Claims resolution coder jobs | Healthcare Careers

Sentara Healthcare Inc Norfolk, VA, USA

Claims Resolution Coder- Remote Responsible 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 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, radiology and other ancillary, CPT, HCPCS related...

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Claims Resolution Coder- Remote

Sentara Health Plans Norfolk, VA, USA

Claims Resolution Coder- Remote page is loaded## Claims Resolution Coder- Remoteremote type: Remotelocations: Norfolk, VAtime type: Full timeposted on: Posted Todayjob requisition id: JR-91627**City/State**Norfolk, VA**Work Shift**First (Days)**Overview:**# **Claims Resolution Coder- Remote**Responsible 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...

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Claims Resolution Coder- Remote

Sentara Norfolk, VA, USA

City/State Norfolk, VA Work Shift First (Days) Overview: Claims Resolution Coder- Remote Responsible 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...

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Claims Resolution Coder- Remote

Sentara Healthcare USA

City/State Norfolk, VA Work Shift First (Days) Overview: Claims Resolution Coder- Remote Responsible 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...

Full Time

Billing and Coding Professional- Surgery and Anesthesia- Remote- Florida Residents

Adept Surgical Billing Solution, LLC Remote (FL, USA)

Whether you are looking to expand your current knowledge or looking to share your extensive skills with us, this could be the start of something amazing. We are a small, close knit team that works together to accomplish tasks daily. Qualifications: Knowledge in Surgery Billing and Coding Coding Certification- CASCC or COC preferred Experience with Microsoft 365 products Minimum 3 years experience in surgical billing Knowledge in all aspects of RCM Insurance credentialling- preferred Job Requirements: Coding and Charge Capture Insurance Claims Billing Resolution of rejections Coding reviews of denials Appeal assistance Coding reviews of documentation in question by the coding team Management of payor chart audits Insurance overpayment reviews Issuance of disputes as needed Ability to assist in aging follow on unpaid claims Address physician documentation matters Month end closing Utilization of reports Knowledge of and adherence to...

Full Time

Surgical Coding Denial Specialist

University of Colorado Medicine Remote (CO, USA)

University of Colorado Medicine (CU Medicine) is the region’s largest and most comprehensive multi-specialty physician group practice. The CU Medicine team delivers business operations, revenue cycle and administrative services to support the patients of over 4,000 University of Colorado School of Medicine physicians and advanced practice providers. These providers bring their unparalleled expertise at the forefront of medicine to deliver trusted, compassionate health care services at primary and specialty care clinics as well as facilities operated by affiliate hospitals of the University of Colorado. We are seeking a detail-oriented and highly motivated Surgical Coding Denial Specialist to join our AR Surgery team. This role plays a critical part in protecting and optimizing revenue for CU Medicine providers by ensuring surgical claims are accurately reviewed, appealed, and resolved. This position offers the flexibility of being 100% remote , and qualified...

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Med Records Coder III

University of Rochester North Gates, NY, USA

Med Records Coder III University of Rochester Job Location Remote Work – New York, Albany, New York, USA, 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 106 H Compensation Range: $21.36 - $29.90 Responsibilities Reviews codes for accuracy in accordance with coding rules and policies. Responsible for system edit reviews and follows up on insurance coding denials for resolution. Essential Functions Uses knowledge of coding systems and system logic to review codes created by electronic charge capture and/or assigns codes through medical record documentation as per designated workflow. Completes system edit reviews to make corrections before transmittal. Troubleshoots problems that prevent claims from being released. Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the...

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Med Records Coder III, Complex

University of Rochester North Gates, NY, USA

Join to apply for the Med Records Coder III, Complex role at University of Rochester 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. Job Details: Job Location: 905 Elmgrove Rd, Rochester, New York, United States of America, 14624 Opening: Regular, Full time, 40 hours/week 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 limited to, market data, education, experience, qualifications, expertise of the individual, and internal equity considerations. Responsibilities: Functions as an...

