9 claims edit coder jobs found in Los Angeles, CA

Job Description Bring your whole self to exceptional care. Cedars-Sinai was tied for #1 in California in U.S. News & World Report's "Best Hospitals 2024-25" rankings, and it's all thanks to our team of 14,000+ remarkable employees! 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 code for claim edit fall outs. The position entails conducting modifier review and assignment, handling complex coding edits that necessitate research and resolution, and validating key data elements like the billing physician and date of service. You are expected to abstract coded data accurately and promptly into the applicable system using relevant applications such as EPIC (CS-Link), EPIC HB...

Grow Healthy If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn't just welcomed - it's nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don't just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it's a calling that drives us forward every day. Job Overview Assigned codes to patient symptoms, diagnosis, operations, and treatments to process reimbursements; knowledge and expertise in reviewing and adjudicating coding services procedures and diagnoses on medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes and CPT codes into the NextGen system. Minimum...

Description In this role, you will assist with coding reviews, charge corrections, and staff education.Youwill optimize reimbursement by ensuring correct infusion, injection, and procedure coding.You will be responsible for clinic billing and coding questions and assisting with charge review work queue edit corrections.Youwill assist the Revenue Integrity Specialist Manager with conducting comprehensive analysis of monitoring claims to ensure timely and appropriate reimbursements and will work with Authorizations Pharmacists on medical necessity reviews when needed. You will also assist with treatment cash quotes, the Copayment Assistance Team, free drug assistance, and other assigned duties. Salary range: $40.04/hr - $52.83/hr Qualifications Required: Minimum of 2 years active Certified Professional Coder (CPC).Successfully completes required education courses to maintain current coding certification. Knowledge of oncology CPT and ICD-10 codes and medical office...

Description In this role, you will assist with coding reviews, charge corrections, and staff education. You will optimize reimbursement by ensuring correct infusion, injection, and procedure coding. You will be responsible for clinic billing and coding questions and assisting with charge review work queue edit corrections. You will assist the Revenue Integrity Specialist Manager with conducting comprehensive analysis of monitoring claims to ensure timely and appropriate reimbursements and will work with Authorizations Pharmacists on medical necessity reviews when needed. You will also assist with treatment cash quotes, the Copayment Assistance Team, free drug assistance, and other assigned duties. Salary range: $40.04/hr - $52.83/hr Qualifications Required: Minimum of 2 years active Certified Professional Coder (CPC). Successfully completes required education courses to maintain current coding certification. Knowledge of oncology CPT and ICD-10 codes and medical...

Job Posting In accordance with federal coding compliance regulations and guidelines, use current ICD-10-CM, CPT-4, and HCPCS code sets/systems to accurately abstract, code, and electronically record into the 3M Coding & Reimburse System (3M-CRS) & the coding abstracting system (3M-ClinTrac), all diagnoses, surgical procedures, and other significant invasive and non-invasive procedures documented by any physician in outpatient medical records (i.e. OP Ancillary/Clinic Visits, and an assorted outpatient surgeries: GI Lab, Heart Cath Lab, Pain Management surgery, and Invasive Radiology, etc.). Address OCE/NCCI edits within 3M-CRS and those returned from the Business Office. Understands PFS coding/billing processes & systems such as PBAR and nThrive/MedAssets/XClaim in a manner to assure claims drop timely with appropriate codes. Performs other coding department related duties as assigned by HIM management staff. Essential Duties + Ambulatory Surgery coding of all...

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. We provide an outstanding benefit package that includes healthcare, 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 Will I be Doing in this Role? Under the general direction of the HID Audit Supervisor, the role operates as a Coding Auditor and shall:  Monitor coding compliance through prebill and retrospective reviews or audits of ICD and/or CPT codes assigned by coding staff. Monitor coding compliance by performing focused audits on high-risk areas identified by the Office of Inspector General (OIG) and the Centers of Medicare and Medicaid Services (CMS)....

Our Client, a Healthcare company, is looking for a Specialty Physician Coder for their Fountain Valley, CA location. Responsibilities: Achievement of productivity standards as established by management. Achievement of quality standards as established by management. In adherence with standard work, 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 medical records according to established coding guidelines, including the ability to review and natively code surgical operative and/or procedure reports. In adherence with standard work, follow established workflow for working claim denials in the Follow-Up work queues and identify opportunities for billing/coding improvements. Participate in developing, implementing, and reviewing programs for coding compliance monitoring, criteria for benchmark comparisons,...

POSITION Specialty Physician Coder Position Type: Temporary Schedule : M-F, 8:00 am - 4:30 pm Assignment Length: Approximately 3-Months, possibly longer. DESCRIPTION Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a critical role in reviewing and analyzing specialty physician coding and billing to support accurate charge capture and compliant reimbursement. This position is responsible for coding office, inpatient, outpatient, and surgical/procedural services with a focus on surgical breast oncology (including plastic reconstructive breast surgery) and Hematology/Oncology. The coder will identify coding trends, irregularities, and opportunities for improvement while collaborating closely with providers and revenue cycle partners. Essential Duties & Responsibilities Review and abstract medical records to capture all billable professional charges Assign accurate ICD-10-CM, CPT, and HCPCS codes for inpatient,...

Job Title: Medical Biller II Salary: $25hr-$28hr DOE Location: Tustin, CA Openings: 1 Position Purpose: The Medical Billing Specialist II supports the revenue cycle team by independently performing a broad range of billing functions with moderate complexity. This role is responsible for accurate insurance verification, charge entry, claim submission, payment posting, and resolution of routine denials to ensure compliance with payer requirements and timely reimbursement. Core Duties and responsibilities, include but are not limited to: Insurance & Eligibility Verification Verify complex insurance coverage (Medi-Cal, Medicare, Managed Care, Commercial, PPO/HMO). Research and resolve discrepancies in patient coverage or eligibility. Document eligibility outcomes in the EHR/PM system. Charge Entry & Coding Support Perform charge entry and apply CPT, ICD-10, and HCPCS codes. Review encounter forms for accuracy; flag missing or incorrect...