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Urgent! Coder, Edit/ Denials Job Opening In Brentwood – Now Hiring Quorum Health Resources

Coder, Edit/ Denials



Job description

Duties and 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.

  • Knowledge, Skills, and Abilities:

  • 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.

  • Must meet and maintain a 95% quality accuracy rate and productivity standards.

  • Must be able to apply official coding guidelines, NCCI edits, CPT Assistants, and Coding Clinics.

  • Must have experience working in a remote environment.


  • Required Skill Profession

    Financial Clerks



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