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Med Records Coder IV, Complex

University of Rochester North Gates, NY, USA

Job Title Med Records Coder IV, Complex Location Remote Work - New York, Albany, New York, United States of America, 12224 Employment Details 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 108 H Seniority level: Mid-Senior level Employment type: Full-time Compensation $24.91 - $34.87 Responsibilities The Medical Coder IV, Complex functions as an advanced coder in the abstraction and in-depth analysis of a variety of medical documentation for multiple specialties and assigns appropriate procedural terminology and medical codes in accordance with applicable coding rules and policies (e.g. ICD-10, CPT-4, HCPCS, DRG). Analyzes, enters and manipulates database. Responds to or clarifies internal requests for medical information. Essential Functions Uses thorough knowledge of coding systems and system logic to review codes created by...

UH

Senior Coder Remote

University Hospitals Shaker Heights, OH, USA

A Brief Overview Under the direction of the Billing Supervisor – the Senior Physician Coding Specialist monitors coder productivity, trains, audits, codes surgical encounters, and serves as a resource for physicians and other departments within the system. Identifies trends with insurance‑related issues and reports findings to the team. What You Will Do Analyzes, on a daily basis and in accordance with established time frames, the outstanding insurance accounts. Initiates appropriate and effective telephone and/or written follow-up on the identified accounts. Communicates with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims. Researches and responds to all telephone inquiries from the customer service department, in a prompt, professional manner meeting departmental guidelines. Reviews and corrects coding rejections. May code ICD-9 from written documentation. May abstract CPT/HCPCS...

UH

Pro Fee Denials/Follow-Up Coder Remote

University Hospitals Shaker Heights, OH, USA

Job Description – Pro Fee Denials/Follow‑Up Coder (Remote – 25000CTF) A Brief Overview Under the direction of the Revenue Cycle Supervisor – Coding, the Physician Coding Specialist II monitors and analyzes unresolved third‑party accounts for multi‑specialty group practices. This position initiates contact and negotiates appropriate resolutions to ensure timely payments of outstanding claims. What You Will Do Analyze, on a daily basis and in accordance with established time frames, outstanding insurance accounts and initiate appropriate and effective telephone and/or written follow‑up on the identified accounts. Communicate with payors and other internal departments as required to obtain critical information that impacts the resolution of both current and future claims. Research and respond to all telephone inquiries from the customer service department in a prompt, professional manner meeting departmental guidelines. Review and correct coding edits and denials. May code...

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IN HOUSE BILLER AND CODER

BADIA MEDICAL Warner Robins, GA, USA

Lifeguard Pediatrics – Warner Robins, GA About Us Lifeguard Pediatrics is a trusted, physician-owned pediatric clinic serving families across Middle Georgia. We are dedicated to providing comprehensive, compassionate, and community-centered care. With a growing need for developmental and behavioral health services in our region, we are expanding our care team to include in-house autism diagnostic services. Position and Responsibilities The biller and coder is responsible for the accurate and timely submission of medical claims to insurance companies and other payors. The medical biller posts payments or adjudications as appropriate. Using knowledge of billing practices and standards including third party payor requirements, the medical biller will investigate denials to process appeals and collect payment. In addition, this position is responsible for reviewing coding for outpatient services for reimbursement and research compliance. Medical Billing Performs claim review,...

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Certified Coder I

Family Health West Fruita, CO, USA

You belong here! At Family Health West, you’re more than an employee, you’re family. When you enter our facility, you know it’s Family Health West because, well, the color speaks for itself. You’ll be part of a team that strives to bring color to care in a vibrant environment by creating fun, effective treatment programs helping to empower and inspire our patients while providing the tools and care they need to achieve their wellness goals. When we say you’ll do what you love, we mean it! Welcomed by open arms and warm smiles, you’ll join a team that encourages professional growth. We are sure to put on our listening ears when you share new ideas and approaches to care because that’s what got us to the top! You’ll wear your badge proudly, knowing that you contribute each day, to providing care that is unmatched, in western Colorado. So, what are you waiting for?! Fill out the application now, and when you hit send do a little happy dance knowing that you just made our day. If it...

