21 pre authorization medical coder jobs found

Job Description Job Description Position Overview: The RCM Coding Specialist is responsible for the accurate assignment of ICD-10-CM, CPT, and HCPCS codes based on clinical documentation to ensure compliant billing, timely claim submission, and optimal reimbursement. This role supports pre-claim workflows by identifying and resolving documentation gaps, validating medical necessity, and ensuring clean claim submission to reduce denials. The position collaborates cross-functionally with billing, AR, clinical, and operational teams to resolve coding and data deficiencies while maintaining compliance with payer guidelines and regulatory requirements. In addition to coding responsibilities, the role performs data analysis to identify trends, improve data quality, and drive revenue cycle performance. Success in this role requires strong attention to detail, deep coding expertise, and the ability to manage multiple priorities in a fast-paced environment. Performs other duties as...

Overview Employment Type: Full time Shift's Available: Days Hours: 8-hour days; 40/hours per week Location: Pampa Regional Medical Center - Rural Health Clinic Responsibilities The Biller is responsible for submitting claims to the appropriate intermediaries and to insure that procedures and charges are coded in compliance with all payers including Medi-Cal and/or Medicare regulations. Responsible for obtaining required authorizations necessary for the processing and payment of claims. The Biller is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD10, CPT, HCPCS, DRG) as they relate to reimbursement. Communicates clearly and efficiently by phone and in person with clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply with the various Government Programs...

Medical AI Auditor We are building the future of clinical documentation, and we need your expert eye to keep it accurate, safe, and reliable. AI-generated medical notes are transforming healthcare by giving providers their time back, but AI needs human expertise to stay grounded. As a Medical AI Auditor, you won't be handling traditional billing and coding compliance. Instead, you will act as the ultimate clinical guardrailreviewing AI-generated behavioral health records to detect "hallucinations" (clinically inaccurate or unsupported content that looks plausible but is factually incorrect). If you are a detail-obsessed medical coder or clinical documentation specialist who loves the intersection of healthcare and technology, this is your sandbox. What You'll Do Detect & Correct: Audit AI-generated behavioral health notes against source session data, catching subtle clinical inaccuracies, unsupported inferences, or errors in medical terminology. Evaluate Note Structure:...

Overview The Revenue Cycle Medical Billing Specialist is responsible for the overall account resolution of patient accounts within the revenue cycle management (RCM) process. Ensures timely billing of claims to payers and follow up of denials, appeals, recoupments and balance management. Ability to audit and provide feedback on the billing process and outcomes. Works cooperatively with other departments to ensure timely billing, reporting and patient account management. Supports the organization’s strategic plan and workplace inclusion initiatives. Abides by the organization’s mission in performing job duties. Demonstrates an understanding and commitment to PPGT’s culture of quality, safety and risk awareness. Responsibilities Reviews submission of claims by third party billing team to the clearinghouse to ensure accuracy. Processes reimbursements and payment adjustments with attention to detail, timeliness, and accuracy. Makes corrections and prepares appeals related to claim...

Medical Dental Coder Harlingen Annex - Harlingen, TX 78550 Description This position is vital in the health care delivery system in function with the fiscal aspect of the Clinic. Adhere to policies and procedures in conducting all clinical charges, payments, adjustments for proper billing and collections. Bills and submits claims to insurances/programs through AthenaOne EMR, follows up on claims statuses, resolves claim denials, submits appeals, post payments and adjustments, and manages collections. Great customer service and telephone etiquette, computer knowledge, professional appearance, attention to detail, able to multitask and work in a fast paced environment. Ability to work well under stress and maintain calm under pressure and work well with team members and willingness to cross-train. Functions as a member of a collaborative health care team to create and maintain a patient centered medical home. Essential Job Functions Communication: Communicates with outside...

