341 claim edit coder jobs found

Remote Ed / Claim Edit CoderNow hiring a Remote ED / Claim Edit CoderHas the knowledge and ability and will be required to code all of the following :inpatient and / or outpatient hospital records, ED records, Home Health & Hospice records and / or professional fee services for PMG specialty providers or demonstrate coding expertise in a specific specialty deemed a critical business need by PHS Coding Leadership using the ICD-9 / 10 CM and CPT-4 classification system.Ensures adherence to Hospital and Departmental Policies and ProceduresWe value our employees' differences and find strength in the diversity of our team and community.At Presbyterian, it's not just what we do that matters.It's how we do it - and it starts with our incredible team.From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.Why Join UsFull Time - Exempt :NoRev Hugh Cooper Admin CenterWork hours...

Job Description Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company’s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals. What you will be doing in this role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT)...

Job Posting Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals. What You Will Be Doing In This Role: The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT) procedure...

It's more than a career, it's a calling MO-REMOTE Worker Type: Regular Job Highlights: Experience : 2+ years of professional coding experience is required. Come join us as a remote Coder II Professional at SSM Health! You will play a crucial role in accurately coding and abstracting medical records for billing and reimbursement purposes. You will be responsible for reviewing patient information, assigning appropriate codes, and ensuring compliance with coding guidelines and regulations. This is a remote position, allowing you to work from the comfort of your own home while contributing to the success of SSM Health. ? Remote work: This position is eligible for remote work in accordance with SSM policies. Note that remote work is not permissible in some states; Human Resources should be consulted for additional information and guidance. * Candidates to reside in MO, IL, OK, or WI (additional states my be considered) Job Summary: Primarily focuses on...

Job Description Job Description Description: About the Role: We are seeking highly experienced Orthopedic Medical Coders with current, hands-on orthopedic coding expertise and a strong multi-specialty coding background to support a dynamic healthcare organization. Candidates must be actively coding orthopedic services on a regular basis and remain current with all orthopedic coding guidelines and industry updates. The ideal candidate will have extensive knowledge of multi-specialty and ortho coding principles, including bundling and unbundling rules, modifier usage, and compliance requirements. In addition to coding responsibilities, this role requires the ability to provide coding feedback, education, and documentation guidance to providers. Flexible schedules are available, with opportunities to work 10, 20, or 30 hours per week. Key Responsibilities Charge Review Work Queues · Review provider-submitted coding in EPIC against clinical documentation ·...

3 days ago Be among the first 25 applicants About Performant At Performant, we’re focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Our mission is to offer innovative payment accuracy solutions that allow our clients to focus on quality of care and healthier lives for all. Medical Coding Auditor – Inpatient (Remote) Location: Remote. Full‑time. Salary: $70,000 – $85,000 per year. Key Responsibilities Audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD‑10, CPT, and HCPCS codes. Ensure coding practices comply with federal, state, and payer‑specific regulations and guidelines, including HIPAA and CMS standards. Detect discrepancies...

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Salary Range: $50,217.00 To $57,749.00 Annually Reports to: Director of Revenue Integrity Job description revision number and date: V 2.0; 5.11.2026 Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices in Massachusetts and across the country. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job...

**ABOUT MACHINIFY:**In October 2025, Machinify acquired Performant and we are now part of the Machinify organization. Machinify is a leading healthcare intelligence company with expertise across the payment continuum, delivering unmatched value, transparency, and efficiency to health plans. Deployed by over 75 health plans, including many of the top 20, and representing more than 170 million lives, Machinify’s AI operating system, combined with proven expertise, untangles healthcare data to deliver industry-leading speed, quality, and accuracy. We’re reshaping healthcare payment through seamless intelligence.**ABOUT THE OPPORTUNITY:**### Hiring Range:$70,000 - $85,000### **Key Responsibilities to include:*** Audit Medical Records: Review and audit medical records to ensure accurate coding of diagnoses, procedures, and services using ICD-10, CPT, and HCPCS codes.* Compliance Monitoring: Ensure that coding practices comply with federal, state, and payer-specific regulations and...

Western Growers Health — a part of Western Growers Family of Companies — provides employer-sponsored health benefit plans to meet the needs of those working for the agriculture industry. The unmatched benefit options provided by Western Growers Health stem from the core mission of Western Growers Association (est. 1926) to support the business interests of employers in the agriculture industry. Our mission at Western Growers Health is to deliver value to employers by offering robust health plans that meet the needs of a diverse workforce. By working at Western Growers Health, you will join a dedicated team of employees who care about offering quality health benefits and excellent customer service to plan participants. If you want to start making a difference working in the health care industry, then apply to Western Growers Health today! Compensation: $46,669.19 - $65,668.50 with a rich benefits package that includes profit‑sharing. This is a remote position and can reside...

