24 pro fee coder jobs found

Experienced Multi-Specialty Surgery Coder The experienced multi-specialty surgery coder is responsible for daily coding, denial management, charge hold, RAI resolution and abstraction. The coder is responsible for escalation of coding questions and requests for coding guidance to the Coding Coordinator and/or Supervisor. Participate in internal QA audits and provide feedback in the compliance QA process. Hours: Monday - Friday, working 40 hours a week Location: Fully Remote - U.S You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Provide coding and abstraction of physician or professional records Provide communications to Coordinator, Supervisors and Managers Complete RAI's, denials, charge hold reports, and coding edits Assist on special coding projects as assigned You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear...

Professional Coder The professional coder will be responsible for handling clinic charges, scrubbing chart for completeness, reviewing diagnosis codes, verifying procedures, along with communicating with providers regarding missing information and working edits. We are a company committed to creating inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity employer that believes everyone matters. Qualified candidates will receive consideration for employment opportunities without regard to race, religion, sex, age, marital status, national origin, sexual orientation, citizenship status, disability, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to Human Resources Request Form.

Surgery Coder Colorectal Specialty We are seeking an experienced Professional Fee Surgery Coder with a strong background in colorectal procedures. The ideal candidate will have a minimum of 2 years of colorectal-specific coding experience and a proven ability to handle high-volume coding efficiently and accurately. Key Responsibilities: Accurately code colorectal surgical procedures for professional billing (Pro Fee). Maintain compliance with all applicable coding guidelines and payer requirements. Review operative reports and assign appropriate CPT, ICD-10, and modifiers. Ensure timely and accurate coding for approximately 30 cases per hour. Collaborate with clinical and billing teams to resolve coding discrepancies. Stay current with industry changes and updates in colorectal coding. Required Qualifications: CPC Certification (Certified Professional Coder) required. Minimum 2 years of colorectal-specific coding experience (not just gastroenterology). 35 years of...

In this high-impact Outpatient Pro-Fee Coding role, you will move beyond simple data entry to perform true clinical extraction, navigating complex operative reports across General Surgery, Plastics, ENT, and Neurosurgery to identify CPT and ICD-10-CM codes. Working within Epic, you'll master a shared work queue where you'll apply advanced logic-including modifiers, dummy codes, and Prop 99-to ensure seamless charge drops for high-dollar encounters. This is a position designed for the technical "detective" who thrives on a 95% quality benchmark and maintains a sharp pace of 12 surgical charts or 18 E/M visits per hour. You'll join a collaborative, remote environment that prizes technical accuracy and peer-to-peer knowledge sharing, offering a highly flexible "5-to-5" style schedule that empowers you to own your workflow while tackling the industry's most intricate surgical specialties. Schedule: Flex schedule. Can start as early as 5am in their timezone and be on as late as...

*Job Title:* Surgery Coder - Colorectal Specialty *Location:* Remote *Employment Type:* Full Time *Position Summary* We are seeking an experienced *Professional Fee Surgery Coder* with a strong background in *colorectal procedures*. The ideal candidate will have a minimum of *2 years of colorectal-specific coding experience* and a proven ability to handle high-volume coding efficiently and accurately. *Key Responsibilities* * Accurately code *colorectal surgical procedures* for professional billing (Pro Fee). * Maintain compliance with all applicable coding guidelines and payer requirements. * Review operative reports and assign appropriate CPT, ICD-10, and modifiers. * Ensure timely and accurate coding for approximately *30 cases per hour*. * Collaborate with clinical and billing teams to resolve coding discrepancies. * Stay current with industry changes and updates in colorectal coding. *Required Qualifications* * *CPC Certification* (Certified Professional Coder)...

Description Under moderate supervision, responsible for reviewing, auditing, and data entry of medical bills for multiple states and lines of business within both Worker’s Compensation and Commercial Health arenas. This would include analysis for the fee schedule or usual and customary application, as well as PPO interface, while meeting contractual client requirements. Essential Job Functions Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines, and PPO discounts Analysis and review of 1 or more assigned states having fee schedules Utilize Fee Schedules, Online Documents, Client instructions, and other training material to properly review medical bills Review medical bills for compensability and relatedness to injury Reprice medical bills to Workers’ Compensation Fee Schedule and PPO Network Research usual and customary/fee schedule applications and system interface as appropriate Reviews...

