The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team.
The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team.
Claims Edit Coder
Los Angeles, CA · On-site
$32.64 - $50.59/hr
The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team.
Claims Edit Coder
Los Angeles, CA · On-site
$32.64 - $50.59/hr
The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team.
Facility Inpatient Surgical and Claims Edit Auditor
Los Angeles, CA · Remote
$29.25 - $33.50/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility inpatient surgical claims experience highly preferred. Why work here? Beyond outstanding ...
Facility Inpatient Surgical and Claims Edit Auditor
Los Angeles, CA · Remote
$29.25 - $33.50/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility inpatient surgical claims experience highly preferred. Why work here? Beyond outstanding ...
Facility Inpatient Surgical and Claims Edit Auditor
Los Angeles, CA · On-site
$45.89 - $73.42/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility inpatient surgical claims experience highly preferred. Why work here? Beyond outstanding ...
Facility Inpatient Surgical and Claims Edit Auditor
Los Angeles, CA · On-site
$45.89 - $73.42/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility inpatient surgical claims experience highly preferred. Why work here? Beyond outstanding ...
Facility Outpatient Surgical and Claims Edit Auditor (Remote)
Los Angeles, CA · Remote
$29.25 - $33.50/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility outpatient surgical claims experience highly preferred.
Facility Outpatient Surgical and Claims Edit Auditor (Remote)
Los Angeles, CA · Remote
$29.25 - $33.50/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility outpatient surgical claims experience highly preferred.
Facility Outpatient Surgical and Claims Edit Auditor (Remote)
Los Angeles, CA · On-site +1
$45.89 - $73.42/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility outpatient surgical claims experience highly preferred. Why work here? Beyond outstanding ...
Facility Outpatient Surgical and Claims Edit Auditor (Remote)
Los Angeles, CA · On-site +1
$45.89 - $73.42/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility outpatient surgical claims experience highly preferred. Why work here? Beyond outstanding ...
Facility Outpatient Surgical and Claims Edit Auditor (Remote)
Los Angeles, CA · On-site
$29.25 - $33.50/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility outpatient surgical claims experience highly preferred. Why work here? Beyond outstanding ...
Facility Outpatient Surgical and Claims Edit Auditor (Remote)
Los Angeles, CA · On-site
$29.25 - $33.50/hr
A Coding Auditor is responsible for reviewing encounters in either a prebill or retrospective ... Facility outpatient surgical claims experience highly preferred. Why work here? Beyond outstanding ...
Certified Professional Coder
Los Angeles, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Los Angeles, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Commerce, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Commerce, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Los Angeles, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Los Angeles, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Commerce, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Commerce, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Commerce, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Certified Professional Coder
Commerce, CA · On-site
$27 - $33.75/hr
... medical claims. Completes accuracy and timely entry of ICD-9-CM, HCPCS procedure codes, and CPT ... charge edit review, and or billing edit review required. * Certified Professional Coder (CPC ...
Senior Claims Examiner - Full Time
Riverside, CA · On-site
$27.28 - $39.57/hr
Responsible for preparing, researching, analyzing, pre-coding and the adjudication of all types of ... Once the edit has been reviewed ensure all matching documentation is attached, and forward to the ...
Senior Claims Examiner - Full Time
Riverside, CA · On-site
$27.28 - $39.57/hr
Responsible for preparing, researching, analyzing, pre-coding and the adjudication of all types of ... Once the edit has been reviewed ensure all matching documentation is attached, and forward to the ...
Pre-code claims, with the provider identification number, rates to be paid, EOB code, authorization ... Once the edit has been reviewed ensure all matching documentation is attached, and forward to the ...
Pre-code claims, with the provider identification number, rates to be paid, EOB code, authorization ... Once the edit has been reviewed ensure all matching documentation is attached, and forward to the ...
Professional Fee Medical Coder II
Emeryville, CA · On-site
$21.75 - $29/hr
Work RFI and edit work queues as needed. * Maintain or exceed a 95% accuracy rate. * Maintain ... Resolve Claims Manager and Epic edits to ensure correct coding of services provided, including ...
Professional Fee Medical Coder II
Emeryville, CA · On-site
$21.75 - $29/hr
Work RFI and edit work queues as needed. * Maintain or exceed a 95% accuracy rate. * Maintain ... Resolve Claims Manager and Epic edits to ensure correct coding of services provided, including ...
Manager, HIM Professional Billing Coding - FT - Days - HIMS - Medical Records @ MV
Mountain View, CA · Remote
... edit, and denial claim reviews ensuring revenue metrics do not exceed claims submissions ... Certified Professional Coder (CPC) and Certified Professional Medical Auditor) CPMA or Certified ...
Manager, HIM Professional Billing Coding - FT - Days - HIMS - Medical Records @ MV
Mountain View, CA · Remote
... edit, and denial claim reviews ensuring revenue metrics do not exceed claims submissions ... Certified Professional Coder (CPC) and Certified Professional Medical Auditor) CPMA or Certified ...
Manager, HIM Professional Billing Coding - FT - Days - HIMS - Medical Records @ MV
Mountain View, CA · On-site
... edit, and denial claim reviews ensuring revenue metrics do not exceed claims submissions ... Certified Professional Coder (CPC) and Certified Professional Medical Auditor) CPMA or Certified ...