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Coder-Certified I

SPCP/Southeast Medical Group Alpharetta, GA, USA

Job Description Job Description Description: Southeast Primary Care Partners is seeking a dedicated and detail-oriented Certified Coder to join our dynamic team. The successful candidate will play a crucial role in accurately coding healthcare claims for reimbursements, ensuring compliance with federal regulations, and contributing to the efficiency and effectiveness of our healthcare services. Certified Coder reviews medical records to assure proper billing. Participates in audits to evaluate if all selected codes are accurate and develops methodologies to improve coding issues identified. Codes must meet QA standards (following both Official Coding Guidelines and Risk Adjustment Guidelines). Position Summary: Requirements: Key Responsibilities: Review patients' medical records to extract relevant information needed for billing and coding. Apply appropriate ICD-10, CPT, and HCPCS Level II code assignments to ensure accurate and timely billing. Work closely with healthcare...

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Coder-Certified I

Southeast Medical Group Alpharetta, GA, USA

Join to apply for the Coder-Certified I role at Southeast Medical Group . Position Summary: Southeast Primary Care Partners is seeking a dedicated and detail‑oriented Certified Coder to join our dynamic team. The successful candidate will play a crucial role in accurately coding healthcare claims for reimbursements, ensuring compliance with federal regulations, and contributing to the efficiency and effectiveness of our healthcare services. The Certified Coder reviews medical records to assure proper billing, participates in audits, and develops methodologies to improve coding issues identified. Codes must meet QA standards following Official Coding Guidelines and Risk Adjustment Guidelines. Key Responsibilities Review patients’ medical records to extract relevant information needed for billing and coding. Apply appropriate ICD‑10, CPT, and HCPCS Level II code assignments to ensure accurate and timely billing. Work closely with healthcare providers and billing teams to...

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Coder I- Remote/CPC

Baptist Health Care Pensacola, FL, USA

Join to apply for the Coder I - Remote/CPC role at Baptist Health Care . Location Requirement: Candidates must reside in one of the following states: Florida, Alabama, or Georgia. If offered the position, they will be required to come onsite in Pensacola, FL for orientation. Job Description: The Coder is responsible for ensuring that claims reflect accurate diagnoses as ordered by the healthcare provider. This position validates that the coding methodology correctly reflects how tests were performed and meets all state, federal, local, and payer guidance. Responsibilities Reviews patient medical records and accurately assigns appropriate ICD-10-CM or CPT-4 codes according to established guidelines. Applies sequencing guidelines to coded data according to official coding rules. Reviews medical records to ensure appropriate documentation. Stays knowledgeable of coding and diagnostic procedures, remaining current about federal legislative changes that affect outcomes....

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Professional Coder- Full time, Days, REMOTE

Centra Health, Inc. Lynchburg, VA, USA

The Professional Coding Analyst II will be responsible for reviewing clinical documentation, assigning appropriate diagnosis, procedure, and in some cases level of service codes to resolve claim edits and denials. Ensures clinical documentation supports the charges posted, following the American Medical Association (AMA), Medicare, and Commercial coding guidelines on claims. Communicates trends and issues to leadership for investigation and resolution. This is a remote role working Monday-Friday, day shift hours. #J-18808-Ljbffr

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HIM Specialty Coder II

Billings Clinic Billings, MT, USA

You’ll want to join Billings Clinic for our outstanding quality of care, exciting environment, interesting cases from a vast geography, advanced technology and educational opportunities. We are in the top 1% of hospitals internationally for receiving Magnet Recognition consecutively since 2006. And you’ll want to stay at Billings Clinic for the amazing teamwork, caring atmosphere, and a culture that values kindness, safety and courage. This is an incredible place to learn and grow. Billings, Montana, is a friendly, college community in the Rocky Mountains with great schools and abundant family activities. Amazing outdoor recreation is just minutes from home. Four seasons of sunshine! You can make a difference here. About Us Billings Clinic is a community-owned, not-for-profit, Physician-led health system based in Billings with more than 4,700 employees, including over 550 physicians and non-physician providers. Our integrated organization consists of a multi-specialty group...

