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Claims Edit Coder Jobs in Michigan (NOW HIRING)

Spectrum Health

Specialist Billing Services

Royal Oak, MI · Hybrid

$18 - $24.25/hr

Our ideal candidate will be well versed in medical billing, medical coding, insurance claims and ... Manage and educate lab Operations and Patient Service Center's (PSC) top-offenders on edit ...

Corewell Health

Specialist Billing Services

Royal Oak, MI · On-site

$18 - $24.25/hr

Our ideal candidate will be well versed in medical billing, medical coding, insurance claims and ... Manage and educate lab Operations and Patient Service Center's (PSC) top-offenders on edit ...

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Claims Edit Coder information

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 Claims Edit Coders?

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 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 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 are popular job titles related to Claims Edit Coder jobs in Michigan? For Claims Edit Coder jobs in Michigan, the most frequently searched job titles are:
What job categories do people searching Claims Edit Coder jobs in Michigan look for? The top searched job categories for Claims Edit Coder jobs in Michigan are:
Claims Edit Coder jobs near you
Infographic showing various Claims Edit Coder job openings in Michigan as of May 2026, with employment types broken down into 73% Full Time, 19% Part Time, and 8% Contract. Highlights an 85% Physical, 5% Hybrid, and 10% Remote job distribution.
Medical Billing and Coding Specialist

Medical Billing and Coding Specialist

North West Labs

Southfield, MI • On-site

$20/hr

Full-time

Posted 24 days ago

Job description

Our team is looking to hire a medical billing and coding/ customer service representative!

Responsibilities:

  • Maintain proper filing procedure; keeping all records in their proper area(s)
  • Maintaining the billing log by entering all correct information and updating notes accordingly
  • Recording information given by accessioning, and entering the information into the proper programs
  • Verifying patients insurances, through either the web-portals we have access to or via phone, and entering the information collected into the proper programs
  • Saving all insurance verification in LabDaq
  • Completion of the “clean-up” list as soon as possible when given by the third-party billing company
  • Attorney follow up after 90 days for auto and workers compensation claims
  • Follow ups on all denials of claims, as well as claims where there is no response by the respective insurance company(s) within four weeks of billed date
  • Maintaining a clean work environment
  • Maintaining proper work attire
  • Maintaining proper work morale as well as a positive working attitude.
  • Minimum Education: High school diploma preferred

Qualifications:

  • Minimum 5 years medical coding
  • Desktop computer skills
  • Databases - Using a computer application to manage large amounts of information, including creating and editing simple databases, inputting data, retrieving specific records, and creating reports to communicate the information.
  • Navigation - Using scroll bars, a mouse, and dialog boxes to work within the computer's operating system. Being able to access and switch between applications and files of interest.
  • Presentations - Navigating the Internet to find information, including the ability to open and configure standard browsers; use searches, hypertext references, and transfer protocols; and send and retrieve electronic mail (e-mail).
  • Spreadsheets - Using a computer application to enter, manipulate, and format text and numerical data; insert, delete, and manipulate cells, rows, and columns; and create and save worksheets, charts, and graphs.
  • Word Processing - Using a computer application to type text, format, edit, print, save, and retrieve word processing documents

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