Manager, HIM Professional Billing Coding - FT - Days - HIMS - Medical Records @ MV
Mountain View, CA · On-site
... edit, and denial claim reviews ensuring revenue metrics do not exceed claims submissions ... Certified Professional Coder (CPC) and Certified Professional Medical Auditor) CPMA or Certified ...
BILLING SUPERVISOR II
Daly City, CA · On-site
$62K - $81K/yr
... and claims software and workflows. * Generates and reviews front-end performance reports (coding accuracy, enrollment status, clean-claim and edit rates) for the Revenue Cycle Manager and ...
BILLING SUPERVISOR II
Daly City, CA · On-site
$62K - $81K/yr
... and claims software and workflows. * Generates and reviews front-end performance reports (coding accuracy, enrollment status, clean-claim and edit rates) for the Revenue Cycle Manager and ...
BILLING SUPERVISOR II
Daly City, CA · On-site
$112K - $128K/yr
... and claims software and workflows. * Generates and reviews front-end performance reports (coding accuracy, enrollment status, clean-claim and edit rates) for the Revenue Cycle Manager and ...
BILLING SUPERVISOR II
Daly City, CA · On-site
$112K - $128K/yr
... and claims software and workflows. * Generates and reviews front-end performance reports (coding accuracy, enrollment status, clean-claim and edit rates) for the Revenue Cycle Manager and ...
BILLING SUPERVISOR II
Daly City, CA · On-site
$62K - $81K/yr
... and claims software and workflows. * Generates and reviews front-end performance reports (coding accuracy, enrollment status, clean-claim and edit rates) for the Revenue Cycle Manager and ...
BILLING SUPERVISOR II
Daly City, CA · On-site
$62K - $81K/yr
... and claims software and workflows. * Generates and reviews front-end performance reports (coding accuracy, enrollment status, clean-claim and edit rates) for the Revenue Cycle Manager and ...
Claims Edit Coder information
What are the key skills and qualifications needed to thrive as a claims edit coder, and why are they important?
What is a claims edit coder?
What is the difference between Claims Edit Coder vs Claims Processing Specialist?
| Aspect | Claims Edit Coder | Claims Processing Specialist |
|---|---|---|
| Certifications | Certified Coding Associate (CCA), CPC | None required, but certifications can be beneficial |
| Work Environment | Healthcare facilities, insurance companies, remote | Insurance companies, healthcare providers, office setting |
| Primary Responsibilities | Review and correct claim data, ensure coding accuracy | Process 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 some common challenges faced by a claims edit coder, and how can they be addressed?

Cedars-Sinai rating
8.6
Based on 131 frontline employees who took The Breakroom Quiz
40th of 1,054 rated hospitals
Job description
Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company's Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals.
What you will be doing in this role:
The Claims Edit Coder (Coder II) operated under the general direction of an audit supervisor and involves responsibilities across various work units, as well as duties specific to the reporting team. In this role, the Coder II reviews ICD-10-CM diagnosis coding and Current Procedural Terminology (CPT) procedure code for claim edit fall outs. The position entails conducting modifier review and assignment, handling complex coding edits that necessitate research and resolution, and validating key data elements like the billing physician and date of service.
You are expected to abstract coded data accurately and promptly into the applicable system using relevant applications such as EPIC (CS-Link), EPIC HB and PB modules, Solventum 360Encompass, Solventum Standalone Encoder, and Select Coder. This role demands proficiency in these systems to ensure the integrity and efficiency of coding operations. Duties include:
- Review medical documentation and health information within various electronic medical or health systems.
- Assign applicable codes such as clinical modification (ICD-10-CM), current procedural terminology (CPT), evaluation and management (E&M), and healthcare common procedure coding system (HCPCS) while adhering to productivity and quality standards for the area(s) of assignment or specialty (Facility or Professional).
- Focus on specialties including, but not limited to: Professional Multispecialty E&M, Facility Emergency Room (non-Single Path), and Outpatient Visits (Facility or Professional).
- Resolve complex edits and alerts with consistent accuracy using current guidelines for the area(s) of assignment or specialty.
- Handle edits such as: Simple Visit, Local and National Coverage Determination, and other Related Edits.
- Communicates with physicians, providers, and external departments regarding documentation clarity, specificity, ensure the completeness of documentation required for code assignment within area(s) of assignment or specialty.
- Expanding skills in procedural coding such as CPT or PCS.
Requirements:
- Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required upon hire.
- High school diploma or GED required.
- Minimum of 2 years of experience working doing code assignment in a healthcare setting.
- Ability to produce quality work product within the established standards per hour.
Why work here?
Beyond outstanding employee benefits including health, paid vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.
Requirements:
- Certified Coding Specialist (CCS), Certified Procedural Coder (CPC), Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) required upon hire.
- High school diploma or GED required.
- Minimum of 2 years of experience working doing code assignment in a healthcare setting.
- Ability to produce quality work product within the established standards per hour.
What Cedars-Sinai employees say
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Benefits
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About Cedars-Sinai
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Industry
Hospitals, outpatient health care and health care and social assistance
Company size
10,000+ Employees
Headquarters location
Los Angeles, CA, US