respond timely and accurately to inquiries. Required Knowledge, Skills, and Abilities Excellent oral and written communication skills Ability to work independently, to demonstrate initiative and good organizational skills Tactful and professional interpersonal relationships with others. Experience with basic PC skills (i.e., Email,...

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. 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: Eligibility on day 1 for all benefits Dollar‑for‑dollar 401(k) match, up to 5% Debt‑free tuition assistance, offering access to many no‑cost and low‑cost degrees, certificates and more Immediate access to time off benefits At Baylor...

Hcc Coding Quality Educator Location: Madisonville, Louisiana, United States of America Category: Clerical Remote: Office/Remote Hybrid Widget: Full time Undefined: Regular At St. Tammany Health System, delivering world-class healthcare close to home is our goal. That means we are committed to attracting and retaining the very best professionals for every position in our health system. We believe the pristine beauty of St. Tammany Parish adds to our attractive compensation package. The health system is nestled in the heart of Covington on the north shore of Lake Pontchartrain. It is a peaceful, scenic, community-oriented area with an abundance of amenities to suit every taste. Job Description and Position Requirements Scheduled Weekly Hours: 40 Job Summary: The HCC Coding Quality Educator (HC) facilitates the improved integrity of medical record documentation through interaction with healthcare providers to support the appropriate representation of severity of illness,...

Coder Lead The Coder Lead will code all patient types as needed; inpatient, same-day surgery, ancillary, ambulatory and provider based clinics. This individual will mentor, train and assist with cross training coding staff, includes newly hired coding staff. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes and procedures for hospital and physician (professional) services for Inpatient and Outpatient records based on knowledge of coding systems, including ICD-10 and CPT. Your Everyday General Duties Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs. Codes complex outpatient or inpatient utilizing encoder software, Computers Assisted Coding (CAC), and reference, in the assignment of ICD-10-CM/PCS, CPT/HCPCS codes, MS-DRG, APR-DRG, POA, SOI, ROM assignments, APC assignment and all required modifiers....

Medical Coder As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location: Remote Work - New York Opening: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 Responsibilities General Purpose: Functions as an advanced coder in the abstraction and in-depth analysis of a variety of medical documentation and assigns appropriate procedural terminology and medical codes in accordance with applicable coding rules and policies. Analyzes, enters and manipulates database. Responds to or clarifies internal...

Your job is more than a job The Coder Lead will code all outpatient types as needed; same-day surgery, ancillary, ambulatory and provider based clinics. This individual will mentor, train and assist with cross training coding staff, includes newly hired coding staff. Must be familiar with reviewing documentation to assign appropriate CPT/HCPCS and ICD-10-CM-PCS diagnosis codes and procedures for hospital and physician (professional) services for Inpatient and Outpatient records based on knowledge of coding systems, including ICD-10 and CPT. Your Everyday Proficiently navigates the patient health record and other computer systems/sources to accurately determine diagnosis and procedures codes, MS-DRGs and APCs. Codes complex outpatient or inpatient utilizing encoder software, Computers Assisted Coding (CAC), and reference, in the assignment of ICD-10-CM/PCS, CPT/HCPCS codes, MS-DRG, APR-DRG, POA, SOI, ROM assignments, APC assignment and all required modifiers....