THE POSITION:  Under general direction this position is responsible for providing billing and coding support within the Ambulatory Care Clinic System. The clinic areas of specialization include ENT, plastic reconstruction, neurology, and urology.  Examples Of Duties: Duties may include but are not limited to the following: Reviews electronic medical records initiated by a health care provider and ensures accuracy of diagnosis, procedure codes, and modifiers in accordance with Federal and State regulations in compliance with billing and coding guidelines. Effectively monitors assigned work queues and reviews claim errors, ensuring timely and accurate resolution of accounts.  Review, Analyze and validate medical records to ensure completeness and accuracy of code selections while identifying educational opportunities. Prepares educational materials to communicate with providers when identifying gaps in clinical documentation for the selection of appropriate...

Job Type Full-time Description Summary This position is primarily responsible for overseeing that all procedures are coded correctly and documented in the surgeon's notes according to AMA, ICD-10, and NCCI coding guidelines while maximizing payment. The Coder is responsible for gathering, verifying and entering into our PM system (EPIC) all scheduled surgical procedures and all outside encounters performed at associated facilities. Responsibilities also include correcting billing information according to insurance guidelines, including all insurance, Medicare, Workers Comp, MVA and Third party carriers. The Coder will communicate with provider coding discrepancies and provide accurate answers and documentation to the physicians when responding or addressing their coding questions or issues. Responsibilities Reviews all procedure and diagnosis codes submitted by provider for accuracy and maximum reimbursement against the documentation and according to AMA,...

Reviews claims in assigned work queues in Cerner Revenue Cycle including CMG Review and Ambulatory Edit failure work items.Analyzes coding edits, reviews timeline notes, reviews clinical documentation, including provider orders, progress notes, surgical and test results thoroughly to interpret and ensure documentation supports the posted charges.Determines appropriate action needed to resolve coding edits / issues and ensure clean claim submission.Performs coding functions, including Current Procedure Terminology (CPT), International Classification of Diseases, tenth revision, Clinical Modification (ICD-10-CM), documentation review, and claim denial review.Applies appropriate modifiers.Ensures charges / coding are in alignment with the American Medical Association (AMA),Medicare, and Commercial coding guidelines on all claims reviewed.Credits / updates charges and coding as needed.Ensures queues are worked timely and efficiently.Maintains Productivity and accuracy...

It's more than a career, it's a calling WI-Turville Bay Worker Type: Regular Job Highlights: This is a full time day shift Coder I, Professional position for SSM Health Cancer Care located at 1104 John Nolen Dr. in Madison, WI. The schedule is 8:00 a.m. to 4:30 p.m. Monday through Friday for a total of 40 hours per week. Ideal applicants will be ROCC certified (Radiation Oncology Certified Coder), have knowledge of ICD10 and CPT. Experience with pre-authorization and reviewing documentation to confirm it supports the coding is also helpful. This is not a fully remote position. Training is in person at the Madison address above. Job Summary: Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge...

? We're Hiring :Health Info Coder - Remote! ?We are seeking a detail-oriented Health Information Coder to join our team and ensure accurate medical coding and data management.The ideal candidate will have experience in medical coding systems, healthcare documentation, and maintaining compliance with industry standards while working remotely.? Location :Las Vegas, United States? Role :Health Info Coder- RemoteJOB SUMMARY :Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures.RESPONSIBILITIES :Manages assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately deciphers charge error reasons and plans follow up steps.Identifies all billable services. Reviews all applicable data sources, including but not limited to, electronic health record, inpatient admit, discharge and transfer (ADT) reports, operative logs (aka Op Logs), nursing home visit...

Title: Outpatient Coder Reports to: Director of Revenue Integrity Classification: Individual Contributor Location: Remote Job description revision number and date : V 2.0; 5.11.2026 Organization Summary: Community Care Cooperative (C3) is a 501(c)(3) non-profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast-growing organization founded in 2016 and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices in Massachusetts and across the country. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary: The Certified Outpatient Coder will be a part of an emerging coding team under the billing...

Job Summary and Responsibilities You have a purpose, unique talents and now is the time to embrace it, live it and put it to work. We value incredible people with incredible skills - but your commitment to a greater cause is something we value even more. This is the heartbeat of our organization and your time will be spent in a supportive, team environment with resources to help you flourish and leaders who care about your success. This is a senior level professional fee coding position with at least three (3) or more years' experience in multiple specialties; coding both inpatient and outpatient professional fee services. Coder II staff key duties include reviewing documentation to assign appropriate CPT, HCPCS, and ICD-10 diagnosis codes, resolve edits in WQs (charge review, claim edit, and follow up), and review denials for possible corrected claims or appeals. Coder II will work with clinic supervisors and/or providers to resolve coding issues and questions, following...

