Denials and Appeals Coder

External Job Description and Responsibilities

• Career Growth Opportunities
• A Culture anchored in a strong sense of belonging
• Benefits (Medical/Dental/Vision) begin the first of the month following 30 days of employment
• 401k (Discretionary match)
• Generous PTO
• 8 Paid Holidays
• Equipment Provided for Remote Roles
• Work invoices daily to maintain view age at the required department standard
• Work cross-workflow, claim edits and No Activity daily through ETM
• Apply extensive knowledge of ICD-10 and CPT guidelines
• Apply TeamHealth coding policies but acknowledging payer policy guidelines may differ due to payer updates, etc.
• Utilize LMRPs, LCDs and NCDs via multiple websites such as CMS or the local MAC as needed for denials
• Report any payer problems, policy changes or denial patterns found to the Denials and Appeals Senior and Supervisor so that it can be researched
• Review any claim processing problems found such as invalid NPI’s, invalid providers, TES Edit, and claim edit problems
• Maintain QA standards of 5% or below, including the annual Level 3 QA assessment
• Maintain required set production for denials and appeals
• Maintain all personal EMR login list by logging in once a month and reporting any login problems or unused logins to management
• Works with other departments to resolve Coding Rejections along with any other problems found
• Perform production coding as needed, including one day during closing
• Assist the Supervisor and Senior with any duties that need completed
• High school diploma or equivalent required. College course work preferred in a healthcare related field. Additional training in coding and medical documentation required
• Extensive knowledge of medical terminology, regulatory requirements and physician billing
• Record of passing Level 2 QA audits
• Proficiency in ICD-10 coding and CPT procedural coding
• CPC, RHIT or CCS-P certification preferred
• Minimum two (2) years medical coding experience
• Excellent organizational, analytical and communication skills
• Maintain confidentiality at all times

Location

• Remote

Working Level

Requirements

• High school diploma or equivalent required. College course work preferred in a healthcare related field. Additional training in coding and medical documentation required
• Extensive knowledge of medical terminology, regulatory requirements and physician billing
• Record of passing Level 2 QA audits
• Proficiency in ICD-10 coding and CPT procedural coding
• CPC, RHIT or CCS-P certification preferred
• Minimum two (2) years medical coding experience
• Excellent organizational, analytical and communication skills
• Maintain confidentiality at all times