12 edits denials coder jobs found

Medical Biller/Coder Job Description CNSO is a vibrant, well-established neurosurgery, spine surgery, orthopedic spine surgery, pain management, and physical therapy practice with multiple office locations throughout Northern New Jersey.Due to continued expansion, CNSO has an exciting opportunity to join its revenue cycle department in its Wayne location.We are seeking an experienced Medical Biller/Coder with strong surgical coding expertise to accurately assign CPT, ICD-10-CM, and HCPCS Level II codes for neurosurgery, orthopedic spine, pain management, physical therapy, and E/M services.The ideal candidate has in-depth knowledge of CMS guidelines, NCCI edits, and payer policies, and communicates professionally with providers, internal teams, and insurance carriers.This position will serve as a subject matter resource for surgical coding and can work both independently and collaboratively.CNSO provides a two-month orientation and training process, and our highly organized revenue...

Medical Coding SpecialistResponsible for chart assembly, chart analysis, coding, and computer abstracting of all discharged patient medical records. Accurately assigns ICD-9-CM codes to all discharge diagnoses and processes requests for patient information. Makes decisions on codes and functions to be assigned in each instance including diagnostic and procedural information, significant reportable elements, and other complex classifications.Principal Accountabilities:Review clinical documentation and assign accurate ICD-10-CM, CPT, and HCPCS codes.Code office visits, procedures, and other services in accordance with payer requirements and organizational policies.Verify that documentation supports the codes and services billed; request clarification from clinicians when needed.Review charges before claim submission and correct coding errors or omissions.Research coding edits, claim rejections, and denials; make corrections and support appeals.Monitor coding work queues and complete...

Acentus is excited to announce an opening for the position of Certified Professional Coder Apprentice (CPC-A) on our team! In this role, you will play a crucial part in ensuring our professional medical billing and coding processes run smoothly, making a significant impact on our ability to help provide exceptional care to patients. We are looking for a friendly and organized individual who is passionate about medical billing and coding and eager to contribute to a supportive environment. The CPC-A position offers entry-level medical coding professionals real-world coding experience through participation in the Acentus structured coding training program. This program provides hands-on experience to help satisfy AAPC requirements for removing the apprenticeship designation from your CPC-A credential. Please note that this is not a fully remote position and does require employees to physically report to our office in Mt. Laurel, NJ. A semi-remote schedule is available after...

Medical Records - Coder I - Full Time - Days Job Summary Under the general direction of the Director CDI/Coding or designee, the Medical Records Coder I will improve documentation, data quality and revenue cycle operations. The coder assigns International Classification of Disease system- 10 (ICD), CM, and PCS codes according to AHA – AMA Guidelines, CMS and NGS. Core Job Responsibilities Assign diagnosis and procedure codes, for accurate and timely billing of most appropriate payer Audit charges and establish proper coding in collaboration with providers Initiate and follow up on queries with providers Assist departments with diagnostic and procedural coding Respond to Insurance, compliance and RAC denials Review and assist in the maintenance of coding related policies and procedures Perform other duties as required. Education/Experience Requirements REQUIRED: AS in Health Information Management, a related degree or equivalent experience Knowledge of EMR, Coding...

Overview Our team members are the heart of what makes us better. At Hackensack Meridian Health we help our patients live better, healthier lives - and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It's also about how we support one another and how we show up for our community. Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change. The Outpatient Coder I is responsible for accurately abstracting data following the Official International Classification of Diseases (ICD)-10-Clinical Modification (CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare and Medicaid Services (CMS) directives across the Hackensack Meridian Health (HMH) network. Performs data entry of required abstracted patient...

Capital Health is a regional leader in progressive, quality patient care, providing services through two hospitals, an outpatient center, satellite ED, and an extensive primary and specialty care network. The Medical Group employs over 600 physicians and other providers who deliver primary, specialty, and hospital‑based care to patients throughout the region. Pay Range: $25.49 - $33.16 per hour (full‑time equivalent 1.0 FTE). Scheduled Weekly Hours: 40 hours. Position Overview This is a full‑time, remote physician coding position open to candidates residing in New Jersey, Pennsylvania, or Alabama. The role requires accurate assignment of CPT, HCPCS, and ICD‑10‑CM codes for professional claims from Capital Health Medical Group for both hospital and outpatient procedures. Essential Functions Review procedure documentation to assign accurate CPT‑4 procedure codes and appropriate modifiers for OR and procedure room cases. Validate provider‑selected ICD‑10‑CM diagnosis codes....

