Coding Appeals Analyst

The Vancouver Clinic P.S.•Vancouver, WA

16h•Hybrid

About The Position

Patient Financial Services is seeking a detail-oriented coding specialist to support accurate billing and minimize coding-related denials as an Appeals Analyst. This role involves analyzing and appealing coding and medical necessity denials, identifying denial trends, and recommending process improvements. The Appeals Analyst will also educate clinicians and staff on coding accuracy and payor guidelines, and ensure timely and accurate claim submissions and follow-up, including reviewing underpaid claims and appealing them based on payor contracts. This position has the potential for off-site work after successful completion of full-time, on-site training and meeting specific requirements.

Requirements

High school diploma or equivalent required
Minimum of one year of experience in medical billing and collections or coding
Working knowledge of ICD-10, CPT, and HCPCS coding and Correct Coding Initiatives (CCI) required
Experience working in a medical office setting required, with demonstrated understanding of standard insurance reimbursement methodologies
Knowledge of medical terminology and anatomy required
Excellent organizational skills and attention to detail required
Must have demonstrated competence with computer systems including electronic health records, and Microsoft Office Suite required
Ability to work, with or without reasonable accommodation, with a diverse population of patients and colleagues
Applicants must be authorized to work for any employer in the U.S.

Nice To Haves

AHIMA (CCA, CCS, CCS-, or RHIT); AAPC (CPC, CPC-A, CPC-H, CPC-H-A, or one of the relevant AAPC specialty-specific coding credentials preferred
Knowledge of government, commercial, and third-party insurance contract practices and claims processing procedures preferred

Responsibilities

Analyze and appeal coding and medical necessity denials
Identify denial trends and recommend process improvements
Educate clinicians and staff on coding accuracy and payor guidelines
Ensure timely and accurate claim submissions and follow-up
Review underpaid claims and appeal based on payor contracts

Benefits

medical
dental
vision
life insurance
AD&D
long term disability
health savings account
flexible spending account
employee assistance program
multiple supplemental benefits (voluntary life, critical illness, accident, hospital indemnity, identity theft protection, legal services, etc.)
401k retirement plan
employer matching contribution up to 4%