Appeal resolution coder jobs | Healthcare Careers

Northwell Health Physician Partners Great Neck, NY

Job Title Required: Background in Inpatient with 3-5 years' experience in Coding or Auditing. Highly Preferred: Auditing experience with DRGs. Job Description Responds to commercial payers, managed care and third party review organizations in managing the appeals/denials process. Supports the review of denial trends and identifies coding issues and knowledge gaps. Job Responsibility Supports denial reviews and response processes; prioritizes and reviews cases denied by commercial payers. Reports program performance and/or corrective action to management on regular basis. Assists in monitoring inpatient denial types, volume and formulates responses to requesting agency; seeks additional resources (e.g. legal counsel) to resolve issues, as needed; develops case-specific written rationale to substantiate and communicate findings. Addresses coding issues and knowledge gaps; functions as a organization resource for litigation as related to coding denials. Maintains hospital...

Full Time

Medical Coding & Appeals Specialist (HYBRID)

Washington University in St. Louis Hybrid (St. Louis, MO)

Champion Accurate Coding. Win Appeals. Make an Impact. Primarily Remote | Monthly Onsite Love the challenge of proving you’re right? This role is for coders who don’t just assign codes — they defend them. You’ll be part of a team that ensures providers are paid accurately for the care they deliver. When a payer says no, you build the case that turns it into yes. Your coding expertise, clinical insight, and persistence directly impact reimbursement and provider success. What makes this role exciting You’ll advocate for correct payment, not just code charts Your work directly reverses denials and underpayments You’ll collaborate with physicians, payers, and fellow coding experts Every appeal you win is a tangible victory What you’ll do Review medical records to validate accurate ICD‑10, CPT, and HCPCS coding Identify documentation or coding issues that impact reimbursement Build, submit, and follow payer...

Ke

Medical Biller & Coder

Kelly Brooksville, FL

Medical Biller & Coder We are seeking an experienced, detail-oriented, and highly motivated Certified Medical Biller and Coder to join our growing healthcare team. In this role, you will manage the full revenue cycle, ensuring accurate coding, timely claim submission, proactive denial resolution, and maximum reimbursement. The ideal candidate will possess strong analytical skills, extensive billing and coding knowledge, and the confidence to effectively communicate with insurance carriers and patients. Key Responsibilities Review clinical documentation and accurately assign ICD-10-CM, CPT, and HCPCS codes. Enter charges for daily patient encounters while ensuring coding accuracy and compliance. Prepare, review, scrub, and submit electronic and paper claims to commercial insurance carriers, Medicare, and Medicaid. Ensure claims are complete and compliant prior to submission. Investigate denied or underpaid claims and identify root causes. Research payer policies and...

SC

MEDICAL DENTAL CODER

Su Clinica Harlingen, TX

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...

HH

Outpatient Coder 2 Certified / PB Coding

Hartford HealthCare Farmington, CT

Coding Specialist Work where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. Job Summary Reviews and validates outpatient and professional clinical documentation and diagnostic results. Extracts data and assigns alpha numeric codes for billing, internal and external statistical...

HH

Outpatient Coder 2 Certified / HIM Coding

Hartford HealthCare at Home Farmington, CT

W ork where every moment matters. Every day, more than 40,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut's most comprehensive healthcare network. The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization. With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system. Position Summary: Reviews and validates outpatient and professional clinical documentation and diagnostic results. Extracts data and assigns alpha numeric codes for billing, internal and external statistical...

MJ

Medical Biller

Minnesota Jobs Minneapolis, MN

Medical Biller & Coder A growing specialty clinic is seeking an experienced Medical Biller & Coder to join their close-knit team. This role is responsible for managing the full billing cycle, including coding, claim submission, and insurance follow-up. We're looking for someone who is confident, detail-oriented, and comfortable advocating with insurance companies to ensure accurate and timely reimbursement. Full-Time | MondayFriday | $ (based on experience) Key Responsibilities Billing & Coding: Perform charge entry and accurately code medical procedures and services Claims Processing: Prepare and submit claims to insurance carriers in a timely manner Payment Posting: Apply insurance and patient payments within the system Denial Management: Investigate, appeal, and resolve claim denials Patient Communication: Contact patients regarding outstanding balances and collect payments Insurance Follow-Up: Work directly with insurance companies to resolve...