Your Future Evolves Here Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones. Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business. Join Evolent for the mission. Stay for the culture. What You'll Be Doing: The Program Integrity Coder- FWA Auditor is responsible for verifying the accuracy of itemized, complex claim review for payment, coding, and billing guidelines in accordance with...

Medical Coder - Independent Dispute Review (IDR) *Location:* 100% Remote *Pay Rate:* $25.00/hour *Schedule:* Monday-Friday | 8:00 AM - 4:30 PM CST *Duration:* Longterm contract (multiyear opportunity) About the Opportunity We are partnering with a nationally recognized medical review organization that supports state and federal agencies, healthcare payers, and employers by providing *independent, unbiased medical claim reviews*. Due to the *No Surprises Act* and a permanent increase in claim volume, this team is expanding and building out a *brandnew Independent Dispute Resolution (IDR) unit*. This is a *stable, longterm opportunity* with consistent work and strong training support-ideal for a CPC or CPCA professional looking to grow their career beyond traditional coding roles. What You'll Do In this role, you will *not be coding charts*. Instead, you'll use your coding knowledge to make *payment determinations* on disputed medical claims. Key responsibilities include: *...

Professional Coder The Professional Coder will review, analyze, and validate CPT and ICD-10 diagnosis codes and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 DX codes. This position is remote. Essential Duties And Responsibilities Effectively reviews, analyzes, and validates CPT, ICD-10 diagnosis codes, HCPCS, modifiers and charges applied by providers to assure compliant with federal and state regulations and insurance carrier guidelines. Perform accurate and compliant coding of CPT and ICD-10 diagnosis codes. Understands National Correct Coding Initiative (NCCI) edits and relative value units as appropriate for the role. Ensure established productivity and quality standards are met. Review denials, research and respond appropriately and timely. Perform audits as determined by management. Assist with all levels of application testing for...

Medical Coder TekSystems is currently hiring for a medical coder that can sit anywhere in the US as it is fully remote, this position does work on EST time zone hours! Must have: 1-3 years of medical coding experience preferably outpatient experience but open to other medical coding experience, must have an active CPC license! These coders will be taking the work from the client coordinators. They will be looking at what the provider sends and coded for payment and what the payer sends and coded for payment. They will be reviewing the case to decide which one is correct, is the correct code being used, and make a determination of what code and payment is recommended by MCMC. Then they pass it off to QA for review. They will do these cases over and over again to push them through. All of the cases are going to be emergency services, so they would like for everyone to have experience in emergency services, inpatient coding, or DRG (diagnosis-related group) coding. This would allow...

Job Description Job Description CERIS is seeking a Certified Coder. The CERIS Certified Coder reverse code previously coded medical bills to determine coding accuracy. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim and processes based on state rules and regulations Determine validity and compensability of the claim using CorVel proprietary programs Make recommendations to referring office Communicate claim status with referring office Read and comprehend all medical reports Adhere to client and carrier guidelines and participate in claims review as needed Assists other claims professionals with more complex or problematic claims as necessary Additional duties/responsibilities as assigned Comply with all safety rules/regulations, in conjunction with the Injury and Illness Prevention Program (“IIPP”), as well as, maintain HIPAA compliance KNOWLEDGE & SKILLS: Ability to learn rapidly to develop knowledge and...

Job Family General Coding Travel Required None Clearance Required None What You Will Do: Pre-Authorization Coding: The coder will review documentation for planned procedures and provide the appropriate CPT for authorization. What You Will Need: High School Diploma or equivalent 3-5 years of relevant experience Certified Professional Coder (CPC) certification from AAPC Knowledge in coding guidelines Good written and oral communication skills Proficiency in use of excel What Would Be Nice To Have: Proficiency in CPT Surgical Coding Additional surgical specialty credentials from AAPC The annual salary range for this position is $40,000.00-$66,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs. What We Offer: Guidehouse offers a comprehensive, total rewards package that includes...

