Certified Professional Coder II

Knowtion Health-posted 11 months ago
Mid Level
Dallas, TX
251-500 employees
Hospitals
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The Certified Professional Coder II consistently generates revenue through professional billing practices by reviewing claims that have been denied for a coding reason and offers suggestions and corrections to be made to the claim based on review of the medical records as well as LCDNCD policies, individual payer medical policies, and coding guidelines.

  • Analyzes coding and the denial information for the claim to identify coding issues that caused the denial on unpaid claims and determines next steps for recovery
  • Creates detailed appeal letters for denials from payer to support payment of patient claims
  • Makes recommendations to client for corrections or changes to the claim based on LCDNCD policies, local coverage, and national coverage, individual payer medical policies, and coding guidelines
  • Reviews and verifies that diagnosis codes on bills adhere to the patients medical records for purpose of reimbursement
  • Notifies management of complex, complicated, or challenging accounts to ensure accounts are progressing effectively
  • Assists Knowtion Health team members by providing coding review feedback, gathering supporting documentation, and submitting appeals
  • Certified Professional Coder (CPC) and Certified Inpatient Coder (CIC) certification
  • Minimum of 5 years of experience working for a hospital or payer, or in a customer service position with experience in inpatient coding, outpatient coding, ICD-10, HCPCS, and CPT codes
  • Preferred experience includes healthcare insurance billing and/or follow-up for hospitals, medical coding, claim adjudication, patient accounting, payer adjuster filing, and/or settlement of accident claims, motor vehicle, or workers' compensation
  • Preferred experience with TruCode and/or 3M
  • A competitive benefits package, including medical, dental, vision, life insurance, short-term disability, long-term disability, paid holidays, 401k, and a generous PTO policy
  • A remote work opportunity with a dedicated distraction-free work space at home
  • A dynamic and competitive work environment with a growing firm in a growing industry
  • Opportunities for professional growth and development in a rapidly evolving industry
  • A culture that is inviting, competitive, and embracing of challenge and celebration of accomplishment
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