3 results for Certified Professional Coder in Minneapolis, MN

Medical Coder

Eden Prairie, MN
remote
Temporary
40 - 55 USD / Hourly
We are looking for a highly skilled Certified Coder to join a fully remote team on a long-term contract basis. This role involves working remotely and collaborating with a dynamic team of certified coders and business analysts to support coding initiatives for benefit plans. The ideal candidate will bring a strong background in healthcare coding, exceptional attention to detail, and the ability to communicate effectively in a collaborative environment. Responsibilities:• Analyze and assign appropriate codes to benefit plan language to ensure accuracy and compliance.• Review and validate coding decisions made by team members for consistency and correctness.• Lead discussions to resolve discrepancies and finalize coding documentation.• Conduct audits on coding results and implement necessary adjustments to maintain quality standards.• Actively participate in project meetings to provide insights and updates on coding processes.• Collaborate with cross-functional teams to align coding practices with organizational goals.• Stay updated on coding and reimbursement methodologies, including ICD-10, CPT codes, and HCPCS.• Provide input and support for managed care projects and related coding requirements.• Create and maintain documentation related to coding processes and audit findings.• Utilize tools like Word, Excel, and PowerPoint to prepare reports and communicate findings.
2026-03-02T00:00:00Z

Coding Appeals Specilist

Minneapolis, MN
remote
Temporary
29 - 33 USD / Hourly
The Acute Coding Appeals Specialist reviews and writes appeals for inpatient DRG denials to support accurate code assignment and reimbursement. This role applies advanced ICD-10, DRG, CMS, and payer-specific knowledge to defend coding decisions, ensure compliance, and address billing and documentation concerns. Key Responsibilities<ul><li>Review inpatient DRG denials and draft well-supported appeal letters using ICD-10-CM/PCS, HCPCS, NCCI, CMS, and CMG guidelines.</li><li>Analyze clinical documentation to validate the originally assigned DRG and ensure compliance with regulatory standards.</li><li>Research payer policies, government regulations, and industry guidelines to strengthen appeal arguments.</li><li>Maintain detailed documentation, tracking spreadsheets, and root cause analyses for denial trends.</li><li>Collaborate with client coding and CDI teams to provide education based on appeal outcomes.</li><li>Meet established productivity and quality standards while maintaining coding certification requirements.</li><li>Stay current on coding updates, regulatory changes, and reimbursement rules.</li><li>Deliver professional, organized, and customer-focused communication with clients.</li></ul>
2026-02-27T00:00:00Z

Clinical Quality HEDIS Reviewer

Eden Prairie, MN
onsite
Temporary
30 - 35 USD / Hourly
Position Description:This role performs ongoing analysis of charts for various STARS and HEDIS® quality measures. The information obtained during these reviews will work to close quality measure gaps as well drive other teams work on provider education on behalf of the insurance plan. Individual must be highly organized, possess strong critical thinking skills, with demonstrated professional maturity and emotional resilience. Day to day work varies based on time of year, with overarching goal to generate completely accurate chart abstraction resulting in improved HEDIS® or other quality program rates. The role requires utilization of multiple sources of information, medical record collection tracking tools, and electronic medical record systems. Primary Responsibilities:<ul><li>Support chart chase processes by requesting records from provider offices as needed.</li><li>Primary source verify abstracted medical record data.</li><li>Over read abstracted and verified medical record data.</li><li>Analyze chart data evaluate for possible data integrity and/or data deficits and document findings.</li><li>Provide education and feedback to primary source verifiers and/or abstractors.</li><li>Meet and maintain production and quality expectations for all assigned measures.</li><li>Responsible for managing and utilizing confidential information from medical records in an appropriate manner following designated guidelines including HIPAA and company policies/guidelines.</li><li>Support Chart Chase Review and abstract medical record data into appropriate applications.</li><li>Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures.</li><li>Applies HEDIS® concepts and principles in the completion of abstraction and review process to ensure full recognition of delivered care for the benefit of the member.</li><li>Transition between priorities and abstraction projects based on program or client needs.</li><li>Ability to work in a self-directive manner and apply critical thinking/problem solving skills by referencing available Technical Specifications, Business Process Documentation, Job Aids, and other tools for clarity/guidance as needed</li></ul>
2026-02-25T00:00:00Z