42 certified appeals coder 8 jobs found

Job Description Summary UofL Health is a fully integrated regional academic health system with five hospitals, four medical centers, nearly 200 physician practice locations, more than 700 providers, the Frazier Rehab Institute and Brown Cancer Center. Address: Home Office Remote, KY 40601 Shift: First Shift (United States of America) With more than 12,000 team members—physicians, surgeons, nurses, pharmacists and other highly skilled health care professionals—UofL Health is focused on one mission: delivering patient-centered care to each and every patient each and every day. Job Overview This position is responsible for managing the appeal of unpaid claims in the Central Business Office. This position will also work closely with insurance carriers in resolving unpaid claims. Job Responsibilities Review and appeal unpaid claims daily. Complete follow-up work on appealed claims. Work with insurance carriers on appeal issues. Provide feedback to the coding department with...

Job Title This position is responsible for managing the appeal of unpaid claims in the Central Business Office. This position will also work closely with insurance carriers in resolving unpaid claims. Job Responsibilities Review and appeal unpaid claims daily. Completes follow-up work on appealed claims. Works with insurance carriers on appeal issues. Provides feedback to the coding department with coding errors or updates. Reviews remit to ensure accurate payment was received. Reviews denials for accuracy. Obtains all necessary information to expedite the appeal process. Closes and prints daily batch proof. Makes charge corrections as needed in the practice management system. Attends continue education programs for coding. Other duties as assigned. Education High School education or GED required. Must have and maintain Certified Professional Coder (CPC) certification through AAPC or must have and maintain CCA, CCS or CCS-P certification...

Job Description Job Description Specialty Senior Medical Coder – General Surgery Location: Irving, TX COMPENSATION & SCHEDULE • $35.75/hr (Non-CGSC Certified) | $42.00/hr (CGSC Certified – General Surgery) • Monday–Friday | 8:00 AM–5:00 PM • W2 | Temp to Perm • Start Date: 03/16/2026 ROLE IMPACT: The Specialty Coder Senior – General Surgery ensures accurate, compliant coding for high-dollar inpatient and outpatient professional services. This role drives revenue integrity by reducing denials, supporting clean claims, and maintaining a minimum 95% coding accuracy rate. Success is defined by precise code assignment, strong documentation review, and consistent productivity in a remote environment. Key Responsibilities • Assign ICD-10-CM, ICD-10-PCS, CPT, and HCPCS codes in accordance with Official Coding Guidelines and AMA CPT standards • Code inpatient and outpatient Evaluation & Management (E/M) and surgical/operative procedures, generating accurate...

Location: Palm Beach, FL | Pay: $28 - $36/hr | Hours: 8 AM - 5 PM Premier, high-growth multi-state surgical practice in Palm Beach seeking an elite Senior Biller to act as our team’s Subject Matter Expert, mentor staff, and optimize our revenue cycle. To follow up with your application, email: Stephanie.Salvant@randstadusa.com Salary: $28 - $36 per hour Shift: First Work hours: 8 AM - 5 PM Education: High School Responsibilities Manage full-cycle billing, charge entry, and coding validation via Nextech. Lead and mentor junior staff to clear daily backlogs (target: 20-30 claims/day). Handle complex out-of-network claims, authorizations, and payer escalations. Manage denials, execute appeals, and ensure compliance (No Surprises Act). Requirements 5+ years of dedicated medical billing experience. Background in Plastic Surgery, Podiatry, Orthopedics, General Surgery, or Trauma billing . Active Certified Professional Coder (CPC) credential. Experience with Nextech,...

Surgical Coding Manager 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. Location: Remote - Nationwide You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Oversees surgical coding team of 8 coders. Facilities and monitors workflows. Assigns work daily and projects as needed Responsible for procedure and diagnostic coding of professional charges. Works...

Overseeing a surgical coding team, the full-time remote Senior Medical Coder will manage workflows, ensure accurate procedure and diagnostic coding, and collaborate with clinical staff to maximize revenue through coding and appeals processes. Key responsibilities Oversees the daily assignments and workflow of a team of 8 coders Codes various medical records using CPT, HCPCS, and ICD-10 codes while ensuring compliance with regulations Communicates with providers regarding coding issues and collaborates with auditors on documentation errors Required qualifications High School Diploma/GED Certified Coder - Billing and Coding preferred, CPC or CCS certification eligible 3+ years of medical coding experience Medical terminology certificate or demonstrated knowledge Experience in ICD-10, CPT, and HCPCS coding or completion of related college coursework

Surgical Coding Manager 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. Location: Remote - Nationwide You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Oversees surgical coding team of 8 coders. Facilities and monitors workflows. Assigns work daily and projects as needed Responsible for procedure and diagnostic coding of professional charges....

