ZipRecruiter

Log In

1

Claims Edit Coder Jobs in Alabama (NOW HIRING)

Southeast Health

Revenue Cycle Specialist I

Dothan, AL · On-site

Coding Certification preferred; * Working knowledge of computers. LANGUAGE/ COMMUNICATION SKILLS ... Provides follow up on claims which did not process correctly; * Provides follow up with insurance ...

Southeast Health

Medicare Specialist I

Dothan, AL · On-site

Summary Performs daily activities involved in the reimbursement process, i.e. claims filing ... Works closely with coding team for accurate submission on claim; * Process and follow up on payer ...

Yulista

Junior Business Analyst

Huntsville, AL · On-site

$26 - $35/hr

Draft, edit, and distribute communication products including announcements, presentations ... Native Claims Settlement Act, in accordance with Title 43 U.S. Code 1626(g). EEO STATEMENT ...

Yulista

Junior Business Analyst

Huntsville, AL · On-site

$26 - $35/hr

Draft, edit, and distribute communication products including announcements, presentations ... Native Claims Settlement Act, in accordance with Title 43 U.S. Code 1626(g). EEO STATEMENT ...

Yulista

Junior Business Analyst

Huntsville, AL · On-site

$26 - $35/hr

Draft, edit, and distribute communication products including announcements, presentations ... Native Claims Settlement Act, in accordance with Title 43 U.S. Code 1626(g). EEO STATEMENT ...

All JobsClaims Edit Coder JobsClaims Edit Coder Jobs in Alabama

Claims Edit Coder information

What is a claims edit coder?

Claims Edit Coders are healthcare professionals who review and analyze medical claims to ensure they are coded accurately and comply with insurance and regulatory guidelines. They use specialized coding systems, such as ICD-10, CPT, and HCPCS, to verify that procedures and diagnoses are properly documented. Their work helps prevent billing errors, reduce claim denials, and ensure timely reimbursement for healthcare providers. Claims Edit Coders often collaborate with billing departments and healthcare providers to resolve discrepancies and improve coding accuracy.

What are the key skills and qualifications needed to thrive as a claims edit coder, and why are they important?

To thrive as a Claims Edit Coder, you need a solid understanding of medical coding (ICD-10, CPT, HCPCS), claims processing, and healthcare regulations, typically supported by a coding certification such as CPC or CCS. Familiarity with electronic health record (EHR) systems, claims editing software, and payer-specific coding guidelines is crucial. Attention to detail, analytical thinking, and effective communication are vital soft skills for accurately identifying and resolving coding errors. These skills ensure correct claim submission, minimize denials, and support timely reimbursement for healthcare providers.

What are some common challenges faced by a claims edit coder, and how can they be addressed?

Claims Edit Coders often encounter challenges such as staying updated with frequent changes in coding regulations and payer-specific requirements. Additionally, coding errors or discrepancies may arise due to incomplete or unclear documentation from providers. To address these issues, it's important to engage in ongoing education, actively communicate with clinical staff for clarification, and utilize reliable coding resources and software. Collaboration with team members and regular training can help maintain accuracy and compliance in claim submissions.

What is the difference between Claims Edit Coder vs Claims Processing Specialist?

AspectClaims Edit CoderClaims Processing Specialist
CertificationsCertified Coding Associate (CCA), CPCNone required, but certifications can be beneficial
Work EnvironmentHealthcare facilities, insurance companies, remoteInsurance companies, healthcare providers, office setting
Primary ResponsibilitiesReview and correct claim data, ensure coding accuracyProcess claims from submission to payment, handle inquiries

Claims Edit Coders focus on reviewing and correcting claim data to ensure accurate coding, while Claims Processing Specialists handle the overall processing of claims from submission to resolution. Both roles require knowledge of insurance policies and coding, but Claims Edit Coders are more specialized in coding accuracy, whereas Claims Processing Specialists manage broader claim workflows.

What are popular job titles related to Claims Edit Coder jobs in Alabama?

For Claims Edit Coder jobs in Alabama, the most frequently searched job titles are:

What job categories do people searching Claims Edit Coder jobs in Alabama look for?