Medical Billing Specialist Revenue Cycle Management is looking for a full-time Medical Billing Specialist to join our team. Hybrid opportunity after 90 days of in-person training (2 days from home, 3 days in office). SUMMARY: The Medical Billing Specialist is responsible for analyzing patients records and coding the patients records based on ICD-10 and CPT codes. Additionally, ensure all charges are reflected on the patient account and communicate with inter-departments regarding any type of discrepancy for corrections. Essential Functions Reviews patient accounts and supporting documentation to ensure all billable services and charges are captured accurately Validates diagnosis and procedure codes on accounts for billing accuracy and payer requirements; escalates discrepancies for correction Communicates with clinical, coding, and front-end teams to obtain or clarify missing or incomplete information Prepares and submits accurate electronic and paper claims to...

Biller Position The Biller is responsible for submitting claims to the appropriate intermediaries and to insure that procedures and charges are coded in compliance with all payers including Medi-Cal and/or Medicare regulations. Responsible for obtaining required authorizations necessary for the processing and payment of claims. The Biller is responsible for the follow-up and denial management as necessary for final resolution. Responsible to identify the various types of diagnosis and procedures codes (ICD10, CPT, HCPCS, DRG) as they relate to reimbursement. Communicates clearly and efficiently by phone and in person with clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply with the various Government Programs billing requirements. Operates computer to input follow up notes and retrieve collection and patient information. Maintains proficiency in Medical Terminology....

## CPC-A Certified Coder RepresentativeApplylocations: San Antonio, Texas, USA - Remotetime type: Full timeposted on: Posted Todaytime left to apply: End Date: August 31, 2026 (30+ days left to apply)job requisition id: R\_2606\_7783**About TaskUs:** TaskUs is a provider of outsourced digital services and next-generation customer experience to fast-growing technology companies, helping its clients represent, protect and grow their brands. Leveraging a cloud-based infrastructure, TaskUs serves clients in the fastest-growing sectors, including social media, e-commerce, gaming, streaming media, food delivery, ride-sharing, HiTech, FinTech, and HealthTech.The People First culture at TaskUs has enabled the company to expand its workforce to approximately 45,000 employees globally. Presently, we have a presence in twenty-three locations across twelve countries, which include the Philippines, India, and the United States.It started with one ridiculously good idea to create a different...

Medical Billing Specialist - Women's Health The Medical Billing Specialist is responsible for the timely and accurate submission of insurance claims, reviewing and updating denied claims for resubmission and performing reconciliations to ensure timely billing for services provided. The Medical Billing Specialist collaborates with patients, revenue cycle counterparts and work units, clinical staff, and insurance providers to drive the efficiency of the billing process and reduce the amount of denied claims. This position is fully remote. Essential Responsibilities: Reviews patient demographic and insurance information and confirms patient benefit details related to services provided by the clinic from insurance providers. Obtains necessary medical documentation from clinicians to provide to insurance companies as required for review and prior authorization of treatment. Documents authorization reference numbers in EMR and/or other systems. Updates and maintains EMR and/or other...

Medical Billing Specialist - Women's Health The Medical Billing Specialist is responsible for the timely and accurate submission of insurance claims, reviewing and updating denied claims for resubmission and performing reconciliations to ensure timely billing for services provided. The Medical Billing Specialist collaborates with patients, revenue cycle counterparts and work units, clinical staff, and insurance providers to drive the efficiency of the billing process and reduce the amount of denied claims. This position is fully remote. Essential Responsibilities: Reviews patient demographic and insurance information and confirms patient benefit details related to services provided by the clinic from insurance providers. Obtains necessary medical documentation from clinicians to provide to insurance companies as required for review and prior authorization of treatment. Documents authorization reference numbers in EMR and/or other systems. Updates and maintains EMR and/or other...

