36 code edit disputes medical coder jobs found

Coding Specialist GENERAL SUMMARY: Ensures proper assignment of diagnosis and procedure codes, along with validating and adjusting charges according to the services the patient received. Works collaboratively with Clinical Documentation Improvement personnel to ensure coding is clinically supported. Participates in the identification and resolution of discrepancies in documentation; assists in training as necessary. Maintains a working knowledge of applicable coding and reimbursement Federal, State, and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Participates in quality assessment and continuous quality improvement activities. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior. SUPERVISION RECEIVED: Works under the...

About Start Corporation Start Corporation is a 501(c)(3) non-profit organization founded in 1984. Our Mission is to promote opportunities, which enhance the self-sufficiency of people to empower them to live and function independently. Job Description We are looking for an experienced Medical Coder to join our team. Minimum Requirements High school diploma or equivalent required. Minimum 2-3 years of professional medical coding experience preferred. Completion of an accredited medical coding or medical billing and coding program preferred. Demonstrated knowledge of ICD-10-CM, CPT, HCPCS, E/M coding, Medicare and Medicaid coding requirements, and medical necessity. Knowledge of medical terminology, anatomy, and healthcare documentation. Experience with electronic health records and healthcare billing systems preferred. Experience reviewing provider documentation and resolving coding discrepancies. Core Competencies Ability to interpret payer policies, coding guidelines,...

Medical Billing SpecialistThe Medical Billing Specialist is a higher-level billing role within the Hospital or Physicians Billing Offices for the Albany Med Health System (AMHS). This role is centered predominantly around denials. The incumbent will be expected to understand and resolve the most complicated of denials and/or will research the denial to learn what is needed by the payer. The incumbent must be able to work independently but also serve as a resource to others in the department. This position will act as a learning partner or mentor to the team. They will exemplify the meaning of teamwork and support their co-workers in a positive environment. This position will also possess the ability to manage assigned projects and present findings with preferred resolutions to leadership. This role will become familiar with running reports out of Epic as assigned. The incumbent will be expected to work independently and meet production standards. Progressive communication with...

Medical Billing SpecialistThe Medical Billing Specialist is a higher-level billing role within the Hospital or Physicians Billing Offices for the Albany Med Health System (AMHS). This role is centered predominantly around denials. The incumbent will be expected to understand and resolve the most complicated of denials and/or will research the denial to learn what is needed by the payer. The incumbent must be able to work independently but also serve as a resource to others in the department. This position will act as a learning partner or mentor to the team. They will exemplify the meaning of teamwork and support their co-workers in a positive environment. This position will also possess the ability to manage assigned projects and present findings with preferred resolutions to leadership. This role will become familiar with running reports out of Epic as assigned. The incumbent will be expected to work independently and meet production standards. Progressive communication with...

Coding SpecialistGENERAL SUMMARY: Ensures proper assignment of diagnosis and procedure codes, along with validating and adjusting charges according to the services the patient received. Works collaboratively with Clinical Documentation Improvement personnel to ensure coding is clinically supported. Participates in the identification and resolution of discrepancies in documentation; assists in training as necessary. Maintains a working knowledge of applicable coding and reimbursement Federal, State, and local laws and regulations, the Compliance Accountability Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Participates in quality assessment and continuous quality improvement activities. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior.SUPERVISION RECEIVED: Works under the...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Enhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding.For physician billing, collaborates with billing department to ensure all bills are satisfied. For hospital, routes to billing charge entry errors...

Coding Specialist (Part-Time)At Commence, we're the start of a new age of data-centric transformation, elevating health outcomes and powering better, more efficient processes to program and patient health. We combine quality data-driven solutions that fuel answers, technology that advances performance, and clinical expertise that builds trust to create a more efficient path to quality care.With human-centered, healthcare-relevant, and value-based solutions, we create new possibilities with data. We provide proof beyond the concept and performance beyond the scope with a focus on efficiencies that transform the lives of those we serve. With a culture driven by purpose, straightforward communication and clinical domain expertise, Commence cuts straight to better care.The Coder Reviewer position is responsible for supporting and conducting reviews and determinations for independent dispute resolutions at both the Federal and State levels. Subject matter expert in clinical...

