10 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...

Coding Specialist 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 and minor invasive and non-invasive procedures, documented by any physician in outpatient medical records (i.e. OP Ancillary visits: Laboratory, Radiology etc.; Clinic Visits; Radiation Oncology; Recurring Visits, 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: Outpatient Ancillary/Clinic Visit/Emergency Department coding of all diagnostic and procedural...

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...

Coding Specialist In accordance with federal coding compliance regulations and guidelines, use current ICD-10-CM, CPT-4, and HCPCS code sets, OCE/NCCI, CMS Transmittals, and other federal billing/coding regulations, manuals, rules, and guidelines to analyze, troubleshoot, and resolve all coding related edits generated within the coding, billing, and Clearinghouse systems: PBAR, nThrive (formerly MedAssets), and Aeos. Analyze, troubleshoot, and resolve all outpatient denial management coding related edits, items, and issues returned from Patient Financial Services (PFS) and assorted claims payers. 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 assorted outpatient surgery: GI Lab, Heart...

Contract Assignment Healthcare System (Epic Ehr) This is a remote position. We're seeking a Certified Professional Coder (CPC) with hands-on front-end Epic operational experience to support a health system's day-to-day coding workflows. This contractor will perform professional coding activities directly within Epic's end-user workflows (e.g., encounter completion, charge entry, charge review workqueues) to ensure accurate, timely, and compliant coding and charge capture. Responsibilities: Review clinical documentation and assign CPT/HCPCS, ICD-10-CM codes within Epic at the point of coding (front end), ensuring compliance with payer guidelines and health system policies. Work in Epic workqueues (e.g., Charge Review, Claim Edit, Coding WQs) to resolve edits, denials, and holds; clear daily queues to meet turnaround goals. Validate medical necessity and modifier usage; correct charge router/charge session issues before billing. Collaborate with revenue cycle, clinic...

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,...

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,...

Job Description Job Description Description: 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...

Coding Specialist III Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE). The Coding Specialist III can maintain up to two concurrent client assignments that are short-term in nature. For each client, the Coding Specialist III reviews documentation to code diagnoses and procedures for inpatient hospital-based claims and data needs. For both professional and technical claims and data needs, the Coding Specialist III reviews clinical documentation to code diagnoses, EM level, and surgical CPT codes. Additionally, this role also validates MS-DRG and APC calculations, abstracts clinical...