JOB SUMMARY The CRC Auditor, conducts coding and documentation quality reviews and generates responses for cases that have been denied by commercial and government payors to ensure hospital inpatient, outpatient, and pro-fee claims, were coded and billed in accordance with nationally recognized coding guidelines, standards, regulations and regulatory requirements, as well as payor and billing guidelines. The responses generated by the Auditor may include system documentation of findings and / or a formal appeal letter. The Auditor will escalate trends to CRC leadership, Conifer Quality & Performance leadership and Conifer Compliance as warranted. The Auditor will perform analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical denials. Assures appropriate action is taken within appeal time frames. Communicates identified denial trends...

Overview Coder - Full Time Laredo Rehabilitation Hospital in Laredo, Texas is a full-service inpatient rehabilitation hospital committed to helping patients in South Texas recover and thrive after serious injuries or illnesses. Our hospital provides intensive rehabilitation programs for stroke patients, brain and spinal cord injuries, orthopedic injuries, and other complex conditions, all under the guidance of our skilled multidisciplinary team. We pride ourselves on offering personalized care – our physical, occupational, and speech therapists tailor each treatment plan to the patient’s unique needs and cultural background, reflecting the community we serve. With modern facilities and a caring bilingual staff, we ensure patients, and their families feel supported and informed throughout the recovery journey. Accredited by The Joint Commission and consistently rated among top rehab providers, Laredo Rehabilitation Hospital is dedicated to restoring independence and improving...

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is powered by the largest, most diverse health data network in the U.S., enabling data to be secure, accessible and usable to inform better health decisions. Datavant is trusted by the world's leading life sciences companies, government agencies, and those who deliver and pay for care. By joining Datavant today, you're stepping onto a high-performing, values-driven team. Together, we're rising to the challenge of tackling some of healthcare's most complex problems with technology-forward solutions. Datavanters bring a diversity of professional, educational and life experiences to realize our bold vision for healthcare. We're looking for experienced and credentialed outpatient coders to become an integral part of our team. The ideal candidate for this role possesses...

*Description* * Assign CPT, ICD-10, and HCPCS codes for anesthesiology procedures. * Analyze medical records for accurate code assignment. * Apply appropriate modifiers for precise coding. * Generate and submit claims promptly. * Verify patient insurance information and resolve discrepancies. * Address denied claims, process appeals as needed. * Collaborate with providers for clear documentation. * Stay updated on coding regulations and compliance requirements. * Liaise with insurance companies and patients for billing inquiries. * Provide coding guidance to team members. *Additional Skills & Qualifications* Additional Skills & Qualifications * Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) desired. * 3-5 years of anesthesiology coding and billing experience preferred * Proficient in coding and billing claims software. * Thorough understanding of compliance and regulatory requirements. *Experience Level* Intermediate Level *Job...

*Registered Nurse Clinical Coder - DRG Audit (100% Remote)* *Position Type:* Contract *Schedule:* Full-time, Remote *Experience Level:* Intermediate (5+ years) *Pay:* $90,000 *Overview* Our client is seeking an experienced *Registered Nurse Clinical Coder* to support DRG audit activities for one of their major healthcare partners. This role focuses on reviewing inpatient medical records, validating DRG assignments, and ensuring coding accuracy from an *insurance and payerside perspective* rather than the provider side. This is an excellent opportunity for an RN with coding experience who enjoys analytical work, documentation review, and collaborating with audit teams. *Key Responsibilities* * Perform *DRG audits* on inpatient medical records to validate ICD10 coding accuracy and DRG assignment. * Review clinical documentation to ensure compliance with payer guidelines and audit standards. * Identify discrepancies, trends, and opportunities for coding improvement. *...

Company Description Vee Healthtek, Inc.delivers cutting-edge solutions that transform healthcare organizations.We offer a comprehensive suite of services that leverage our industry expertise to provide the best possible value to our clients.By creating customized strategies, we address specific challenges and provide growth opportunities.Our technology-driven services empower organizations to improve workflows, increase cost efficiency, and streamline business processes.With a track record of success, Vee Healthtek, Inc.is the partner of choice for organizations looking to invest in innovation and drive sustainable growth.Learn more at https :/ / www.veehealthtek.com.Job Summary Responsible for assigning diagnostic and procedural codes to patient charts of moderate to high complexity using ICD-10-CM, CPT and HCPCS or any other designated coding classification system in accordance with coding rules and regulations.Abstracting required clinical information from the medical...

