- Cedars-Sinai (Los Angeles, CA)
- …team of 14,000+ remarkable employees! What you will be doing in this role: The Claims Edit Coder ( Coder II) operated under the general direction of an ... inclusive environment that fuels innovation. Req ID : 13346 Working Title : Claims Edit Coder Department : CSRC Coding Audit Business Entity : Cedars-Sinai… more
- University of Rochester (Albany, NY)
- …and internal equity considerations. Responsibilities: GENERAL PURPOSE Functions as an advanced coder in the abstraction and in-depth analysis of a variety of medical ... recognized coding guidelines. Reviews and resolves coding denials. Resolves problems with claims having errors related to improper coding and provides feedback for… more
- Waystar (Atlanta, GA)
- …technology teams to prioritize and deliver new functionality to meet the rule, edit , and claims reporting needs of onboarding clients Clearly communicate ... & Edits Manager and has the responsibility for establishing new client payer edit configurations. The goal of the position is to ensure implementation clients exceed… more
- Molina Healthcare (Phoenix, AZ)
- …to law enforcement or for payment recovery. KNOWLEDGE/SKILLS/ABILITIES Reviews post pay claims with corresponding medical records to determine accuracy of claims ... investigations Thorough knowledge of PC based software including Microsoft Word ( edit /save documents) and Microsoft Excel ( edit /save spreadsheets, sort/filter)… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …the two aspects of the business together to inform configuration that supports accurate claims processing. Act as a key resource and contact for clinical coding, the ... codes that accurately represent services. Collaboration with configuration teams (ie , Claims and Product) is vital to ensure codes are established in the… more
- Humana (Charleston, WV)
- **Become a part of our caring community and help us put health first** Code Edit Disputes team reviews and educates providers when there is a dispute on adjudicated ... claims that contain a code editing related denial or...Minimum of 3 years' experience as a Certified Medical Coder + Demonstrate ability to problem-solve complex coding issues… more
- Humana (San Juan, PR)
- …compliance with regulatory requirements, and supports operational efficiency in claims management. The Medical Coding Coordinator 3 performs advanced administrative, ... for researching, reviewing, and educating providers regarding disputes on adjudicated claims involving code editing denials or recoveries. The coordinator analyzes,… more
- University of Rochester (Rochester, NY)
- … reviews to make corrections before transmittal. + Troubleshoots problems that prevent claims from being released. Identifies cause of edit and independently ... accordance with coding rules and policies. Responsible for system edit reviews and follows up on insurance coding denials...+ High School diploma or equivalent and 1-year Medical Coder experience required + Associate's degree preferred + Or… more
- University of Rochester (Rochester, NY)
- …individual, and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE The Med Records Coder III functions as an advanced coder in the ... Reviews and resolves coding denials. + Resolves problems with claims having errors related to improper coding and provides...data and reviews codes for accuracy. + Performs system edit checks and corrects errors as needed. + Responds… more
- University of Rochester (Albany, NY)
- …and internal equity considerations._ **Responsibilities:** GENERAL PURPOSE Functions as an advanced coder in the abstraction and in-depth analysis of a variety of ... Reviews and resolves coding denials. + Resolves problems with claims having errors related to improper coding and provides...data and reviews codes for accuracy. + Performs system edit checks and corrects errors as needed. + Responds… more
- University of Rochester (Albany, NY)
- …that prevent claims from being released. + Identifies cause of edit and independently resolves issue by reviewing the patient encounter to understand the ... through medical record documentation as per designated workflow. + Completes system edit reviews to make corrections before transmittal. + Ensures work queue and… more
- CommonSpirit Health (Centennial, CO)
- …review, claim edit , and follow up), and review denials for possible corrected claims or appeals. Coder II will work with clinic supervisors and/or providers ... multiple specialties; coding both inpatient and outpatient professional fee services. Coder II staff key duties include reviewing documentation to assign appropriate… more
- St. Luke's University Health Network (Allentown, PA)
- …codes to individual patient medical records for data retrieval, analysis and claims processing. Codes and abstracts all pertinent medical information according to ... the coding manager with hospital coding workflow, monitoring account and claim edit work queues and re-assigning coding professionals as needed, including contract… more
- Waystar (Atlanta, GA)
- …and technology teams to prioritize and deliver new functionality to meet the rule, edit , and claims reporting needs of onboarding clients + Clearly communicate ... & Edits Manager and has the responsibility for establishing new client payer edit configurations. The goal of the position is to ensure implementation clients exceed… more
- HCA Healthcare (Nashville, TN)
- …to apply! **Job Summary and Qualifications** As a work from home Outpatient Coder , you will work outpatient coding related alerts/edits for same day surgery, ... areas predominately post initial/final coding. You will also perform the alert/ edit resolution activities in the applicable systems. The alerts/edits shall be… more
- AmeriHealth Caritas (Charleston, SC)
- …reimbursement to providers. + Participate in Provider Reimbursement medical policy and edit reviews. + Requests/runs queries to identify root causes of claim ... denials, incorrect payments and claims that are not correctly submitted for payment. +...+ American Academy of Professional Coders (AAPC) Certified Professional Coder (CPC) required.; + Associate's Degree or equivalent education… more
- Geisinger (Danville, PA)
- …position provides daily support for coding and reimbursement needs across negotiations, claims processing, and provider setup. A minimum of one certification is ... financial impact. Oversees daily coding and reimbursement support to negotiations, claims processors and provider set-up representatives. A minimum of one… more
- Novant Health (Charlotte, NC)
- …to patients and staff for billing and insurance questions. Ensures charges drop for claims processing. Works closely with practice coder in resolution process. + ... resolving Work Queues in Epic including, but not limited to: Follow Up; Claim Edit ; Charge Review (Audit and Review); Missing Guarantor. Resolves work queue errors &… more
- Mount Sinai Health System (Elmhurst, NY)
- …credentials. At least six months coding experience preferred. Certified Professional Coder /AAPC. Ability to use computer. Average dexterity and knowledge of software ... accounts receivable team to ensure the time processing of claims and all revenue is captured. Maintains daily logs...Works with management and the billing vendor daily, on edit list and/or requests for additional information as to… more