TM

Professional Coding Auditor and Educator - Remote

Tufts Medicine PA

Professional Coding Auditor And Educator - Remote This role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing.In addition, this role focuses on performing the following Health Information Management duties:Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information.An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a hands on environment.The majority of time is spent in the delivery of support services or activities, typically under supervision.An experienced level role that requires basic knowledge of job procedures and tools obtained through work experience and may require vocational or technical education.Works under moderate supervision, problems are typically of a routine nature, but may at times require interpretation or...

GT

Remote Medical Biller

GoToTelemed New York, NY

GoTo Telemed seeks an exceptional Remote Medical Biller to manage comprehensive Revenue Cycle Management (RCM) operations for our rapidly expanding telehealth platform serving multiple medical specialties and healthcare providers nationwide.As a key member of our distributed RCM team, you will process, manage, and optimize medical claims for an increasing portfolio of telehealth providers--with new clients and provider networks added every month as our organization scales.In this critical role, you will be the financial backbone of our provider network, managing the complete end-to-end billing lifecycle including patient eligibility verification, insurance claim submission, payment posting, accounts receivable follow-up, and comprehensive denial management.Your expertise in medical coding (CPT, ICD-10-CM, HCPCS), telehealth modifiers, payer policies, and compliance will directly impact provider revenue, patient satisfaction, and our organizational growth trajectory.This position...

MH

Medical Billing and Coding Specialist

MedHQ, LLC Wichita, KS

Trajectory RCS joined the MedHQ family in 2024 after enjoying 10 years as a well-established revenue cycle company with an annual growth rate of 40% to 50% and 150 employees. Together they now serve small hospitals, physician groups, ambulatory surgery, and outpatient centers nationwide by optimizing healthcare cash flow through integration of both business office processes and clinical documentation. MedHQ, LLC, is a fast growing, leading provider of consulting and technology–enabled expert services for outpatient healthcare. With a 97% long‑term client retention rate spanning over 20 years, MedHQ serves Ambulatory Surgery Centers (ASCs), Surgical Hospitals, Physician Practices, and Hospital and Healthcare Outpatient Facilities nationwide. The MedHQ RITE Values—Respect, Innovation, Trust, and Energy—permeate all service line offerings with a unique personalized approach balancing exceptional transactional and emotional intelligence, and above all excellent customer service. We...

Ve

RCS Medical Coding Auditor (CPC, CPMA)

Veradigm Raleigh, NC

Position SummaryThe RCS Medical Coding Auditor is responsible for auditing professional (ProFee) medical coding to ensure accuracy, compliance, and alignment with AMA CPT, CMS, NCCI and payer guidelines. This role supports coding integrity, mitigates compliance risk, and drives continuous quality improvement through targeted education and audit-based feedback.The ideal candidate brings strong hands-on experience with professional fee coding , deep knowledge of E/M, surgical, and modifier use , and the ability to translate audit findings into actionable insights.Key ResponsibilitiesPerform daily QA to ensure accuracy of completed coding and provide targeted coding education and feedbackValidate ICD‑10‑CM, CPT, HCPCS, and modifier assignment against clinical documentation to ensure accuracy and compliance with AMA CPT, ICD-10, CMS, NCCI, and payer-specific guidelinesConduct medical chart audits of professional services across multiple specialtiesIdentify coding discrepancies,...

AA

Provider Coding Auditor & Educator (Remote)

Anne Arundel Dermatology Owings Mills, MD

Overview We are seeking an experienced Professional Fee Coding Auditor & Educator to partner with physicians and APPs on coding accuracy, documentation improvement, compliance, and provider education. Must currently posses both the CPC and CPMA certifications in order to be considered for the role. The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a “hands on” environment. The majority of time is spent in the delivery of support services or activities, typically under...

PC

Medical Billing Specialist - NOT REMOTE

Peninsula Community Health Services of Alaska Adak, AK

TITLE :Medical Billing Specialist on site in Kenai AlaskaREPORTS TO :CFOWORK WEEK :Hours not to exceed 40 per weekWAGE CLASSIFICATION :Non-exempt $21.00 per hourOSHA RISK CLASSIFICATION :LowSUMMARY POSITION STATEMENTThis position exists to ensure the financial well-being of the PCHS organization through timely and accurate filing of insurance claims and collection of patient accounts and ensure proper posting of payments into existing PCHS systems for medical dental optometry and / or behavioral health.This position may be responsible for any or all the essential functions listed below in the electronic health record systems.ESSENTIAL FUNCTIONS / ROLES & RESPONSIBILITIES OF THE POSITIONCollaborate with staff providers team members patients and insurance companies to get all claims processed and paid.Capable of performing all aspects of medical billing independently including but not limited to charge entry posting insurance payments rejections and follow-up.Assign correct...

