286 claims resolution coder jobs found

City / StateNorfolk, VAWork ShiftFirst (Days)Overview :Claims Resolution Coder- RemoteResponsible for reviewing medical documentation to assign modifiers to insurance claims with issues identified by the National Correct Coding Initiative (NCCI), Medicare Outpatient Code Editor (OCE),or other third party payer specific claims processing guidelines.Works with Coding, Billing and Reimbursement staff to resolve edits.Is additionally responsible for trending errors, supporting identification of root causes, and effective communication with coding and training staff to improve coding accuracy and clean claims processing.Researches regulations to ensure accuracy of CPT codes and documentation.Associates degree in Health Information Technology or Medical Billing preferred.2 years direct application of coding, medical billing or reimbursement in health care setting, hospital or physician office required.CPC or CCS coding certification required at time of hire.Thorough knowledge of lab,...

Certified Coder Clinica Sierra Vista is excited to be one of the largest Federally Qualified Health Centers in the Nation! We're honored to serve the men and women of the fields. We also offer care and support to the inner city, the rural and isolated, those of low, moderate, and fixed incomes, and families from an array of cultural backgrounds who speak several languages. We don't inquire about immigration status because we simply don't need to know. If you come to us, we will treat you like any other patient. As we grow our team, we are looking for individuals who believe the patient is always #1. Why work for us? Competitive pay which matches your abilities and experience Health coverage for you and your family Generous number of vacation days per year A robust wellness plan and health club discounts Continuing education assistance to grow and further your talents 403(B) plan with company matching Intrigued? We'd love to hear from you! Please review the job details...

POSITION SUMMARY This role is responsible for accurately and appropriately coding ambulance claims, including claim submission, follow-up on denied claims, and ensuring compliance with relevant billing regulations to facilitate timely reimbursement for services. ESSENTIAL JOB FUNCTIONS 1. Examines patient care reports to gather essential information for insurance documentation. 2. Contacts facilities, hospitals, or patients to acquire missing information and physician certification statements. 3. Collects data such as insurance company names, policyholder details, policy numbers, and services provided to accurately complete claim and/or billing records. 4. Communicates with insurance companies to verify coverage, determine payor schedules, and gather benefit details. 5. Assigns relevant codes based on documented information in the patient care report and determines the appropriate level of ambulance service. 6. Allocates charges for services supported by...

Med Records Coder III As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location: 905 Elmgrove Rd, Rochester, New York, United States of America, 14624 Opening: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 106 H Compensation Range: $21.36 - $29.90 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education, experience,...

Assistant Coding Manager As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location: 905 Elmgrove Rd, Rochester, New York, United States of America, 14624 Opening: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 110 Compensation Range: $60,431.00 - $84,603.00 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not limited to, market data, education,...

POSITION SUMMARY This role is responsible for accurately and appropriately coding ambulance claims, including claim submission, follow-up on denied claims, and ensuring compliance with relevant billing regulations to facilitate timely reimbursement for services. ESSENTIAL JOB FUNCTIONS Examines patient care reports to gather essential information for insurance documentation. Contacts facilities, hospitals, or patients to acquire missing information and physician certification statements. Collects data such as insurance company names, policyholder details, policy numbers, and services provided to accurately complete claim and/or billing records. Communicates with insurance companies to verify coverage, determine payor schedules, and gather benefit details. Assigns relevant codes based on documented information in the patient care report and determines the appropriate level of ambulance service. Allocates charges for services supported by documentation in the patient care...

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together. Under direction of the Coding Manager, the primary responsibility of the MedicalCoder is to ensure that codes representing current International Classification of Diseases, 9th Revision (ICD-9) or 10th Revision (ICD-10), Current Procedural Terminology (CPT), and the Healthcare Common Procedure Coding System (HCPCS) accurately reflect documented services by applying a demonstrated knowledge of anatomy,...

Job Description The purpose of this position is to apply the appropriate diagnostic and procedural codes to individual health information for data retrieval, analysis, and claims processing. The DRG coder creates consistency and efficiency in inpatient claims processing and data collection to optimize DRG reimbursement and facilitate data quality in hospital inpatient services. Responsibilities The coder abstracts pertinent information from patient records and assigns ICD-9-CM/ICD-10-CM, ICD-10-PCS or CPT/HCPCS codes, creating APC or DRG group assignments. Queries physicians when code assignments are not straightforward or documentation in the record is inadequate, ambiguous, or unclear for coding purposes. The coder keeps abreast of coding guidelines and reimbursement reporting requirements. Brings identified concerns to supervisor or department manager for resolution. Abides by the standards of Ethical Coding as set forth by the American Health Information Management...

U.S. Medical Billing Specialist (VA Medical Biller) We are seeking an experienced U.S. Medical Billing Specialist (VA Medical Biller) to support U.S.-based healthcare clients with their revenue cycle operations. This is a telecommute/work from home position, ideal for someone detail-oriented, highly organized, fluent in English, and experienced in U.S. medical billing standards. Compensation: US $1,200 $1,700/month Key Responsibilities Submit clean claims electronically and by paper when required. Verify insurance eligibility and benefits. Apply accurate CPT, ICD-10, and HCPCS codes. Process claims across multiple specialties and payer types. Handle workers' compensation, auto accident, and out-of-network claims. Accounts Receivable & Follow-Ups Track denied claims and resubmit corrected claims as needed. Follow up with insurance companies regarding unpaid claims, rejections, and appeals. Contact patients regarding outstanding balances and payment plans. Post...

