Responsibilities:
• Review provider medical coding of services rendered for medical claim submission
• Review and respond to medical coding inquiries submitted by providers and staff
• Work directly with providers to resolve specific medical coding issues
• Analyze data for errors and report data problems
• Partner with billing staff to correct and resubmit claims based on review of the records, provider input, and payor input
• Work with clinical and non-clinical groups to identify undesirable coding trends
• Ensure claims are medically coded consistently by following CPT, ICD-10 and HCPCS rules and guidelines; escalate issues that may impact this immediately to the Compliance Committee
• Abide by HIPAA and Coding Compliance standards
• Collect data from various sources, maintain electronic records and logs, file paperwork, and operate office equipment
• Accomplish other tasks as assigned
Qualifications:
• 2+ years coding
• 2+ years medical billing experience (preferred but not required)
• Experience with insurance and revenue cycle management processes
• Ability to read and understand insurance EOB’s
• Proficient in reviewing edits between CPT, ICD10, and HCPCS codes
• Experience in reviewing insurance review denials and payer policies
• Professional coder certification through a recognized organization such as AAPC (preferred) or AHIMA
• Leadership qualities with the ability to effectively educate providers remotely
• Acute attention to detail with a strong, self-sufficient work ethic
• Excellent organization and use of time management skills
• Ability to prioritize workload and have a strong sense of urgency when time sensitive situations arise
• Proficient with computers and navigating within multiple applications
• Proficient in MS Office (specifically Teams, Outlook, Excel, and Word)
• Strong verbal and written communication, as well as customer service skills; must be able to listen and communicate effectively with leadership, providers, and co-workers
• Goal-oriented and a consistent performer
• Must be self-motivated, punctual, dependable, and able to work independently
• Must be trustworthy, honest and have a positive and professional attitude
Experience with wound care (preferred but not required)
Experience with insurance and revenue cycle management processes
Benefits:
• Compensation: $21.00 - $23.00 hourly
• This position is classified as: Hourly, Non-Exempt; Part-time employment (20-25 hours)
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