14 edits denials coder jobs found

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Medical Coder (Remote) 30+ days ago Requisition ID: 1131 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;...

Join to apply for the Professional Billing Coder II role at Onvida Health 2 days ago Be among the first 25 applicants Join to apply for the Professional Billing Coder II role at Onvida Health Get AI-powered advice on this job and more exclusive features. Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Job Description Work Status Details: REGULAR FULL TIME | 80.00 Hours Every Two Weeks Shift: Days Pay Rate Type: Hourly Location: Remote Listed is the base hiring salary range offered for this position. Actual salaries may vary depending on factors, including but not limited to skills and experience. The salary range listed is just one component of the total rewards/compensation package offered to candidates. Min = $22.62 Mid = $28.28 Max = $33.93 Summary The Professional Billing Coder II is an intermediate-level coding professional responsible for independently reviewing medical documentation and assigning accurate diagnostic and...

Job Description Staff Position Description Position Title: Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department: Health Information Management Safety Sensitive: YES Reports to: HIM Director/Manager Exempt Status: NO Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country. Key Responsibilities Ensures data quality in compliance with State, Federal and regulatory requirements. • Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits. • Codes all professional charges to ensure accurate and timely billing • Perform coding reviews and/or surgical coding for practices and providers. • Evaluates and report audit findings or reviews and reports on results to physicians and/or...

Professional Services Certified Coding ReviewerAll KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI's vision to be among the kindest, highest quality health systems in the country.Ensures data quality in compliance with State, Federal and regulatory requirements. Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits. Codes all professional charges to ensure accurate and timely billing Perform coding reviews and/or surgical coding for practices and providers. Evaluates and report audit findings or reviews and reports on results to physicians and/or operations directors. Provides technical guidance, training, and on-going coding education when instructed, to physicians and their office staff and other ancillary departments on both general and specific coding issues to include documentation and guidance in quality coding for proper...

Responsibilities Review provider medical coding of services rendered for medical claim submission Review and respond to medical coding inquiries submitted by providers and staff Work directly with providers to resolve specific medical coding issues Analyze data for errors and report data problems Partner with billing staff to correct and resubmit claims based on review of the records, provider input, and payor input Work with clinical and non-clinical groups to identify undesirable coding trends Ensure claims are medically coded consistently by following CPT, ICD-10 and HCPCS rules and guidelines; escalation of issues that may impact this immediately to the Compliance Committee Abide by HIPAA and Coding Compliance standards Collect data from various sources, maintain electronic records and logs, file paperwork, and operate office equipment Accomplish other tasks as assigned Qualifications 2+ years coding 2+ years medical billing experience (preferred but not required)...

Responsibilities • Review provider medical coding of services rendered for medical claim submission • Review and respond to medical coding inquiries submitted by providers and staff • Work directly with providers to resolve specific medical coding issues • Analyze data for errors and report data problems • Partner with billing staff to correct and resubmit claims based on review of the records, provider input, and payor input • Work with clinical and non-clinical groups to identify undesirable coding trends • Ensure claims are medically coded consistently by following CPT, ICD-10 and HCPCS rules and guidelines; escalate issues that may impact this immediately to the Compliance Committee • Abide by HIPAA and Coding Compliance standards • Collect data from various sources, maintain electronic records and logs, file paperwork, and operate office equipment • Accomplish other tasks as assigned Qualifications • 2+ years coding • 2+ years medical billing...

Staff Position Description Position Title: Professional Services Certified Coding Reviewer Position Code: Coder-8125 Department: Health Information Management Safety Sensitive: YES Reports to: HIM Director/Manager Exempt Status: NO Position Purpose: All KHI employees are expected to perform their respective tasks and duties in such a way that supports KHI’s vision to be among the kindest, highest quality health systems in the country. Key Responsibilities Ensures data quality in compliance with State, Federal and regulatory requirements. Evaluates medical record documentation and charge reports to ensure completeness, accuracy and compliance with the Correct Coding Initiative Edits. Codes all professional charges to ensure accurate and timely billing Perform coding reviews and/or surgical coding for practices and providers. Evaluates and report audit findings or reviews and reports on results to physicians and/or operations directors. Provides technical guidance,...

