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Claims Edit Coder Jobs (NOW HIRING)

Western Growers Family of Companies

Plan Coder

$44K - $65K/yr

At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a ... and edit correspondence, reports, emails, and other written materials. • Superior ability to ...

AltaMed

Certified Professional Coder

Los Angeles, CA

$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 ...

AltaMed

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 ...

AltaMed

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 ...

AltaMed

Certified Professional Coder

Los Angeles, CA

$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 ...

AmeriHealth Caritas

Application Architect

Working with GIT source code version control; and Using DevOps and Agile development methodologies ... CES (Claims Edit System) to manage product upgrades, support regular LCD (Local Coverage ...

Renown Health

Revenue Integrity Specialist

Reno, NV · On-site

$25.66 - $35.92/hr

Coding and claims edit experience required. License(s): None Certification(s): None Computer / Typing: Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and ...

Renown Health

Revenue Integrity Specialist

Reno, NV

$82K - $82K/yr

Coding and claims edit experience required. License(s): None Certification(s): None Computer / Typing: Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and ...

WebTPA

Claims Examiner I

Irving, TX · On-site

... edit logic). * Incumbents are expected to meet and/or exceed qualitative and quantitative ... Knowledge of CPT and ICD-10 coding required. * Knowledge of COBRA, HIPAA, pre-existing conditions ...

Alivi

On-site Medical Claims Examiner

Miami, FL · On-site

... ICD-10 Codes, under the correct provider contract and member benefits. * Responds to provider ... Maintains the department's claim edit rules and processing claims according to client specific ...

Ovation Healthcare

Coder, Edits/Denials

$19.25 - $25.50/hr

Ovation Healthcare seeks an Edit & Denials Coder to review medical records to determine appropriate ... Creates appropriate letters to substantiate the validity of claims. * Meets with facility liaison ...

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Claims Edit Coder information

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How much do claims edit coder jobs pay per hour?

As of Jul 4, 2026, the average hourly pay for claims edit coder in the United States is $27.49, according to ZipRecruiter salary data. Most workers in this role earn between $18.99 and $34.62 per hour, depending on experience, location, and employer.

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.
More about Claims Edit Coder jobs
What cities are hiring for Claims Edit Coder jobs? Cities with the most Claims Edit Coder job openings:
What states have the most Claims Edit Coder jobs? States with the most job openings for Claims Edit Coder jobs include:
What job categories do people searching Claims Edit Coder jobs look for? The top searched job categories for Claims Edit Coder jobs are:
Claims Edit Coder jobs near you
Infographic showing various Claims Edit Coder job openings in the United States as of June 2026, with employment types broken down into 90% Full Time, and 10% Part Time. Highlights an 90% In-person, and 10% Remote job distribution, with an average salary of $57,182 per year, or $27.5 per hour.
Application Architect

Application Architect

AmeriHealth Caritas Health Plan

Newtown Square, PA • On-site

Full-time

Posted 5 days ago

AmeriHealth Caritas rating

8.5

Company rating: 8.5 out of 10

Based on 70 frontline employees who took The Breakroom Quiz

85th of 277 rated insurance

Job description

TITLE: Application Architect (Job ID 434835)
LOCATION: Newtown Square, PA (remote work option 100% of the time)
DUTIES:
Manage OPTUM Claims Pricing and Editing software products including CES (Claims Editing Software), EZGroup, Rate Manager, and WebStrat. Service vendor software in lower environments and perform validation. Promote changes to quality assurance and production environments as well as work with business stakeholders to test changes and obtain approvals. Participate in feasibility analysis of new systems/applications as well as architectural review and strategy development (e.g. ARB). Monitor the operating efficiency of existing application systems, and provide proactive maintenance. Review, analyze, and modify systems, including coding, testing, configuring, and debugging large-scale systems. Responsible for providing guidance and arranging resources for technical support to address production issues. Participate in training as appropriate, on new or revised systems/applications. Contribute to the development of test plans and participate in post-implementation reviews. Participate in the technical design of projects that anticipate and proactively address roadblocks and obstacles. Responsible for conducting complete diagnosis of significant business problems, factoring in a strong understanding of the technical architecture. Facilitate design sessions by presenting logical statements of business problems and design. Recommend tools and methodologies for projects. Follow established and relevant SOPs and methodologies in performing work in order to provide recommendations to management on changing tools/methodologies/standard operating procedures, as appropriate. Use advanced understanding of the relevant programming languages, tools, and technologies for the area supported. Use advanced understanding of the software development life cycle (SDLC), including Agile methods, to act as a resource to others on the existing applications supporting a business area. Leverage understanding of architectural issues, and factor them into decisions and recommendations. Maintain awareness of when regulatory issues are applicable and who to engage to address any concerns. Remote work option 100% of the time.
EDUCATION/REQUIREMENTS:
Bachelor's degree (or foreign equivalent) in Computer Science, Information Technology, Management Information Systems, or a closely related field. Must have 5 years of experience with the following: Working with IT application architecture in healthcare products; Using MS SQL server to write complex queries to pull data, analyze and generate reports, write stored procedures, functions, and triggers for new application development, and debug, review and apply performance tuning to existing code; Working with GIT source code version control; and Using DevOps and Agile development methodologies to architect applications utilizing Scrum ceremony framework. Must have 2 years of experience with the following: Using cloud technologies such as Azure or AWS to design and develop cloud-based applications; and Using Optum CES (Claims Edit System) to manage product upgrades, support regular LCD (Local Coverage Determinations), NCD (National Coverage Determinations) and KB (Knowledge Base) updates, and perform production support to identify points of failure in the product. Remote work option 100% of the time

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