UPMC Corporate Revenue Cycle is hiring a Coder II- Profee to join our Coding Department! This position will be a work-from-home position working Monday through Friday during business hours. In this role, you will be working on claim edits across all specialties. As the Coder II, you will review all pertinent physician, nursing, and ancillary documentation. Depending on the type of service and place of service, you will determine the level of acuity, procedure(s) performed, billable supplies, and diagnosis to substantiate medical necessity. As well as review and sequence all codes to maximize reimbursement and address any potential bundling issues. The position will also handle LMRP/CCI edit and coding denial resolution. Responsibilities: Utilize computer applications and resources essential to completing the coding process efficiently. Meet and maintain charge lag and appropriate coding productivity standards within the time frame established by management staff....

Coder II Professional Fee Inspired by faith. Driven by innovation. Powered by humankindness. CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation's largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 158 hospital-based locations, in addition to its home-based services and virtual care offerings. The posted compensation range of $24.03 - $36.59/hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law. This is a senior level professional fee coding position with at least three (3) or more years' experience in multiple specialties; coding both inpatient and...

Duties: Job Summary: Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing. This role is responsible for reviewing and accurately coding office, hospital, and surgical/procedures for reimbursement and ensuring accurate and compliant medical coding for inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. The Specialty Physician Coder works with the Coding Compliance Manager on discovered coding trends, irregularities, and needed action items. Job Responsibilities: -Achievement of productivity standards as established by management. -Achievement of quality standards as established by management. -Analyze and interpret medical information in the medical record and assign and sequence the correct ICD-10-CM, CPT, and/or HCPCS codes to the diagnoses/procedures of office, inpatient, and/or outpatient...

Job Summary Primarily focuses on coding of moderate complexity, such as outpatient or inpatient evaluation and management and minor procedures. Job Responsibilities Manage assigned charge review and coding-related claim edit work queues to ensure timely and accurate charge capture. Accurately decipher charge error reasons and plan follow-up steps. Identify all billable services. Review all applicable data sources, including the electronic health record, inpatient admit, discharge and transfer reports, operative logs, nursing home visit documentation, procedure reports from non-electronic health record systems, etc. Review medical record documentation in the electronic health record and/or on paper. Identify, enter, and post CPT‑4 and ICD‑10 codes to the electronic health record. Identify need for medical records from outside the organization and follow established procedures to obtain them. Ensure all coded services meet appropriate Medicare, NCCI or payer‑specific guidelines....

Senior Specialty Physician Coder – Interventional Our client, a Healthcare company, is looking for a Senior Specialty Physician Coder – Interventional for their Fountain Valley, CA location. Responsibilities: Under the direction of the Coding Compliance Manager, the Senior Specialty Physician Coder plays a key role in reviewing and analyzing specialty coding and billing for charge processing. This role will be responsible for reviewing and accurately coding office, hospital, and surgical procedures for reimbursement and ensuring accurate and compliant medical coding for both inpatient and outpatient services, diagnostic tests, and other medical services rendered to patients. In addition, the Senior Specialty Physician Coder will serve as a point of contact for contract coders, maintain the continuity of contract coding operations, and ensure the implementation of Client policies and procedures. The Senior Specialty Physician Coder will also work with the Coding Compliance...

Title: Outpatient Coder Reports to: Director of Revenue Integrity Classification: Individual Contributor Location: Boston, Hybrid Job description revision number and date: V 2.0; 5.11.2026 Organization Summary Community Care Cooperative (C3) is a 501(c)(3) non‑profit, Accountable Care Organization (ACO) governed by Federally Qualified Health Centers (FQHCs). Our mission is to leverage the collective strengths of FQHCs to improve the health and wellness of the people we serve. We are a fast‑growing organization founded in 2016 and now serving hundreds of thousands of beneficiaries who receive primary care at health centers and independent practices in Massachusetts and across the country. We are an innovative organization developing new partnerships and programs to improve the health of members and communities, and to strengthen our health center partners. Job Summary The Certified Outpatient Coder will be a part of an emerging coding team under the billing and...

Medical Coder - Edit Configuration Analyst At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!! Job Summary The Edit Configuration Analyst I performs research on editing concepts and analyzes related claims data, applying coding standards, industry knowledge, and federal regulations to ensure correct billing practices. In this role, the incumbent will perform research, analytics, and/or...

Medical Coder - Edit Configuration Analyst At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!! Job Summary The Edit Configuration Analyst I performs research on editing concepts and analyzes related claims data, applying coding standards, industry knowledge, and federal regulations to ensure correct billing practices. In this role, the incumbent will perform research, analytics, and/or...