GeBBS Healthcare Solutions , a nationally recognized leader in Health Information Management (HIM) and Revenue Cycle Management (RCM), is seeking an Profee Coder - Internal Med (per diem) . We are seeking coding professionals with a proven ability to work in a fast-paced, quality-driven environment for a W-2 position on a part time, remote basis. Schedule & Availability: Availability up to 15–20 hours per week required Pay for this role is around $25.50/hr at production for edits and $26.16/hr at production for Coding. Hours scheduled based on business needs (not guaranteed weekly) Coverage needs include planned PTO and fluctuating volumes Opportunity to pick up additional “call-in” hours on a first-come, first-served basis Must be available Monday–Friday between 6:00 AM – 6:00 PM PST Key Responsibilities: Perform Profee Internal Medicine coding for outpatient/clinic encounters Ensure accurate assignment of CPT, modifiers, and ICD-10 codes Meet productivity and quality...

Medical Biller Under general supervision, the incumbent is responsible for examining, verifying, and maintaining data involved in processing medical care claims for alternate resources reimbursement and performing other third-party billing-related duties. The primary function of this position is to bill/process all medical care claims timely to ensure reimbursement from third-party payers. The work involves the review of medical claims to ensure accuracy and completeness and obtain missing information. The incumbent performs various accounting, budget, or financial management support-related duties or assignments related to medical billing. Essential duties and responsibilities include: Responsible for received claims up until Third-Party Payer has paid the claim. Receives and examines alternate resource claims to ensure they are complete with appropriate supporting documents. Verifies accuracy of health claim number that claimed amounts are authorized and that the...

1. Review charges for accuracy and completeness prior to claim submission, identifying coding, modifier, and demographic errors that would result in rejection or denial. 2. Resolve claim edits, scrubber holds, and clearinghouse rejections on a daily basis in both athenaOne and eCW. 3. Research, document, and appeal denied claims, including preparation of appeal correspondence and assembly of supporting documentation. 4. Work aged accounts receivable by payer, aging bucket, and dollar value, prioritizing by recovery likelihood and timely filing exposure. 5. Contact payers by telephone and portal to obtain claim status, resolve processing errors, and pursue reprocessing. 6. Perform root-cause analysis on recurring denials and communicate the coding, configuration, or front-end workflow corrections required to prevent recurrence. Payment posting and reconciliation 7. Post electronic remittance advice (835) files and manual EOBs across assigned client practices and payers in both...

$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 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. 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...

Overview We are seeking an experienced Emergency Department Facility Coding Specialist to join our remote coding team. This role is responsible for reviewing emergency department medical records and accurately assigning ICD-10-CM, CPT/HCPCS, and facility Evaluation & Management (E/M) codes while ensuring compliance with payer, regulatory, and organizational requirements. The ideal candidate will have recent emergency department facility-fee coding experience, strong knowledge of injection and infusion coding, and an active coding certification through AAPC or AHIMA. Responsibilities Review emergency department medical records and assign accurate ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, and applicable modifiers. Accurately assign facility E/M levels based on client-specific emergency department leveling guidelines and facility charging methodologies, including use of the ACEP leveling tool. Analyze documentation from physicians, nursing...

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...

Quadris Team, LLC - A Revenue Cycle Management Group, is searching for a dynamic person to join us, working with our highly skilled Medical Coding Team to fill the role of Medical Coding Auditor & Educator.We are a 100% remote team supporting our clients across the United States! See us at.The ideal applicant will be a subject matter expert in both Facility and Profee medical coding auditing.Job Focus :The Senior Coding Auditor may be responsible for a variety of duties and obligations, depending on the client and assignment.These responsibilities may include inpatient / outpatient / professional fee facility auditing, denial management, coding, implementation specialist, job aid creation, training, and specialty coding.The position may also be responsible for management of the audit team and project management.All coding and auditing are performed within the scope of regulatory and compliance law expectations.Auditing Responsibilities :May include conducting inpatient,...