WM

Senior Inpatient Coder (REMOTE)

Westchester Medical Center New York, NY

Senior Inpatient Coder (REMOTE)Valhalla-NY-10595-United StatesJob Summary :The Senior Inpatient Coder is responsible for addressing appeals to insurance companies and coding highly complex medical records using the current International Classification of Diseases (ICD10 CM / PCS codes) and entering coded information into an automated grouper system.Technical guidance and acting in a lead role is expected.Does related work as required.Responsibilities :Addresses appeals to insurance denials to facilitate expedient resolution and reimbursement.Interprets and applies American Hospital Association Official Coding guidelines to articulate and support principle and secondary diagnoses and selected procedures.Identifies and analyzes patterns in possible coding errors or other trends and reports to the the coding leadership team.Participates in mandated medical record review processes.Using current ICD10 CM / PCS coding systems, assigns and records an accurate code to all diagnoses,...

DC

MEDICAL CODER SPECIALIST

Duke Clinical Research Institute Durham, NC

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions for Duke Health. This position is 100% remote. All Duke University remote workers must reside in one of the following states: North Carolina,Alabama, Arizona, Connecticut, District of Columbia, Florida, Georgia, Illinois, Iowa, Kentucky, Louisiana, Maine, Michigan, Missouri, Montana, New Hampshire, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, Washington....

CM

Medical Biller/Coder

CRA MSO LLC Chula Vista, CA

Job Description Job Description Our growing Ophthalmology practice has a vacancy for a Full Time Biller/ Coder role. This role will work on-site in our Chula Vista location and provide billing support to the corporate office as well as other satellite clinics. The ideal candidate has experience working in a collections role for an ophthalmology practice. This person will thrive in a busy, fast-paced environment and can multi-task while keeping a superb professional demeanor. The role will report to the Billing Manager. What do we need? We are seeking a talented and proficient Claims Denial Resolution Specialist/ Coder to join our growing team. At American Eye Associates we provide our Specialists the opportunity to learn, be challenged, and grow your career within the Revenue Cycle industry. Ideal candidates will possess claims processing experience and a competitive desire to maximize returns. What will you provide? · Understanding and proficient use of medical...

PS

Revenue Cycle Coder Denial Specialist

Proliance Surgeons Seattle, WA

At Proliance Surgeons our patients come from all walks of life - and so do we. We hire and support people from diverse backgrounds, fostering growth and development to make Proliance a great place to work. Our unique experiences and perspectives help us deliver Exceptional Outcomes, Personally Delivered . We are proud to offer a comprehensive and competitive benefit and pay package including health coverage, 401k with match and profit share, PTO and more! For further details regarding Benefits and Washington State Minimum Wage details please visit our careers page at www.proliancesurgeons.com/careers. Compensation during the offer process will be determined based on factors such as compensation structure, experience, qualifications, and internal equity. Be Part of Who We Are! Position Summary We are seeking a detail-oriented and analytical Revenue Cycle Coding Denial Specialist (Remote) to join our team. This role plays a key part in identifying denial trends, supporting...

my

Provider Coding Auditor & Educator (Remote)

myDermRecruiter United States

Professional Fee Coding Auditor & Educator We are seeking an experienced Professional Fee Coding Auditor & Educator to partner with physicians and APPs on coding accuracy, documentation improvement, compliance, and provider education. Must currently possess both the CPC and CPMA certifications in order to be considered for the role. The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or...