Surgical Coding Manager 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. Location: Remote - Nationwide You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: Oversees surgical coding team of 8 coders. Facilities and monitors workflows. Assigns work daily and projects as needed Responsible for procedure and diagnostic coding of professional charges....

I'm the owner of a revenue cycle management (RCM) consulting firm and the founder of a new AI tool built to help healthcare billing teams verify medical necessity before a claim is ever submitted. I'm looking for 4 motivated students to train directly under me for a hands-on externship — real claims, real payers, real coding decisions, not busywork. About Pro Practice Solutions Pro Practice Solutions, LLC is a healthcare billing and coding consulting firm supporting medical practices with revenue cycle management, coding compliance, provider credentialing, and CMS documentation guidance. I bring over 24 years of hands-on experience across nearly every corner of medical billing and coding, and I'm now applying that experience to build AI technology for the industry. About the Externship You'll work directly with me on live client accounts, learning the revenue cycle from the ground up. This isn't shadowing — you'll be doing the work, with me reviewing and teaching as you go....

Job Type Full-time Description General Job Summary: Contributes in the delivery of excellent orthopaedic care in a patient centered environment by completing data entry and coding for all premier orthopaedic care provided within the multi-specialty practice. Essential Job Functions: 1. Establishes and maintains effective working relationships with coworkers, managers and providers. 2. Collects, reviews, codes, and data entry of all charges for a multi-specialty practice. 3. Responsible for quality control of all billable charges according to the coding compliance plan. 4. Maintains current records of hospital admissions, surgeries, discharges, and consultations as necessary. 5. Maintains required billing records, reports, files, etc. 6. Responsible for educating providers regarding charges. 7. Responsible for contributing to claims corrections and appeals. 8. Provides accurate coding information to all pertinent departments. 9. Maintains...

Facility: Administrative Regional Training Cntr Shift: Shift 1 Status: Full Time FTE: 1.0 Bargaining Unit: ACE Associates Exempt from Overtime: Yes Work Schedule: Days Hours: 7-4, 8-4 flexible Job Summary Under the direction of the Manager/Director of Revenue Integrity, including oversight from System revenue cycle leadership, the Revenue Integrity Coder of Infusion Services will be responsible for optimization of charge capture, charge review, appropriate documentation and work queue edits for all infusion services, specifically Oncology and Chemotherapy. This position serves as the primary contact/resource for Patient Financial Services, Revenue Integrity and Infusion Clinical Staff. The position requires advanced knowledge of Oncology, Chemotherapy, and Infusion drug requirements of various insurance providers as well as federal billing rules, Medicare and Medicaid. The incumbent actively participates as needed in both external third‑party audits and internal audits and...

STRIDE Billing Specialist At STRIDE Community Health Center, we're dedicated to more than just providing healthcare-we're committed to making a lasting impact on the lives of our patients and the communities we serve. As one of Colorado's largest Federally qualified healthcare centers (FQHC), we offer comprehensive services-including primary care, dental, pharmacy, behavioral health, health education and outreach services across 13 clinics in the Denver Metro area. With over 35 years of experience serving our community, our growing team is at the heart of our mission. We believe healthcare is about more than treating illness; it is about fostering wellness and addressing the unique needs of every patient, ensuring no one is left behind. If you're passionate about making a meaningful difference, thrive in a collaborative environment, and are ready for a career that transforms lives-including your own, STRIDE is the place for you. General Purpose: Responsible for understanding...

Location: Palm Beach, FL | Pay: $28 - $36/hr | Hours: 8 AM - 5 PM About Us: Premier, high-growth multi-state surgical practice in Palm Beach seeking an elite Senior Biller to act as our team's Subject Matter Expert, mentor staff, and optimize our revenue cycle. To follow up with your application, email, Stephanie.Salvant@randstadusa.com salary: $28 - $36 per hour shift: First work hours: 8 AM - 5 PM education: High School Responsibilities Responsibilities: Manage full-cycle billing, charge entry, and coding validation via Nextech. Lead and mentor junior staff to clear daily backlogs (target: 20-30 claims/day). Handle complex out-of-network claims, authorizations, and payer escalations. Manage denials, execute appeals, and ensure compliance (No Surprises Act). Requirements: 5+ years of dedicated medical billing experience. Background in Plastic Surgery, Podiatry, Orthopedics, General Surgery, or Trauma billing . Active Certified...

