Claims Edit Coder

This is a fully remote position, open to applicants in California.

📋 Description

• Evaluate medical records and health information across various electronic medical or health systems.

• Assign relevant codes such as clinical modification (ICD-10-CM), current procedural terminology (CPT), evaluation and management (E&M), and healthcare common procedure coding system (HCPCS), all while adhering to productivity and quality benchmarks for the designated areas or specialties (Facility or Professional).

• Concentrate on specialties that include, but are not limited to: Professional Multispecialty E&M, Facility Emergency Room (non-Single Path), and Outpatient Visits (Facility or Professional).

• Accurately resolve complex edits and alerts by applying current guidelines relevant to the areas of assignment or specialty.

• Manage edits such as: Simple Visit, Local and National Coverage Determination, and other Related Edits.

• Communicate effectively with physicians, providers, and external departments to ensure clarity and specificity in documentation, while confirming the completeness of documentation needed for appropriate code assignment within the areas of assignment or specialty.

• Enhance skills in procedural coding, including CPT or PCS.

⛳️ Requirements

• Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA) is required upon hire.

• A high school diploma or GED is mandatory.

• At least 2 years of experience in code assignment within a healthcare environment is necessary.

• Capability to produce high-quality work products in alignment with established hourly standards.

🏝️ Benefits

• Health care

• Paid time off

• 403(B)