These nonexempt positions are Monday – Thursday, 7:30am – 5:00pm, Friday, 7:30am – 12:00pm with a possibility of some overtime. Benefits Benefits include: Medical health insurance (100% paid by AHI for employee). Retirement plan with employer matching 2 weeks Paid Vacation 1 week Paid Sick 9 paid holidays – New Years, Good Friday, Memorial Day, 4th of July, Labor Day, Thanksgiving (Thursday & Friday), Christmas Eve & Christmas Day. How to Apply Interested applicants can: Call 806-510-7250 Fax their resume to 806-510-7284 – Attn: Human Resources Email resume to jobs@amarilloheart.com Background check required. EOE Statement: We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. CERTIFIED NURSING ASSISTANT - CARDIOLOGY We are seeking a...

Job Description Job Description Description: Summary/Objective Primary duties include, but are not limited to: consistent follow-up on unpaid claims utilizing monthly aging reports and filing appeals when appropriate to obtain maximum reimbursement. Secondary duties include but are not limited to: data entry of all patient demographics, guarantor and insurance information, posting procedures and insurance/patient payments, scheduling, and ensuring authorizations are current. General Duties Ensure all claims are submitted weekly Verifies completeness and accuracy of all claims prior to submission Accurately post all insurance and patient payments daily Timely follow-up on insurance claim denials Reading and interpreting insurance explanation of benefits Completion of monthly aging reports to follow-up on unpaid claims aged over 30 days Monthly patient statements Obtaining referrals/authorizations Scheduling of appointments Competencies Leadership and staff...

The Medical Coder is responsible for assigning procedure and diagnosis codes for insurance billing, reviewing claims data, researching medical records, and corresponding with insurance companies to secure accurate reimbursement for healthcare claims. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims Adhere to coding policies and procedures consistent with industry-standard guidelines for CPT, ICD-9 and ICD-10 Answer coding questions Review clinical documentation to ensure it meets the level of CPT codes, ICD-10 and ICD-11 codes Perform related duties as...

Revenue Cycle Management is looking for a Medical Billing Specialist to join our team! Hybrid opportunity after 90 days of in-person training (2 days from home, 3 days in office) SUMMARY: The Medical Billing Specialist is responsible for analyzing patient's records and coding the patient's records based on ICD-10 and CPT codes. Additionally, ensure all charges are reflected on the patient account and communicate with inter-departments regarding any type of discrepancy for corrections. ESSENTIAL FUNCTIONS: Reviews patient accounts and supporting documentation to ensure all billable services and charges are captured accurately Validates diagnosis and procedure codes on accounts for billing accuracy and payer requirements; escalates discrepancies for correction Communicates with clinical, coding, and front-end teams to obtain or clarify missing or incomplete information Prepares and submits accurate electronic and paper claims to commercial insurance carriers...

The Medical Coder to assign procedure, diagnosis codes for insurance billing, review claims data, research and correspond with insurance companies in an effort to obtain accurate reimbursement for healthcare claims. Duties include but are not limited to: Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing. Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission. Conduct medical records research and correspond with insurance companies and healthcare professionals to resolve issues resulting from denied claims Adhere to coding policies and procedures consistent with the industry-standard guidelines for CPT, ICD-9 and ICD-10. Answer coding questions Review clinical documentation to ensure it meets the level of CPT codes, ICD-10 and ICD-11 codes Performs related duties,...

Job Description Job Description Westside Podiatry is searching for a confident professional that is adept at medical insurance billing, coding, and receivables recovery, with a strong background in Athena. The candidate must have proven productivity track record, great attitude, thrive in a fast paced production environment, be quality oriented, and possess the ability to adapt to a variety of technologies. You will work closely with patients, providers, insurance companies, and medical/surgical representatives to ensure the proper revenue for the practice. Skills Required: You must have at least 3 years of in-depth medical business office experience. This should include experience with coding, posting, electronic remittance filing, A/R, plus strong positive working relationships with patients and insurance companies. We will only consider candidates with medical billing experience. Critical and analytical thinking is key. Must be able to work independently and in a team...

