Jobs · Sales

Claim Edit/Denial Coder

Signature Performance, Inc. · United States · 1 mo ago
RemoteRemoteSalesFull-time

About You

You are a person who loves to support accurate and compliant claims submissions. In the role of Claim Edit/Denial Coder, you'll be responsible for reviewing and resolving claim coding-related claims edits, rejections, and denials within Epic. Tell us about your experience with Medical Coding.

Are you a team player and a self-motivator?

We are counting on you to manage multiple projects using your problem-solving skills.

We are looking for someone UNCOMMON. What is uncommon about you? Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you.

About The Position

Review, research, and resolve professional fee and facility coding edits, claim rejections, and payer denials within Epic work queues for multiple specialties, including but not limited to:

  • NCD/LCD medical necessity edits
  • MUE edits
  • Primary diagnosis code edits
  • NCCI edits
  • Device code edits
  • Modifier edits
  • Place of service edits
  • Charge, diagnosis, procedure, and claim-level coding edits routed through Epic work queues

Navigate Epic patient encounters, chart review, coding review tools, charge review, account notes, claim edit details, denial information, and related work queues to determine the appropriate coding action.

Review provider documentation in Epic to validate CPT, HCPCS, ICD-10-CM, modifiers, units, place of service, and other coding elements prior to claim correction or resubmission.

Correct coding-related issues in Epic or communicate required corrections to billing, revenue integrity, coding leadership, or other appropriate teams based on workflow and security access.

Document denial findings, coding rationale, and follow-up actions in Epic notes, work queue comments, or designated tracking tools in accordance with departmental standards.

Investigate and resolve coding-related denials from payers to support accurate reimbursement, reduce rework, and promote denial prevention.

Identify trends in Epic work queue edits, payer denials, documentation gaps, modifier usage, diagnosis sequencing, or charge capture issues and escalate opportunities for education or process improvement.

Minimum Requirements

  • Education: Minimum of 2 years of Medical Coding experience required.
  • Certifications: CCSCCS-PCPCRHITRHIA
  • Experience: Experience using Epic for claim edit resolution, coding work queues, charge review, account review, encounter review, chart review, and/or denial follow-up strongly preferred.
  • Experience: Experience with CPT, ICD-10, HCPCS and Modifiers.
  • Experience: Experience with Professional Fee Coding.
  • Experience: Experience with Facility coding.

About Us

We are proud to put our signature on each one of our employees. When you are a member of Signature Performance, you are a part of a solutions-based organization where the values of passion, integrity, courage, and respect are the driving forces behind all our decision-making. We trust you to do important work and bring the best version of yourself to work every day, so we want to help you achieve a work-life balance while consistently challenging yourself.

We believe in fully developing each one of our Associates. We deliver a performance-driven atmosphere with competitive pay, world-class training and development classes, resources, and events, an award-winning culture where everyone thrives, and so much more.

About The Benefits

  • Health Insurance for Our Associates
  • Fully Paid Life Insurance
  • Fully Paid Short- & Long-Term Disability
  • Paid Vacation
  • Paid Sick Leave
  • Paid Holidays
  • Professional Development and Tuition Assistance Program
  • 401(k) Program with Employer Match

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