Job description

Below are some key highlights of the position –

Position : Coding/Denials Specialist
Location : REMOTE JOB
Duration : 3 Months Contract
Shift : Day Shift, M-F, no Holidays / Weekends

Job Description Details:

*****Coders with back end experience required*****

ESSENTIAL FUNCTIONS

• Provides detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, ICD-10-PCS codes, and CPT-4 procedural codes for UB-04 outpatient or inpatient claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, regulations as directed by the Supervisor Clinical / Coding Payment Resolution.
• Interprets data, draws conclusions, and reviews findings with all level of Payment Resolution Specialist for further review.
• Takes initiative to continuously learn all aspects of Payment Resolution Specialist role to support progressive responsibility.
• Other duties as needed and assigned by the Supervisor Clinical / Coding Payment Resolution.
• Maintains a working knowledge of applicable Federal, State and local laws/regulations

MINIMUM QUALIFICATIONS:

• High school diploma or Associate degree in Accounting or Business Administration or related field, and a minimum of four (4) years' experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or customer service activities or an equivalent combination of education and experience. Experience in a complex, multi-site environment preferred.
• Must possess comprehensive knowledge of professional/physician diagnostic and procedural coding, as normally obtained through a coding certificate program and least one (1) year of physician/professional or hospital outpatient coding experience or minimum of two (2) years of relevant hospital inpatient coding experience including DRG assignment.
• Must be a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).
• Must have experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
• Possesses detailed understanding of principles, methods, and techniques related to compliant healthcare billing/collections.
• Possesses expertise in medical terminology, disease processes, patient health record content and the medical record coding process.
• Must be comfortable operating in a collaborative, shared leadership environment.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS

• This position operates in a typical office environment. The area is well lit, temperature controlled and free from hazards.
• Incumbent communicates frequently, in person and over the phone, with people in all locations on product support issues.
• Manual dexterity is needed to operate a keyboard. Hearing is needed for extensive telephone and in person communication.
• The environment in which the incumbent will work requires the ability to concentrate, meet deadlines, work on several projects at the same time and adapt to interruptions.
• Must be able to set and organize own work priorities and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles.

Job Type: Contract

Pay: $28.00 - $30.00 per hour

Schedule:

• Monday to Friday

Experience:

• ICD-10: 1 year (Preferred)

Work Location: Remote

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