Outpatient Coder I The Outpatient Coder I is responsible for accurately abstracting data following the Official International Classification of Diseases (ICD)-10-Clinical Modification (CM), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) Guidelines for Coding and Centers for Medicare and Medicaid Services (CMS) directives across the Hackensack Meridian Health (HMH) network. Performs data entry of required abstracted patient information into the electronic medical record system. Queries physicians when appropriate. A day in the life of an Outpatient Coder I at Hackensack Meridian Health includes: Assigns codes to clinical services performed for use in reimbursement and data collection Accountable for coding and abstracting of patient encounters, including diagnostic, surgical, and procedural information, significant reportable elements, and complications. Assesses clinical documentation and communicates with physicians and...

Outpatient Coding AuditorThe Outpatient Coding Auditor is responsible for auditing coded outpatient medical records to ensure compliance with official coding guidelines, regulatory agencies, and internal policies. This role supports coding accuracy, education, and process improvement through detailed review of encounters, identification of trends and variances, and communication with coding staff and leadership. This position also collaborates with external vendors to monitor performance and incorporate industry best practices into audit feedback and education.EducationHigh school diploma or equivalent required.ExperienceMinimum of 5 years of experience in hospital auditing or education experience ICD-10-CM and Outpatient CPT-4, HCPCs coding experience required. Knowledge of Medical Necessity APC, OCE, LCD, and NCD edits required. 3M Encoder experience, Meditech, EPIC, or CERNER preferred.SkillsCCS or COC, CPC, RHIT, RHIA required. Knowledge of ICD-10-CM, CPT-4 and HCPCs coding,...

Position Summary The Outpatient Coding Auditor is responsible for auditing coded outpatient medical records to ensure compliance with official coding guidelines, regulatory agencies, and internal policies. This role supports coding accuracy, education, and process improvement through detailed review of encounters, identification of trends and variances, and communication with coding staff and leadership. This position also collaborates with external vendors to monitor performance and incorporate industry best practices into audit feedback and education. Education High school diploma or equivalent required. Experience Minimum of 5 years of experience in hospital auditing or education experience ICD-10-CM and Outpatient CPT-4, HCPCs coding experience required. Knowledge of Medical Necessity APC, OCE, LCD, and NCD edits required. 3M Encoder experience, Meditech, EPIC, or CERNER preferred. Skills CCS or COC, CPC, RHIT, RHIA required. Knowledge of ICD-10-CM, CPT-4 and...

Capital Health is a regional leader in progressive, quality patient care, providing services through two hospitals, an outpatient center, satellite ED, and an extensive primary and specialty care network. The Medical Group employs over 600 physicians and other providers who deliver primary, specialty, and hospital‑based care to patients throughout the region. Pay Range: $25.49 - $33.16 per hour (full‑time equivalent 1.0 FTE). Scheduled Weekly Hours: 40 hours. Position Overview This is a full‑time, remote physician coding position open to candidates residing in New Jersey, Pennsylvania, or Alabama. The role requires accurate assignment of CPT, HCPCS, and ICD‑10‑CM codes for professional claims from Capital Health Medical Group for both hospital and outpatient procedures. Essential Functions Review procedure documentation to assign accurate CPT‑4 procedure codes and appropriate modifiers for OR and procedure room cases. Validate provider‑selected ICD‑10‑CM diagnosis codes....

Coding Auditor The Coding Auditor will be responsible for inpatient and outpatient coding and auditing for various specialties. This role will also be responsible for preparing and presenting audit results. Duties and Responsibilities Perform coding audits and compliance audits for providers, including physicians and mid-level providers. Prepare reports of audits and present audits to internal and external parties as needed Complete accurate application of appropriate coding and documentation guidelines, including but not limited to, E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidance Provide physician education when necessary. This could include, but is not limited to, audit findings or edit and denial trending. Complete coding audits for our copartners' coding WQ Work with any offsite auditors Evaluate and report on the overall quality of physician documentation that supports selected...

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...