Medical Coder (Edits & Denials)

DaMar Staffing; Brentwood (TN); On-site; USD 60,000 - 90,000; Full time

Job summary

DaMar Staffing is seeking an Edit & Denials Coder to review medical records and assign correct billing codes. The role entails performing advanced coding and appeals, investigating payer issues, making charge corrections, and submitting timely appeals to insurers.

The candidate should have 5+ years of Edit & Denials coding experience, hold an AAPC or AHIMA credential, and be proficient in MS Office. Collaboration with AR teams and the ability to pass a coding assessment are essential.

Qualifications

• 5+ years of Edit & Denials coding
• Active AAPC or AHIMA credential
• Ability to independently resolve denials
• Strong payer knowledge
• Knowledge of ICD-10 and CPT Coding
• Must be comfortable working with AR teams to resolve issues
• Must pass a coding assessment
• Proficient in Microsoft Office, including Outlook, Excel, and Teams
• Ability to multi-task and have excellent communication skills

Responsibilities

• Reviews documentation to identify facts for appealing claims denied by third-party payers or holds in host systems or billing clearinghouse, creating letters to substantiate claim validity.
• Meets with facility liaison to review documentation, resolve coding, and follow up; investigates reimbursement issues with other coding staff and faculty.
• Researches payer policies and processes.
• Reviews clinical documentation to identify facts to describe patient conditions and treatment with accurate diagnoses and procedures.
• Works on assigned queues and reviews remittance advice for rejections and accuracy of payments.

Skills

Independent denial resolution

Payer knowledge

ICD-10 CPT coding

AR collaboration

Coding assessment

MS Office (Outlook, Excel, Teams)

Multi-tasking & communication

Education

Active AAPC or AHIMA credential

Job description

Edit & Denials Coder

Required Skills & Experience- 5+ years of Edit & Denials coding

• Active AAPC or AHIMA credential
• Ability to independently resolve denials.
• Strong payer knowledge
• Knowledge of ICD-10 and CPT Coding
• Must be comfortable working with AR teams to resolve issues.
• Must be able to pass a coding assessment.
• Must be proficient in Microsoft Office, including Outlook, Excel, and Teams.
• Ability to multi-task and have excellent communication skills

Job Description

We are seeking an Edit & Denials Coder to review medical records to determine appropriate billing codes and necessary documentation. This role is responsible for performing advanced coding and appeal activities; investigating payer issues, completing charge corrections, and for timely filing of appeals to insurance companies.

Key Responsibilities:

• Reviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse. Creates appropriate letters to substantiate the validity of claims.
• Meets with facility liaison to review documentation, resolve coding, and tagging files for follow-up. Investigates and problem‑solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with facility liaison or other clinical staff as needed to provide documentation feedback and to develop appeals.
• Researches payer policies and processes.
• Reviews clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient’s conditions and treatment.
• Works assigned work queues and tasks and reviews remittance advice for rejections and accuracy of payment amounts as needed. Identifies invoices or claims that have been rejected per billing edits/criteria.