AA

Provider Coding Auditor & Educator (Remote)

Anne Arundel Dermatology United States

Professional Fee Coding Auditor & Educator We are seeking an experienced Professional Fee Coding Auditor & Educator to partner with physicians and APPs on coding accuracy, documentation improvement, compliance, and provider education. Must currently possess both the CPC and CPMA certifications in order to be considered for the role. The Coding Auditor and Educator role focuses on activities related to revenue cycle operations such as billing, collections, and payment processing. In addition, this role focuses on performing the following Health Information Management duties: Responsible for the accuracy, maintenance, security, and confidentiality of patient's health information. An organizational related support or service (administrative or clerical) role or a role that focuses on support of daily business activities (e.g., technical, clinical, non-clinical) operating in a "hands on" environment. The majority of time is spent in the delivery of support services or...

HM

Inpatient Coder - Fully Remote

Hurley Medical Center United States

Coding Specialist General Summary: Ensures proper assignment of diagnosis and procedure codes, along with validating and adjusting charges according to the services the patient received. Works collaboratively with Clinical Documentation Improvement personnel to ensure coding is clinically supported. Participates in the identification and resolution of discrepancies in documentation; assists in training as necessary. Maintains a working knowledge of applicable coding and reimbursement Federal, State, and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Participates in quality assessment and continuous quality improvement activities. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior. Supervision Received: Works under...

Co

Coding Validation Coder I

Cotiviti United States

Job Title Cotiviti has multiple openings for full-time coders. These roles will focus on claims audits for appeals, checking for completeness & accuracy based on coding guidelines. Experience with E&M coding & auditing is preferred. These are full-time remote positions and can be done anywhere within the continental US and will work a traditional day time schedule. Responsibilities Perform daily audits on provider appeals for completeness and accuracy based on specified coding guidelines to ensure appropriateness for reimbursement. Apply client specific coding guidelines when applicable. Learns new appeal categories as production need requires. Stays current on coding guidelines appropriate to the position. Uses the Cotiviti applications to processes CV appeals to meet both production and accuracy standards. Reviews quality feedback from QA. Submits questions for clarification as needed. Utilizes the 'QA Resolution' process when disagreement occurs...

TE

Medical Biller

TEKsystems Edina, MN

*Overview* A growing specialty clinic is seeking an experienced *Medical Biller & Coder* to join their close-knit team. This role is responsible for managing the full billing cycle, including coding, claim submission, and insurance follow-up. We're looking for someone who is *confident, detail-oriented, and comfortable advocating with insurance companies* to ensure accurate and timely reimbursement. Full-Time | Monday-Friday | $ (based on experience) *Key Responsibilities* * *Billing & Coding:* Perform charge entry and accurately code medical procedures and services * *Claims Processing:* Prepare and submit claims to insurance carriers in a timely manner * *Payment Posting:* Apply insurance and patient payments within the system * *Denial Management:* Investigate, appeal, and resolve claim denials * *Patient Communication:* Contact patients regarding outstanding balances and collect payments * *Insurance Follow-Up:* Work directly with insurance companies to resolve...

IS

Certified Medical Coder (OBGYN or Ortho)

Imagine Staffing Technology, An Imagine Company New York, NY

Certified Medical Coder (OBGYN or Ortho) FL, GA, IL, MD, NJ, NC, TX, VA, WV, IA, NY Nature & Scope: Positional Overview Are you a Certified Medical Coder ready to bring your expertise to a fully remote, contingent-to-hire opportunity? Join our client’s forward-thinking team and leverage your skills in accurate coding, compliance, and documentation to ensure seamless healthcare operations. We offer the flexibility of remote work, a collaborative virtual environment, and the chance to grow within a supportive organization. If you are detail-oriented, driven, and passionate about making a difference in healthcare, we want to hear from you! Apply today to take the next step in your coding career. Role & Responsibility Tasks That Will Lead To Your Success Review E/M, diagnostic and procedural documentation and assign correct CPT and diagnosis codes. Work with RCM team to identify patterns, trends and variations in coding and documentation practices. Prepare documentation...

HM

Inpatient Coder - Fully Remote

Hurley Medical Center United States

Coding Specialist General Summary: Ensures proper assignment of diagnosis and procedure codes, along with validating and adjusting charges according to the services the patient received. Works collaboratively with Clinical Documentation Improvement personnel to ensure coding is clinically supported. Participates in the identification and resolution of discrepancies in documentation; assists in training as necessary. Maintains a working knowledge of applicable coding and reimbursement Federal, State, and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Participates in quality assessment and continuous quality improvement activities. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior. Supervision Received: Works under...

126 appeal resolution coder jobs found