Remote OP Facility Claims Edit Coder for SDS, IVR, and OBS

Job Description & Requirements


Remote OP Facility Claims Edit Coder for SDS, IVR, and OBS


StartDate: 11/25/2024

Pay Rate: $28.00 - $38.00

POSITION: Remote OP Facility Claims Edit Coder for SDS, IVR, and OBS
DEPARTMENT: HIM
START: ASAP, 6 month duration with extension (On-Going)
END: 6/30/2025
LOCATION: REMOTE

JOB DESCRIPTION: The OP Facility Claims Edit Coder will be responsible for coding all types of Edits pre-bill out of multiple systems after the account has been completed by the production coder.  This candidate should have a strong background with most of these types of edits as well as billing understanding.  

• NCD/LCD Medical Necessity Edits
• MUE edits
• OP-10, OP-8, OP -13, OP-39
• Perferred MAC: Nordian (Jurisdiction JE) experience
• Laterality edits
• Manifestation code/First -listed Dx edits
• SDS Coding experience (including IVR)
• Longitudinal medical Record knowledge
• NCCI edits (P2P, etc.)
• CPT vs. Device code edits
• Internal Keck edits (Missing procedure, LAB edits

OP facility claims edit coder will need to have working knowledge of CPT, ICD-10, HCPCS, and Modifiers coding principles. Knowledge of medical/surgical terminology. Job standards are expected to be performed at the EXPERT level.

MINIMUM QUALIFICATIONS:
• Must have a High School Diploma; or equivalent combination of education and experience.
• Two (2) years RECENT OP Facility Claims Edit coding experience
• Proficient with OP Facility Coding Guidelines.
• Knowledge in ICD10-CM and ICD-10-PCS, CPT, HCPCS coding principles.

PREFERRED QUALIFICATIONS:
• Cerner/PowerChart and 3M HDM experience - Not necessary but perferred
• Four (4) years RECENT FACILITY Outpatient Claims Edit, Interventional Radiology, Ambulatory Surgery, Observation and Ancillary coding experience.


WORKING HOURS NEEDED:
• M – F 8hrs per day, 40hrs a week M-F Business Hours PST
• Flexible hours, once gotten through initial audit

COMPENSATION & BENEFITS:
• Health & Dental
• PTO, Sick Time, 6 paid holidays
• 401K, HAS
• Weekly Pay

Facility Location

Welcome to the vibrant heart of Southern California, where as a healthcare professional, your days will be as varied as the city itself. Los Angeles beckons with its palm-lined streets and the promise of adventure around every corner. Here, in this sun-drenched metropolis, you will find an urban oasis that works just as hard as you do, offering an escape into diverse cultures, iconic landmarks, and serene beach sunsets after demanding shifts. With each new neighborhood, a mosaic of experiences unfold—a testament to the dynamic spirit that you, a healthcare hero, embody in this ever-evolving landscape.

• Explore the stars at Griffith Observatory and hike the trails of Griffith Park.
• Enjoy a day of wonder at the Getty Center, immersed in art and architecture.
• Experience the thrill of a live show at the renowned Pantages Theatre.
• Savor gourmet flavors at the bustling Grand Central Market.
• Unwind with a leisurely paddleboard session in the tranquil waters of Marina Del Rey.

Job Benefits


Becoming an AMN Healthcare professional gives you the incredible opportunity to gain critical career experience, work with new people, and earn a highly competitive salary—but the perks don't stop there. There are many additional benefits to enjoy, including:

• Medical, dental and vision benefits
• Earned time off and paid holidays
• Paid continuing education time
• 401(K) retirement planning
• Short-term disability, life insurance, paid jury duty
• Access to the largest network of facilities and providers in the country
• Industry experienced workforce management team
• Licensure and certification reimbursement

About the Company


At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.