Location: Miramar, Florida At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: Reviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance. Responsibilities: Communicates with insurance companies about coding errors and disputes (physician billing). Abstracts pertinent data points for billing and quality reviews. Communicates with various departments as needed to ensure accuracy of patient data. Conducts audits and/or coding reviews with various health care professionals to ensure all documentation is accurate (physician billing). May assign and sequence basic CPT (Current...

Medical Coding AuditorBecome a part of our caring communityThe Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.Use your skills to make an impactAdditional Job DescriptionWork Style: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Work Hours: Typical business hours are Monday-Friday, 8 hours/day, 5 days/week-- some flexibility might be possible, once training is complete and depending on business needs. Associates are expected to start each workday between 6AM-9AM EST, regardless of their home time zone.Required Qualifications – What it takes to SucceedCPC, COC, CCS, RHIA, or RHIT Certification...

Job Description GENERAL SUMMARY: As an Outpatient Professional Coder, you'll play a vital role in our healthcare organization by translating complex medical documentation into accurate diagnostic and procedural codes that drive both reimbursement and quality patient care. Your expertise in coding principles and procedures directly impacts our organization's financial health, data integrity, and ability to support medical research and clinical decision-making. This position ensures compliance with coding guidelines and regulations while optimizing reimbursement and maintaining the highest standards of accuracy and professionalism. PRINCIPAL DUTIES AND RESPONSIBILITIES: Clinical Documentation & Analysis Conduct thorough reviews of patient medical records to identify all diagnostic and operative procedures requiring coding Analyze provider documentation with precision to assign or verify appropriate Evaluation & Management (E&M) CPT codes Collaborate with medical...

General Summary Using established coding principles and procedures reviews analyzes and codes diagnostic and/or procedural information from the patient’s medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. Remote Position Using established coding principles and procedures reviews analyzes and codes diagnostic and/or procedural information from the patient’s medical record for...

Health Information Management (HIM) Coding SpecialistLocation: Miramar, FloridaAt Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.SummaryReviews medical record documentation. May assign codes to medical diagnoses, procedures and modifiers, when applicable, using appropriate coding classifications for assigned areas/record types to ensure proper billing and compliance.ResponsibilitiesEnhances and maintains coding knowledge and skills. Reviews all appropriate work queues daily to address edits and makes corrections following procedures and processes. Seeks clarification from healthcare providers or other designated resources to ensure accurate and complete coding. Reviews medical record documentation to determine all appropriate diagnosis (including HCC Coding Hierarchical...

General Summary Using established coding principles and procedures, reviews, analyzes and codes diagnostic and/or procedural information from the patient’s medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. General Summary Using established coding principles and procedures, reviews, analyzes and codes diagnostic and/or procedural information from the patient’s medical record for...

Job Title Business (Non-Clinical) Company Henry Ford Medical Group Requisition Number 2611335 General Summary Using established coding principles and procedures, reviews, analyzes and codes diagnostic and/or procedural information from the patient's medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. Principal Duties and Responsibilities Identifies all diagnostic and operative...

Job Description Job Description Description:   Charge Capture and Claim Submission Review and verify charges, CPT/ICD-10/HCPCS codes, and modifiers for orthopedic office visits, procedures, injections, imaging, DME, and surgical services before billing. Prepare, scrub, and submit clean claims to commercial, government, and third-party payers through athenaOne, resolving claim edits and clearinghouse rejections promptly. Track global surgical periods, bundling rules, and payer-specific requirements to ensure correct billing for orthopedic procedures. Denial Management and Appeals Work denials, rejections, kicked claims, and no-response claims daily in athenaOne; determine the kick reason and root cause, correct, and resubmit within payer timely-filing limits. Draft and submit appeals with supporting documentation, including for medical-necessity, authorization, coordination-of-benefits, and downcoding denials common in orthopedics. Route registration-driven denials...