Benefits: 401(k) 401(k) matching Dental insurance Health insurance Paid time off Training & development Vision insurance Position Summary We are seeking a detail-oriented and knowledgeable Medical Biller and Coder to join our healthcare clinic team. This role is responsible for accurately coding medical procedures and diagnoses, submitting insurance claims, posting payments, and ensuring timely reimbursement while maintaining compliance with healthcare regulations and clinic policies. The ideal candidate is organized, professional, and committed to supporting quality patient care through accurate billing and coding practices. Essential Duties and Responsibilities Review patient charts, clinical documentation, and physician notes for accurate coding and billing Assign appropriate ICD-10, CPT, and HCPCS codes for services rendered Prepare and submit electronic and paper insurance claims in a timely manner Verify insurance eligibility, benefits, and...

Associate Director - Medical Science Liaison - Gastroenterology (Dallas TX) Join to apply for the Associate Director - Medical Science Liaison - Gastroenterology (Dallas TX) role at BioSpace Associate Director - Medical Science Liaison - Gastroenterology (Dallas TX) 1 day ago Be among the first 25 applicants Join to apply for the Associate Director - Medical Science Liaison - Gastroenterology (Dallas TX) role at BioSpace At Lilly, we unite caring with discovery to make life better for people around the world. We are a global healthcare leader headquartered in Indianapolis, Indiana. Our employees around the world work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to our communities through philanthropy and volunteerism. We give our best effort to our work, and we put people first. We’re looking for people who are determined to make life better for people around the world. Organization...

Medical AI Auditor We are building the future of clinical documentation and need your expert eye to keep it accurate, safe, and reliable. As a Medical AI Auditor, you will act as the ultimate clinical guardrail—reviewing AI‑generated behavioral health notes to detect hallucinations. What You’ll Do Audit AI‑generated behavioral health notes against source session data, catching subtle clinical inaccuracies, unsupported inferences, or errors in medical terminology. Ensure documentation aligns with behavioral health standards and distinguishes between appropriate clinical language and inappropriate or robotic phrasing. Navigate multi‑platform, document‑intensive review systems while maintaining a high level of focus. Apply advanced editing and proofreading skills to perfect English grammar, punctuation, and terminology, directly training the AI to write better notes. What We Are Looking For Baseline Credential: Certified Professional Coder – Apprentice (CPC‑A) from AAPC, or...

Key Responsibilities:Claims and Billing Operations. Prepare, review, and submit insurance claims (electronic and paper when needed) for professional and or facility services. Verify that claims include accurate patient demographics, insurance information, authorizations, diagnosis codes, procedure codes, modifiers, units, and supporting documentation as applicable. Maintain clean claim workflows and resolve claim edits and clearinghouse rejections promptly. A/R Follow-Up and Denials Management. Monitor accounts receivable aging and prioritize follow-up based on payer rules, dollar value, and timely filing limits. Investigate and resolve denials, underpayments, and request for information (medical records, referrals, authorizations). Submit corrected claims and appeals with appropriate documentation and accurate coding support. Payments and Patient Billing. Post and reconcile payments and adjustments from ERAs and EOBs. Identify and escalate payer payment variances and contract...

Medical Billing SpecialistRevenue Cycle Management is looking for a Medical Billing Specialist to join our team! This is a hybrid opportunity after 30-90 day in-person training (4 days from home 1 day in office).Summary:The Medical Billing Specialist is responsible for analyzing patients records and coding the patients records based on ICD-10 and CPT codes. Additionally ensure all charges are reflected on the patient account and communicate with inter-departments regarding any type of discrepancy for corrections.Essential Functions:Reviews medical record documentation to ensure pertinent diagnoses are codedUtilizes ICD 10 CPT clinical reports UDS reports H&P reports operative reports code diagnosis and modifiers according to coding guidelinesCommunicates effectively with all appropriate parties regarding missing information to ensure proper billing submissionPrepares and submit electronic and paper claims to insurance carriers and gov payersManages the status of accounts and...