Huron Consulting Group Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes. Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients. Joining the Huron team means you'll help our clients evolve and adapt to the rapidly...

Job Description Job Description Job Summary: We are seeking a detail-oriented surgical Biller and Coder with proven experience to lead the daily operations of our billing and coding department at our Babylon office. The ideal candidate will have strong leadership skills, a deep understanding of surgical billing and coding processes, and the ability to ensure accuracy, compliance, and efficiency across the department. Key Responsibilities Manage the end-to-end billing lifecycle for surgical and non-surgical services , from charge entry and claim submission through final resolution Ensure timely and accurate submission of claims, medical records, and operative reports through payer and insurance portals Monitor, analyze, and resolve claim denials, underpayments, and payment delays , including proactive follow-up to ensure timely reimbursement Initiate, track, and manage reconsiderations, disputes, and first- and second-level appeals in accordance with payer...

Job Description Job Description Job Summary: We are seeking an experienced Medical Biller & Certified Coder with a strong focus on Accounts Receivable to join our busy, high-volume Family Practice. This role is essential to maintaining the financial performance of the practice and requires a candidate who is highly skilled in A/R follow-up, denial resolution, and insurance collections. The ideal candidate is detail-oriented, persistent, and results-driven. Key Responsibilities: Manage and maintain all aspects of Accounts Receivable, with a focus on timely follow-up and resolution Investigate and resolve denied, rejected, and unpaid claims with insurance carriers Work aging reports to ensure prompt reimbursement and minimize outstanding balances Communicate with insurance companies to correct claim issues and secure payment Post payments and reconcile Explanation of Benefits (EOBs) accurately Submit corrected claims and appeals as needed Handle patient billing...

Job Description Job Description About the Role Our growing Ophthalmology practice is seeking an experienced Medical Biller with strong insurance and revenue cycle knowledge to join our team. This position plays a key role in maintaining the financial health of the practice while also supporting front desk operations to ensure a smooth patient experience. The ideal candidate has hands-on experience with ophthalmology billing, and is comfortable managing claims from submission through payment resolution. This is a great opportunity to join a patient-focused specialty practice where your billing expertise directly contributes to efficient operations and quality patient care. Key Responsibilities Submit and manage medical claims for ophthalmology services including office visits, diagnostic testing, and minor procedures Review and correct claim errors to ensure clean claim submission and maximize reimbursement Follow up on unpaid or denied claims and manage appeals when...

Professional Surgical Coder I 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 Surgical Coder I is expected at South Shore Physician Ambulatory Enterprise to query providers when documentation requires clarification and he/she proactively works with medical leadership to address concerning documentation trends. The Professional Coder I works with direct support from and under the direction of the Billing and Coding...

Job Description Job Description Job Title: Medical Biller (Long-Term Temporary) Pay: $22–$24 per hour Schedule: Monday–Thursday, 9:00 AM–5:00 PM (PST); minimum 20 hours per week within this window Location: Onsite (Kent, WA) Start Date: Immediately Employment Type: Long-term temporary / part-time (3-6 Months)   About the Role Simply Great Staffing is seeking a detail-oriented Medical Biller with hands-on optometry coding experience to support end-to-end revenue cycle activities—submitting clean claims, managing accounts receivable, driving denial resolution/appeals, and assisting with patient scheduling and occasional phone reception. The ideal candidate thrives in a fast-paced clinic environment, understands Medicare Advantage payer policies, and consistently delivers high first-pass claim acceptance rates.   Key Responsibilities Coding & Charge Capture Accurately code optometry encounters using ICD-10-CM,...

Employment Opportunities Provides high level technical competency and subject matter expertise analyzing physician/provider documentation in Inpatient health records to determine the principal diagnosis, secondary diagnoses, principal procedure, and secondary procedures. Assigns appropriate Medicare Severity Diagnosis Related Groups (MS-DRG), All Patient Refined DRGs (APR), Present on Admission (POA), as well as Severity of Illness (SOI) & Risk of Mortality (ROM) indicators for Inpatient records. Identifies Hospital Acquired Conditions (HAC), Patient Safety Indicators (PSI) to ensure accurate hospital reimbursement. Utilizes encoder software applications, which includes all applicable online tools and references in the assignment of International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis and procedure codes, MS-DRG, APR DRG, POA, SOI & ROM assignments. Essential Functions: Knows, understands, incorporates, and demonstrates the Trinity Health...

As a community, the University of Rochester is defined by a deep commitment to Meliora - Ever Better. Embedded in that ideal are the values we share: equity, leadership, integrity, openness, respect, and accountability. Together, we will set the highest standards for how we treat each other to ensure our community is welcoming to all and is a place where all can thrive. Job Location (Full Address): Remote Work - New York, Albany, New York, United States of America, 12224 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (United States of America) Range: UR URG 107 H Compensation Range: $23.06 - $32.29 The referenced pay range represents the minimum and maximum compensation for this job. Individual annual salaries/hourly rates will be set within the job's compensation range, and will be determined by considering factors including, but not...

