Senior Edits & Denials Coder — Appeals & Corrections

Insight Global; Brentwood (TN); Presencial; USD 65.000 - 90.000; Jornada completa

Descripción de la vacante

Insight Global is seeking an Edit & Denials Coder to review medical records and determine appropriate billing codes and necessary documentation. The role involves advanced coding and appeal activities, investigating payer issues, and timely filing of appeals to insurance companies.

The candidate should have at least 5 years of experience in edit and denials coding across professional and facility settings, with proficiency in EHR systems and payor policies.

Formación

• 5 years minimum of Edit & Denials coding experience.
• Professional and facility coding experience.
• Experience making changes in EHR systems.
• Experience reviewing and correcting coding edits.

Responsabilidades

• Review medical records to identify facts for appealing denied claims.
• Create letters to substantiate claim validity.
• Collaborate with facility liaison to review documentation and tag files for follow-up.
• Investigate payer issues with coding staff and faculty.
• Develop appeals with clinical staff for documentation feedback.
• Research payer policies and processes.
• Review clinical documentation to select appropriate diagnoses and procedures.
• Manage work queues and verify remittance advice for rejections and payment accuracy.
• Identify invoices or claims denied per billing edits.

Conocimientos

Edit & Denials coding

Facility coding

EHR systems

Coding edits review

Cross-client ability

Herramientas

Billing software

Descripción del empleo

Insight Global is seeking an Edit & Denials Coder to review medical records and determine appropriate billing codes and necessary documentation. The role involves advanced coding and appeal activities, investigating payer issues, and timely filing of appeals to insurance companies.

The candidate should have at least 5 years of experience in edit and denials coding across professional and facility settings, with proficiency in EHR systems and payor policies.