Job Title :Gastroenterology ProFee Coder (E / M & Surgical) Company Description Vee Healthtek, Inc.delivers cutting-edge solutions that transform healthcare organizations.We offer a comprehensive suite of services that leverage our industry expertise to provide the best value to our clients.Through close collaboration and a deep understanding of market trends, we create customized strategies that deliver tangible outcomes.Our technology-driven services empower organizations to thrive in the evolving healthcare landscape, resulting in improved workflows, increased cost efficiency, and streamlined business processes.Learn more at www.veehealthtek.com.Job Summary The Gastroenterology ProFee Coder is responsible for accurate assignment of diagnosis, procedure, and Evaluation & Management (E / M) codes for physician professional services within a gastroenterology practice or health system.This role focuses exclusively on professional fee coding , ensuring compliance with CPT,...

Job Description The Compliance Auditor, Billing and Coding Compliance is responsible for the oversight and management of auditing and monitoring billing and coding compliance activities, assist with internal compliance policies and procedures, completing compliance risk assessments, and developing risk-based educational materials to ensure compliance with federal/state laws and regulations, and UT Health San Antonio policies. Responsible for effectively communicating information and audit findings through presentations, graphs, reports, and educational materials, etc. Responsibilities Provide oversight on billing compliance auditing, monitoring, and educational activities within the compliance department. Performs audits of electronic and manual documentation, coding, and billing systems. Conducts close-out meetings with senior management of audited departments. Maintain current knowledge of changes in federal and state coding and billing regulations/guidelines...

Become a part of our caring community and help us put health first The Inpatient Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Inpatient Medical Coding Auditor work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Humana is looking for an experienced medical coding auditor to review inpatient hospital claims for proper reimbursement, handle provider disputes in a result-oriented and metrics-driven environment. If you are looking to work from home, for a Fortune 100 company that focuses on the well-being of their consumers and staff, and rewards performance, then you should strongly consider the Inpatient Coding Auditor (MSDRG). The Inpatient Medical Coding Auditor contributes to overall cost reduction, by increasing the...

$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...

Job Description A client of Innova Solutions is immediately hiring for a HIM Coder . Position type: Full-time, Contract Duration: 5+ Months Location: Remote (looking for candidates based out in HI, CA, WA or OR) As a HIM Coder, you will: Review inpatient and outpatient medical records daily to identify and assign accurate diagnosis and procedure codes. Abstract clinical data and ensure coding is completed within required productivity and compliance timelines. Apply ICD-10-CM, CPT, and HCPCS Level II guidelines to ensure proper code selection and sequencing. Communicate with physicians and internal teams to clarify documentation, diagnoses, and procedures when needed. Monitor coding accuracy, resolve discrepancies (including DRG‑related issues), and maintain adherence to coding standards and policies. Required Skills & Qualifications 2+ years of recent hospital coding/abstracting experience within the last 5 years (inpatient and/or outpatient). Certified Coding...

Overview Outpatient Coder- multi-specialty - Healthcare & Research Job ID: 1011744 Alamogordo, New Mexico | Job Type: Contract | Added: 01/21/26 Job Description A client of Innova Solutions is immediately hiring for an Outpatient Coder multi-specialty . Position type: Full-time, Contract Duration: 3+ Months Location: Remote in Texas, Louisiana, Arkansas, Georgia, New Mexico. As an Outpatient Coder multi-specialty you will: Responsible for maintaining current and high-quality ICD-10-CM and CPT coding for all outpatient diagnoses and procedural occurrences, through the review of clinical documentation and diagnostic results, with a consistent coding accuracy rate of 95% or better. The coder will accurately abstract data into any and all appropriate client’s Health electronic medical record systems, verifying accurate patient dispositions and physician data, following the Official ICD-10-CM Guidelines for Coding and Reporting and CPT Guidelines. Outpatient coding is...