The Patient Account Representative Coder will be responsible for reviewing and coding from the medical record, already billed, or suggested from provider or computer generated applications for straight‑forward to complex coding, and any account receivable activities for the physician clinics within Saint Luke's Health System. Activities include, but are not limited to, coding, charging, troubleshooting charge related issues, responding to inbound and outbound billing calls from patients, resolving payment credits, identifying and correcting medical claim errors that may prevent payment and identifying, correcting, and resubmitting medical claims denied by insurance companies. Resolving claim edits, working denials and appeals. Evaluation and coding of ICD, CPT, HCPCS. All coding initiatives, NCCI edits, incidentals/inclusive, and bundling rules, etc. Demonstrate competency for invalid diagnosis, modifiers, coding related issues, and be able to have moderate decision making in...

Job Family General Coding Travel Required None Clearance Required None What You Will Do Review multi-specialty inpatient and outpatient and clinical Charge Correction requests for ICD-10, CPT and HCPCS coding for accuracy and make necessary corrections. Review LCD and NCD criteria and insurance billing guidelines. Report any changes as necessary to collections teams. Electronically file replacement claims and some payment posting as needed. M-F onsite training for approx. 3-6 months. After training hybrid with 90% being remote/working from home. What You Will Need High School Diploma/GED (relevant experience may be substituted for formal education) 1+ years of medical coding experience AAPC CPC or AHIMA CCS coding certification Experience in ICD-10, CPT and HCPCS Level II Coding Ability to determine medical necessity of services provided and charged based on provider/clinical documentation Knowledge, understanding and proper application of Medicare, Medicaid, and third‑party...

Job Description Job Description ob Description We are seeking a seasoned Medical Billing Specialist (certified coder) for a busy practice of two Providers in Podiatry (George Dieter location opening soon!). Must have background or experience in a medical setting (private practice or hospital). The candidate should be a team player, ability to take initiative and multi task. This is a full time position, part time not available. Bilingual is preferred but not required. Please review the essential job function and you MUST meet the Position Requirements (certification must be attained within 90 days of employment). Essential Functions: The following description of job responsibilities and performance expectations is intended to reflect the major responsibilities of the job, but is not intended to describe minor duties or other responsibilities as may be assigned from time to time. Keys charge information into entry program and produces billing. Processing of insurance...

Job Description Job Description Certified Medical Biller & Coder (In-Person) — Total Medical Billing Total Medical Billing is hiring an experienced  Certified Medical Biller & Coder  to join our team  on-site . If you’re accurate, organized, and confident working claims from start to finish, we’d love to meet you. Responsibilities Assign accurate  ICD-10, CPT, HCPCS  codes and review documentation Submit claims, correct rejections, and manage claim edits Post payments (ERA/EOB), balance accounts, and resolve discrepancies Work denials, follow up on A/R, and submit appeals as needed Verify eligibility/benefits and maintain HIPAA compliance Requirements Current certification (CPC, CCS, CCA, or equivalent) 2+ years billing/coding experience preferred Strong knowledge of modifiers, payer rules, and denial resolution Detail-oriented with strong communication and time management Position In-person  (Total Medical Billing) Full-time...

Career Opportunities with Livingston HealthCare A great place to work. Current job opportunities are posted here as they become available. The Level I Coder (clinic and outpatient) performs the coding functions necessary to the operations of the Livingston HealthCare Medical Records Department. Codes clinic and outpatient claims in accordance with prevailing laws and regulations. Must have working knowledge of CPT and ICD-10-CM coding guidelines. Schedule: 1.0FTE (40 hours) Mon-Fri 8a-4:30pm Compensation: $23.82/hr +DOE Robust Benefits Package ESSENTIAL FUNCTIONS, DUTIES, AND RESPONSIBILITIES: Codes clinic and outpatient encounters in accordance with current CPT and ICD-10-CM guidelines. Charges capture analysis prior to releasing account, and reports charge corrections to clinic or outpatient departments for education and resolution. Conducts record analysis for coding purposes in accordance with medical staff bylaws and state and federal regulations. Reports to...

Job Description Job Description SUMMARY: In-person Full Time Billing Specialist performs diagnosis and procedural coding to individual patient health information for data retrieval, analysis, and claims processing. DUTIES AND RESPONSIBILITIES: Reviews the patient ‘s medical record for accurate and complete documentation prior to coding. Works closely with the physician coordinator regarding discrepancies found in patient’s record prior to claim submission Codes for assigned physicians, locations, and/or departments from review of medical record documentation. Applies knowledge of current coding and billing requirements to assure claims are submitted correctly Brings identified concerns and trends to the manager/team lead for resolution. Reviews coding and billing worklists and resolves claim rejections. Enters patient demographic information and verifies patient insurance coverage QUALIFICATIONS : Working knowledge of CPT and ICD10 coding Medical...