The top searched job categories for Claims Edit Coder jobs in Alabama are:

What cities in Alabama are hiring for Claims Edit Coder jobs?

Cities in Alabama with the most Claims Edit Coder job openings:

Claims Edit Coder jobs near you

Revenue Cycle Specialist I

Dothan, AL • On-site

Southeast Health
See more jobs at Southeast Healthexternal

Full-time

Re-posted 18 days ago

Key responsibilities

  • Performs daily activities involved in the reimbursement process, including claims filing, follow-up, and entry of payments and adjustments.

  • Coordinates with insurance companies, clinical team, and coding team to ensure accurate claim submission, follow-up on non-payment, and resolution of billing issues.

  • Processes payments, manages accounts receivable, and communicates with patients and third-party payers to ensure accurate reimbursement and financial documentation.

Job description

Southeast. Always the right career direction.
Job Description Summary
Performs daily activities involved in the reimbursement process, i.e., claims filing/follow-up, entry of payments/adjustments, follow-up on non-payment or payments below contracted fee schedule amount. Identifies any repetitive errors, either system/manual so that corrective action may be taken and documented. Performs all tasks in a timely manner to ensure consistency in Accounts Receivables totals and maintain a minimum of days in A/R.
Job Description
QUALIFICATIONS:
  • High School diploma;
  • One year of revenue cycle experience preferred;
  • Working knowledge of CPT and ICD 10 coding systems;
  • Coding Certification preferred;
  • Working knowledge of computers.

LANGUAGE/ COMMUNICATION SKILLS:
  • Excellent written, verbal and interpersonal skills;
  • Ability to interact with customers in both hospital and clinic environments.

SKILLS:
  • Basic keyboard/typing skills;
  • Basic computer skills;
  • Calculator skills.

POSITION DUTIES:
  • Works as part of a multi-disciplinary team to provide answers to inquiries and questions;
  • Troubleshoot problems and provide information;
  • Handle intervention or referrals with a professional and respectful customer service focus telephonically and/or in person;
  • Provides a variety of support services in connection to the day-to-day operations in a health care environment;
  • Maintains working knowledge of regulatory guidelines for billing;
  • Provides claim submission for services provided at SEH;
  • Provides follow up on claims which did not process correctly;
  • Provides follow up with insurance companies or individuals to obtain accurate reimbursement;
  • Reviews correspondence daily for appropriate follow up;
  • Works closely with clinical team for accurate charges and modifiers;
  • Verifies third party payer coverage;
  • Coordinates authorizations when appropriate;
  • Works closely with coding team for accurate submission on claim;
  • Process and follow up on payer denials, consulting with various entities for completion;
  • Research and resolve client billing problems or issues;
  • Provide communication on the methods and principles used for billing to the customers and resolve concerns;
  • Study contractual terms and conditions of payment to ensure payments are made consistent with terms;
  • Conduct work functions to assist with late charge processes;
  • Works closely with third party collection vendors for accurate payment records;
  • Assist patients and their families with applying for financial assistance;
  • Establish payroll deduction transactions;
  • Make daily deposits to the bank;
  • Ensure change fill requests are complete for department's daily function;
  • Work with patients to develop self-pay arrangements and payment plans when applicable;
  • Post payments for both insurance and individuals;
  • Review accounts and initiate refunds when applicable;
  • Communicate self-pay balances for upcoming services and collect balances due;
  • Work with accounting department for accurate financial documentation;
  • Edit account for correct coverage documentation;
  • Apply contractual adjustments in accordance with contracts;
  • Print, scan and index correspondence to the appropriate account;
  • Works closely with electronic payment process vendor for accurate posting and adjustments electronically;
  • Oversee the electronic flow of the account through the billing process to include bad debt;
  • Performs all other duties as assigned.

Shift
DayShift Details
8:00 am - 4:30 pm
FTE
1
Type
Regular
Join one of Forbes 500 best mid-sized employers in America.
Equal Employment Employer
Southeast Health is committed to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. In addition, Southeast Health will provide reasonable accommodations for qualified individuals with disabilities.

Apply