If you are an existing employee of South Shore Health then please apply through the internal career site. Requisition Number: R-21350 Facility: LOC0014 - 549 Columbian Street549 Columbian StreetWeymouth, MA 02190 Department Name: SHS Physician Services Admin Status: Full time Budgeted Hours: 40 Shift: Day (United States of America) Under experienced leadership the Professional Surgical Coder I is an advanced coding position that is responsible for accurate and timely assignment of codes to diagnoses and procedures for all outpatient and inpatient diagnostic and procedural coding. Using established department policies and procedures in conjunction with the current versions of ICD-10 and CPT-4, the Professional Surgical Coder I will determine the proper diagnosis, assign co-morbidities and complications, secondary diagnoses and any HAC (Hospital Acquired conditions) documented. As well as both E/M codes and procedure codes. The Professional...

Job Title Coder Physician Job Description Summary/Objective Under limited supervision the Coder Physician reviews medical records and performs coding on all diagnoses, procedures, DRG/APC, and charge codes. The Coder Physician uses the most accurate codes for reimbursement purposes, research, epidemiology, statistical analysis outcomes, financial and strategic planning, evaluation of quality of care, and communication to support the patient's treatment. The Coder Physician will be charged with maintaining the confidentiality of patient records and procedures. Essential Job Functions Responsible for abstracting, coding, sequencing and interpreting the clinical information from inpatient, outpatient, emergency department, pro fee, and clinical medical records. Responsible for the assignment of correct principal diagnoses, secondary diagnoses and principal procedure and secondary procedure codes with attention to accurate sequencing. Utilizes technical coding principals and...

Certified Professional Coder (Cpc) The Certified Professional Coder (CPC) serves as liaison between the medical group and the external coding vendor. This role ensures consistent communication, accurate and compliant coding practices, timely issue resolution, and alignment with organizational policies and payer requirements. The Coding Liaison supports documentation integrity, monitors vendor performance, and acts as a subject matter expert for coding-related inquiries. This role works closely with providers, clinical staff, and revenue cycle teams to review medical records, validate documentation completeness, apply correct CPT®, ICD-10-CM, and HCPCS codes, and educate providers on documentation best practices. Key Responsibilities Serve as the liaison to ensure coding queries issued by the vendor are addressed by providers, resolved appropriately, and returned to the vendor in accordance with established timelines. Identify documentation deficiencies and initiate...

Benefits 401(k) 401(k) matching Competitive salary Dental insurance Health insurance Opportunity for advancement Paid time off Training & development Vision insurance Role Overview We are seeking a highly detail-oriented Medical Biller with specialized experience in Pain Management, Orthopedics, Imaging, Physical Therapy, and Home Health billing. The ideal candidate isn't just a data entry clerk; you are a denial management expert who understands the complexities of Workers’ Compensation (IWCC) and commercial insurance claims. You will take ownership of the revenue cycle, from initial submission to the final appeal of a denial. Specific Requirements Specialty Expertise: Proven experience billing for Professional Imaging, Physical Therapy (understanding timed units), and Home Health services. Injury Claim Specialist: Deep understanding of Commercial and Injury claims, specifically navigating the Illinois Workers’ Compensation Commission (IWCC) guidelines. Portal...

Medical Biller & Coder (Certified) Kidney Associates of Kansas City – Kansas City, MO Fun, challenging team environment with excellent benefits! Kidney Associates of Kansas City is seeking a detail-oriented and experienced Medical Biller & Certified Medical Coder to join our team. This role plays a vital part across the entire revenue cycle—from coding and claim submission through payment posting and follow-up—ensuring accuracy, compliance, and optimal reimbursement. Position Details Full-time schedule: Monday–Thursday: 8:30 AM – 5:00 PM Friday: 8:30 AM – 4:30 PM Hybrid work option: 3 days onsite / 2 days remote (after training) Must reside in the Kansas City area Key Responsibilities Review medical codes (ICD-10, CPT, HCPCS) for accuracy prior to claim submission Perform internal coding audits to ensure accuracy and compliance with regulations and payer requirements Submit claims to insurance carriers in a timely manner Post payments and reconcile accounts...