Department/Unit: Patient Billing Service Work Shift: Day (United States of America) Salary Range: $49,763.00 - $69,668.00 The Medical Billing Specialist is a higher-level billing role within the Hospital or Physicians Billing Offices for the Albany Med Health System (AMHS). This role is centered predominantly around denials. The incumbent will be expected to understand and resolve the most complicated of denials and/or will research the denial to learn what is needed by the payer. The incumbent must be able to work independently but also serve as a resource to others in the department. This position will act as a learning partner or mentor to the team. They will exemplify the meaning of teamwork and support their co-workers in a positive environment. This position will also possess the ability to manage assigned projects and present findings with preferred resolutions to leadership. This role will become familiar with running reports out of Epic as assigned. The incumbent...

100 Park Street Glens Falls, NY 12801 59D Myrtle Street 1275 Broadway Albany, NY 12204 Full time 70286 Department/Unit: Patient Billing Service Work Shift: Day (United States of America) Salary Range: $49,763.00 - $69,668.00 The Medical Billing Specialist is a higher-level billing role within the Hospital or Physicians Billing Offices for the Albany Med Health System (AMHS). This role is centered predominantly around denials. The incumbent will be expected to understand and resolve the most complicated of denials and/or will research the denial to learn what is needed by the payer. The incumbent must be able to work independently but also serve as a resource to others in the department. This position will act as a learning partner or mentor to the team. They will exemplify the meaning of teamwork and support their co-workers in a positive environment. This position will also possess the ability to manage assigned projects and present findings with preferred...

ELLIS HOSPITAL POSITION DESCRIPTION TITLE: Accounts Receivable Representative/ Coder II DEPARTMENT: Physician Revenue Cycle REPORTS TO: Manager Patient Financial Services SECTION I BASIC FUNCTION: The Accounts Receivable Representative/ Coder will be responsible for achieving accurate and timely accounting for professional accounts receivable as set by policies and procedures. Responsible for reviewing and posting charges, payments and adjustments to the patient accounting system on a daily basis, and ensuring outgoing data is accurate. Review and resolve outstanding accounts receivable with insurance companies and patients. In addition to AR responsibilities this position will be responsible for coding review, resolving coding edits and denials with the focus on ensuring that the account is resolved in a timely and appropriate manner. SECTION II EDUCATION AND EXPERIENCE REQUIREMENTS: Education: High School Diploma or Equivalent required. Associate’s degree...

GENERAL SUMMARY: Using established coding principles and procedures, reviews, analyzes and codes diagnostic and/or procedural information from the patient’s medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. PRINCIPAL DUTIES AND RESPONSIBILITIES: · Identifies all diagnostic and operative procedures for coding by thoroughly reviewing the patient’s medical record. · May analyze provider...

WHY HENRY FORD: Remote Position GENERAL SUMMARY: Using established coding principles and procedures reviews analyzes and codes diagnostic and/or procedural information from the patient’s medical record for reimbursement/billing purposes. Accurately abstracts information from the medical record for compilation of a patient database, which supports medical research projects, patient care evaluation and administrative decision making related to patient care. The coding function is considered a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. The coding function also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditation guidelines. PRINCIPLE DUTIES AND RESPONSIBILITIES: • Identifies all diagnostic and operative procedures for coding by thoroughly reviewing the patient’s medical...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...

Become a part of our caring community The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Medical Coding Auditor extracts clinical information from a variety of medical records and assigns appropriate procedural terminology and medical codes (e.g., ICD-10-CM, CPT) to patient records. The Medical Coding Auditor work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Use your skills to make an impact Additional Job Description WORK STYLE: Remote, work at home. While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. WORK HOURS:...