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Lead Medical Coding Specialist

Emerus Little Rock, AR, USA

Lead Medical Coding Specialist The Lead Medical Coding Specialist works in conjunction with the Coding Supervisor to ensure accuracy, consistency and efficiency in relation to code assignment for reimbursement and reporting purposes. The Lead Medical Coding Specialist will complete quality reviews for coding staff in order to validate code and reimbursement assignments. This position is a "working" Lead position and is expected to work alongside staff as well as provide direction. Essential Job Functions Assist Coding Supervisor in the supervision of Medical Coding staff for Emergency Facilities, Inpatient, Observation and Ancillary services coding Assists in managing staffing schedule and departmental overtime Performs quality review of staff for accuracy/efficiency and identifies charge capture opportunities Completes metric reporting as required by agreed upon deadlines and assists in month end close processes In conjunction with the Coding Supervisor, ensures standard...

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Trinity Health: Coder IV – Inpatient Coder (Remote)

CloudDevs Lansing, MI, USA

Trinity Health: Coder IV Inpatient Coder (Remote) Employment Type: Full time Shift: Description: 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...

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Remote Medical Billing Coder

Fair Haven Community Health Care New Haven, CT, USA

Job Description Job Description Fair Haven Community Health Care For over 54 years, FHCHC has been an innovative and vibrant community health center, catering to multiple generations with over 165,000 office visits across 21 locations. Guided by a Board of Directors, most of whom are patients themselves, we take pride in being a healthcare leader dedicated to delivering high-quality, affordable medical and dental care to everyone, regardless of their insurance status or ability to pay. Our extensive range of primary and specialty care services, along with evidence-based programs, empowers patients to make informed choices about their health. As we expand our reach to underserved areas, our commitment to prioritizing patient needs remains unwavering. FHCHC's mission is to enhance the health and social well-being of the communities we serve through equitable, high-quality, and culturally responsive patient-centered care. Remote in New Haven, Connecticut Job purpose...

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Certified Medical Coder/Biller

Lapinehealth Oregon, WI, USA

Description NOTE: This is not a Remote position General Statement of Duties The Certified Coder is a member of the Billing Team and is responsible for insuring the accuracy and completeness of clinical coding. Also assists with claims submission and follow up, researches claim denials and follows up with insurances and patients. Communicates with patients, insurance companies, and staff to ensure the health center’s billing and collections processes are carried out in accordance with established policies. Overall responsibility is to maximize revenues and cash flow to the organization. Responsibilities and Essential Functions Certified Medical Coder Review codes for all documented professional services provided Applies CPT, ICD, HCPCS and modifiers following coding guidelines New vs Established evaluation and management code selection Missing orders for services that are documented but not coded Age mismatch on wellness CPT codes and ICD codes Other age or gender coding...

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Med Records Coder III

University of Rochester Rochester, NY, USA

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):**905 Elmgrove Rd, Rochester, New York, United States of America, 14624**Opening:**Worker Subtype:RegularTime Type:Full timeScheduled Weekly Hours:40Department:910503 United Business Office CodingWork Shift:UR - Day (United States of America)Range:UR URG 106 HCompensation 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,...

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Med Records Coder III

University of Rochester Rochester, NY, USA

Med Records Coder III at University of Rochester Remote Position – New York, Albany, New York, USA, 12224 Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 910503 United Business Office Coding Work Shift: UR - Day (USA) 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, qualifications, expertise of the individual, and internal equity considerations. Responsibilities Reviews codes for accuracy in accordance with coding rules and policies. Responsible for system edit reviews and follows up on insurance coding denials for resolution. Essential Functions Uses knowledge of coding systems and system logic to review codes created by electronic charge...

205 claims resolution coder jobs found