Claims Edit Coder Jobs in Georgia (NOW HIRING)

Description

The Front-End Revenue Cycle Supervisor is a working supervisor responsible for overseeing and supporting front-end revenue cycle functions, including coding coordination, charge entry, edit management, and resolution of payer edits and rejections. This role collaborates closely with the Patient A/R and Back-End Revenue Cycle Supervisors and the RCM Manager to ensure clean claims, reduced denials, and accurate data capture at the front end of the billing process. The supervisor actively participates in daily workflows while also monitoring process efficiency and recommending improvements.

Requirements

Key Responsibilities

Coding, Charge Entry, and Edit Management

• Oversee and support daily workflows for charge entry, coding coordination, and edit resolution.
• Work collaboratively with coders and clinical teams to ensure charges are accurate, complete, and compliant prior to claim submission.
• Review edit and rejection reports regularly, ensuring timely and accurate resolution of front-end claim errors.
• Identify recurring issues related to coding, provider documentation, or charge entry and escalate trends to the RCM Manager.
• Serve as a liaison between coding staff and providers to support documentation improvement and code accuracy.

Cross-Functional Collaboration

• Work closely with the Patient A/R Supervisor to ensure front-end data integrity supports clean patient balances and minimizes billing issues.
• Partner with the Back-End Supervisor to align workflows related to edits, denials, and payer rejections that originate from front-end errors.
• Collaborate with the RCM Manager to implement changes in workflows based on payer policy updates, denial trends, and compliance findings.
• Participate in cross-departmental workgroups to streamline end-to-end revenue cycle processes and improve first-pass claim acceptance.

Payor Trends and Clean Claim Submission

• Monitor payer-specific edit trends and address root causes of front-end claim rejections or delays.
• Stay current on payer policy changes, prior authorization requirements, and coding guidelines affecting front-end workflows.
• Recommend and help implement system updates, staff training, or workflow changes in response to payer developments.
• Track and report on front-end-related denial rates, charge lag times, and edit resolution performance.

Staff Supervision and Workflow Support

• Supervise front-end revenue cycle staff workflows, including charge entry, encounter review, and edit resolution.
• Provide daily support and task coordination to ensure charge entry deadlines and clean claim goals are met.
• Assist in onboarding, training, and mentoring staff in front-end processes and payer-specific rules.
• Monitor staff performance metrics and provide constructive feedback to support process consistency and accuracy.
• Cover open shifts or high-volume periods to ensure service level goals are met.
• Provide workflow oversight, assign daily priorities, and support staff in resolving complex issues.
• Promote accountability and a collaborative work environment focused on results and service quality.

Compliance and Quality Control

• Ensure front-end workflows support compliance with payer policies, coding regulations, and internal documentation standards.
• Audit charge entry, coding interfaces, and edit resolution activities to identify and correct quality issues.
• Ensure timely documentation of resolution steps taken on rejected or held charges.

Qualifications

Education and Certification

• Associate's (Bachelor's preferred) degree in Healthcare Administration, Finance, or a related field preferred; or three (3yrs) or more directly related experience.
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) certification is highly desirable.

Experience

• Minimum of 3 years of experience in healthcare revenue cycle management, with a focus on front-end processes such as charge entry, coding, or clearing house operations.
• At least 1-2 years of supervisory or team lead experience in a related role.

Skills and Abilities

• Strong understanding of medical terminology, ICD-10, CPT, and HCPCS coding systems.
• Proficiency with electronic medical records (EMR) and revenue cycle/billing software.
• Excellent analytical, organizational, and communication skills to manage team tasks and resolve complex issues.
• Ability to lead by example in a hands-on supervisory role, balancing operational duties with team management.

Key Physical and Mental Requirements:

• Ability to lift up to 50 pounds.
• Ability to push or pull heavy objects using up to 50 pounds of force.
• Ability to sit for extended periods of time.
• Ability to stand for extended periods of time.
• Ability to use fine motor skills to operate office equipment and/or machinery.
• Ability to receive and comprehend instructions verbally and/or in writing.
• Ability to use logical reasoning for simple and complex problem solving

• FLSA Classification: Non-exempt

Southeast Primary Care Partners** is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

6/2025