318 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,...

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...

Introduction Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Coding Account Resolution Specialist-Outpatient Parallon Benefits Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital...

Job Description Job Description Job Title : Certified Medical Coder Location : Remote: Must be in AL, FL, GA, IL, MD, NJ, NC, TX, VA, WV, IA, or NY. Hire Type : Temp-to-Hire Pay Range : $23.00 - $27.30/hour Work Type : Full-time Work Model : Remote Work Schedule : Monday – Friday, 8am – 4:30pm Nature & Scope: Positional Overview The Imagine Group is recruiting for a Certified Medical Coder on behalf of our client, a leading not-for-profit healthcare network serving Western New York, this organization provides comprehensive medical services through hospitals, outpatient centers, and long-term care facilities across the region. It is committed to advancing community health through innovation, education partnerships, and patient-centered care. In this role, you will be responsible for reviewing and accurately assigning diagnostic and procedural codes to patient records in compliance with ICD-10, CPT, and HCPCS guidelines. You will ensure proper...

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...

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): 2619 W Henrietta Rd, Rochester, New York, United States of America, 14623 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-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...

Coding Account Resolution Specialist-Inpatient Do you want to join an organization that invests in you as a Coding Account Resolution Specialist-Inpatient? At Parallon, you come first. HCA Healthcare has committed up to $300 million in programs to support our incredible team members over the course of three years. This position is a work from home position! Some flexibility in the schedule! Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include: Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and...

Company Description : Job Summary : We are seeking a knowledgeable and detail?oriented Certified Ambulance Biller / Coding Specialist to join our billing team. This role is responsible for reviewing patient care reports, applying proper ambulance billing codes, ensuring compliance with federal and state regulations, and submitting clean claims for timely reimbursement. The ideal candidate understands EMS industry billing practices and has experience with accurate documentation review and denial prevention. #osmcareers Responsibilities : Review Patient Care Reports (PCRs), run sheets, and supporting documentation for accuracy and completeness. Apply correct ambulance billing codes, including HCPCS, CPT, and ICD?10, according to documentation and payer requirements. Determine appropriate levels of service (BLS, ALS1, ALS2, SCT, mileage, etc.) based on medical necessity and documentation. Enter and validate charges in the billing system prior to claim...

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 108 H Compensation Range: $24.91 - $34.87 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...

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: Remote Work - New York, Albany, New York, United States of America, 12224 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,...

Job Description Job Description Description: Summary of Role Individuals will be responsible for coding all physician, clinical, and surgical claims. Review documentation via EHR or operative note to verify the accuracy and completeness of CPT and ICD10 code assignment for claims submission. The Medical Coder is responsible for translating medical documentation into standardized codes that accurately represent the patient's medical history, treatments, and procedures. The role ensures that the hospital’s billing processes are precise and compliant with regulations, facilitating efficient reimbursement from insurance companies and payers. Key Responsibilities Serves as the key point of contact for coding information Provides onsite coding and documentation, education, and feedback to providers for coding changes (CPT including E&M, modifiers and internal codes, ICD-9, ICD-10, HCPCS), annual updates, payor requirements, and insurance rejection resolution Staying...

Position Summary TheMedical Coder/Audit Specialist position is an exempt salaried position thatensures that AAAI's coding, documentation, and billing practices are accurate,compliant, and aligned with payer regulations. This role reduces risk exposure,strengthens revenue capture, manages payer portals, and supports providersthrough education and proactive auditing. This position supports timelysubmission of insurance claims to a wide variety of payers and functions as anintermediary between healthcare providers, clients, patients and healthinsurance companies. Must be certified from an accredited organization such as AAPC (CPC) (CCS) is required in coding and / or billing. Reports To: Medical PracticeAdministrator Principal Duties andResponsibilities 1.Revenue Protection & Growth Accurate Coding = Correct Reimbursement: Ensures all CPT/ICD-10 codes and HCPCS are properly supported, reducing underpayments. Audit-Driven Optimization: Identifies missed...

