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Claims Edit Coder Jobs in Minnesota (NOW HIRING)

Billing Manager

Saint Paul, MN · On-site

$85K - $95K/yr

Ensure strict adherence to HIPAA guidelines, coding standards and payer contracts. This role ... claims, direct appeals and resolving payer disputes to maximize cash flow and minimize claim ...

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 Minnesota?

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

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

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

Senior Inpatient Medical Coder - Acute Edits & Denials

UnitedHealth Group

Eden Prairie, MN • Remote

$24 - $43/hr

Full-time

Retirement

Re-posted 4 days ago


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7.6

Company rating: 7.6 out of 10

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Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. 

As a Senior Inpatient Medical Coder/Acute Edits and Denials Claims Analyst, you will work remotely to correct, CCI, Medically Unlikely (MUE) Edits, and Medical Necessity Edits in addition to periodic coding. 

You will also work combine 3 day payment window, denial claim edit, dental and various other WQ accounts.   You will ensure that all Inpatient acute hospital coding assignments are accurate according to coding policies and based on the documentation provided in the medical record. 

Using a thorough knowledge of coding policies and procedures as well as medical terminology and technology, you will be responsible for querying  physicians for documentation under the direction of the Coding Operations Manager or Quality Management personnel.

Experience with the following acute inpatient hospital coding elements is required: MS- DRG and APR DRG (severity and risk of mortality) assignment, complication and comorbidity secondary diagnosis code identification, present on admission indicators, ICD-10-PCS procedure code assignment.

Experience with charge, supply codes, EPIC Account Activities functions and payer billing workflows is beneficial but not required (these will be trained).

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Responsibilities:

  • Work acute inpatient hospital claim edits, denials, 3-day rule combines and other secondary work queues for Allina Health.
  • (Coding) Recodes medical records to satisfy the claims, edits, and denials using coding classifications to ensure data integrity and proper assignments.
  • (Coding) Analyzes medical records to ensure accurate coding, and send provider feedback to improve the quality of documentation to support code assignment and billing.
  • (Coding) Collects and abstracts data elements.
  • Assists customers to address complex issues related to unbilled and incomplete records.
  • Identifies and suggests areas of improvement in high compliance risk coding areas.
  • Combine accounts; identifies codes that require charge build, collaborate with other departments on charging and documentation requirements, participates in special projects involving payer and compliance reviews
  • Other duties as assigned.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • Associate's degree
  • One of the following credentials is required upon hire required, and to be maintained annually:
    • Coder certification with credentialing from AHIMA and/or AAPC (RHIA, RHIT, CCS, CIC)

    • Certified Coding Specialist - American Health Information Management Association (AHIMA)

    • CIC Certified Inpatient Coder from American Academy of Professional Coders (AAPC)

    • Registered Health Information Technician - American Health Information Management Association (AHIMA)

    • Registered Health Information Admin - American Health Information Management Association (AHIMA)

  • 2 years of Coding experience
  • 2 years of Acute Care inpatient medical coding experience (hospital, facility, etc.) 

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $24.00 to $43.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO, #GREEN


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