Remote Certified Outpatient Medical Coder & Denial Specialist Position Type: Full-Time, Contract-to-Hire Location: Remote (Candidates must reside in TN, KY, IN, OH, or VA ) Compensation: $18.00 - $26.00 / hour (Depending on experience) Equipment: IT Equipment will be provided by the company Job Overview We are seeking a highly skilled, self-motivated Certified Outpatient Medical Coder & Denial Specialist to join a rapidly growing healthcare organization. In this role, you will have the unique opportunity to help rebuild a billing and coding team from the ground up under the guidance of a highly supportive, experienced manager. This position is ideal for an independent remote worker who thrives in a fast-paced environment, possesses a strict commitment to quality ( 95% accuracy standard ), and has a strong blend of pro-fee outpatient coding and back-end denial management expertise. Core Responsibilities 60% Denial Management & Appeals: *...

Job Description Job Description Description: At STRIDE Community Health Center, we’re dedicated to more than just providing healthcare-we’re committed to making a lasting impact on the lives of our patients and the communities we serve. As one of Colorado’s largest Federally qualified healthcare centers (FQHC), we offer comprehensive services-including primary care, dental, pharmacy, behavioral health, health education and outreach services across 13 clinics in the Denver Metro area. With over 35 years of experience serving our community, our growing team is at the heart of our mission. We believe healthcare is about more than treating illness; it is about fostering wellness and addressing the unique needs of every patient, ensuring no one is left behind. If you’re passionate about making a meaningful difference, thrive in a collaborative environment, and are ready for a career that transforms lives-including your own, STRIDE is the place for you. General Purpose :...

Job Title: Surgical Coder Job Type: Full Time Typical Schedule: Monday-Friday 8:30-5pm Essential Duties: Reviews operative reports and assigns and sequences accurate CPT codes, modifiers, and ICD-10 codes to surgical procedures. Enters CPT, modifiers and ICD-10 codes into the practice management software for claim submission. Reviews and analyzes data when insurance denies payment of surgical procedures. Ensures proper codes were submitted and files appeal letter if needed in order to receive proper reimbursement. Responsible for tracking appeals. Maintains current knowledge of relevant coding changes as they become effective and assists in implementing them. Answers questions from patients, clinical and billing staff. Maintains patient confidentiality and follows HIPAA Guidelines. Assists prior authorization team with needed CPT codes for upcoming surgical cases to obtain authorization. Assists patients with Surgical estimates. Performs other duties as assigned....

Inpatient Surgical Coder- PRN Job Category: Clinic Support Supervisor: Shayna Johnson Requisition Number: INPAT012456 Posted: July 8, 2026 Part-Time Remote Phoenix, AZ 85023, USA Job Details • Reviews and abstracts clinical documentation from complex inpatient orthopedic and spine surgery records to assign accurate ICD-10-CM, ICD-10-PCS, DRG, POA, and discharge disposition codes. • Independently codes high-acuity inpatient orthopedic spine surgery cases including cervical, thoracic, and lumbar procedures, revisions, fusions, instrumentation, and neurological-related musculoskeletal procedures. • Provides real-time feedback and training for coding staff to improve coding quality and productivity. • Applies and validates accurate MS-DRG assignments while ensuring compliance with CMS, UHDDS, Official Coding Guidelines, and payer-specific requirements. • Identifies coding trends, documentation gaps, and reimbursement risks and communicates findings to leadership....

Inpatient Surgical Coder- PRN Job Category: Clinic Support Supervisor: Shayna Johnson Requisition Number: INPAT012456 Posted: July 8, 2026 Part-Time Remote Phoenix, AZ 85023, USA Job Details • Reviews and abstracts clinical documentation from complex inpatient orthopedic and spine surgery records to assign accurate ICD-10-CM, ICD-10-PCS, DRG, POA, and discharge disposition codes. • Independently codes high-acuity inpatient orthopedic spine surgery cases including cervical, thoracic, and lumbar procedures, revisions, fusions, instrumentation, and neurological-related musculoskeletal procedures. • Provides real-time feedback and training for coding staff to improve coding quality and productivity. • Applies and validates accurate MS-DRG assignments while ensuring compliance with CMS, UHDDS, Official Coding Guidelines, and payer-specific requirements. • Identifies coding trends, documentation gaps, and reimbursement risks and communicates findings to leadership....

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a dynamic health care resource accredited by the DNV that includes two hospitals, an outpatient center, satellite ED, and an expansive network of primary and specialty care. Capital Health Medical Group is made up of more than 600 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region. Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates. The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and...