Overview The Revenue Cycle Medical Billing Specialist is responsible for the overall account resolution of patient accounts within the revenue cycle management (RCM) process. Ensures timely billing of claims to payers and follows up on denials, appeals, recoupments, and balance management. Ability to audit and provide feedback on the billing process and outcomes. Works cooperatively with other departments to ensure timely billing, reporting and patient account management. Supports the organization's strategic plan and workplace inclusion initiatives. Abides by the organization's mission in performing job duties. Demonstrates an understanding and commitment to PPGT's culture of quality, safety and risk awareness. Responsibilities Reviews submission of claims by third party billing team to the clearinghouse to ensure accuracy. Processes reimbursements and payment adjustments with attention to detail, timeliness, and accuracy. Makes corrections and prepares appeals related to claim...

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...

Overview Introduction Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: Coding Account Resolution Specialist-Outpatient Parallon Benefits Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation. Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more. Free...

Position Title HIM Outpatient Surgery/Ambulatory Coder Liberty Hospital Position Summary / Career Interest: The HIM Outpatient Surgery/Ambulatory Coder is responsible for reviewing outpatient/inpatient EHR. This position monitors CPT, ICD-10, and HCPCS code changes. Audits and/or assigns codes (CPT, HCPCS, and diagnosis) for professional and hospital accounts for Primary Care/Medical Specialty/Simple Procedural services from clinical documentation for accurate professional billing and facility APC assignment. The HIM Outpatient Surgery/Ambulatory Coder is a resource for the physicians and other health care providers in regard to coding and to review medical documentation to insure appropriate physician and facility coding and billing. Responsibilities and Essential Job Functions Reviews outpatient/inpatient EHR for appropriate documentation and signatures, and reviews interface charges prior to billing. Reviews departmental reporting structures and requests...

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...

Coder Location Requirement: Candidates must reside in one of the following states- Florida, Alabama, or Georgia. If offered the position, will be required to come onsite in Pensacola, FL for orientation. The Coder is responsible for ensuring that claims reflect accurate diagnosis as ordered by the health care provider. This position validates that the coding methodology correctly reflects how the tests was 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. Responsible for being knowledgeable of coding and diagnostic procedures, as well as remaining current about federal legislative changes that affect outcome. Communicate questions or concerns to the Coding Manager, HIM...

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): 2619 W Henrietta Rd, Rochester, New York, United States of America, 14623 Opening: Worker Subtype: Regular Time Type: Full time Scheduled Weekly Hours: 40 Department: 900370 Health Info Mgmt-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...

JOB SUMMARY The Health Information Management (HIM) Coder impacts Memorial's Healthcare quality initiatives and reimbursement through the assignment of the most accurate and optimal diagnosis and procedural codes to individual patient health information for data retrieval, analysis, and claims processing. Under the direction of the Health Information Management (HIM) Coding and Clinical Documentation Integrity (CDI) Manager, this position will code and analyze physician documentation contained in health records (electronic, paper or hybrid) to determine the appropriate principal diagnosis, secondary diagnoses, and procedures codes to accurately capture MS-DRG assignment. Use the Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) procedure codes and all required modifiers in accordance with coding rules and regulations. The coding information is used to determine APC's (Ambulatory Payment Classification) for data quantitative analysis,...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...

Company : Allegheny Health Network Job Description : GENERAL OVERVIEW: Performs all related internal, concurrent, prospective and retrospective coding audit activities. Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier assignments, ICD diagnosis and procedure coding, DRG/APC structure according to regulatory requirements. Reports findings both verbally and in writing and communicates results to affected areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in accordance with coding principles and guidelines. Promotes cooperation with CDMP and compliance programs to improve documentation which supports compliant coding. Interacts with external consultants regarding billing, coding and/or documentation and evaluates their recommendations and/or teaching...