Claims Edit Specialist

Mountain Region Support • Centennial, CO

1d • Remote

About The Position

This is an advanced level claims edit specialist position reporting to the HB Manager Coding Auditor/Educator. The Claims Edit Specialist will review and resolve hospital-based claim edits for both inpatient and outpatient services and provide specific education on these claim edits to hospital coders through a variety of mediums, including direct interactive learning sessions individually or in group settings, written guides, protocols, etc. Responsible for facilitating training, education, and support to hospital coders which may be based on detailed analysis of general or coder-specific trends, focus-recommended edits, or support teams. S/he provides support to all areas of Management, internal Coding, and Billing. CommonSpirit has more than 700 care sites across the U.S. from clinics and hospitals to home-based care and virtual care services, making it accessible to nearly one out of every four U.S. residents. CommonSpirit is committed to building healthy communities, advocating for those who are poor and vulnerable, and innovating how and where healing can happen both inside our hospitals and out in the community. This position is open to remote/out of state candidates residing in Alabama, Arizona, Arkansas, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Missouri, Mississippi, Nebraska, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, and Wyoming.

Requirements

• HS Diploma/GED
• CPC Source: AAPC or CCS or CCS-P, or RHIT, or RHIA Source: AHIMA
• Certified Professional Coder (CPC Certification)
• CCS (Certified Coding Specialist)
• CCS-P (Certified Coding Specialists – Physician based)
• RHIT (Registered Health Information Technician)
• RHIA (Registered Health Information Administrator)

Nice To Haves

• Associates degree or equivalent work experience in lieu of degree

Responsibilities

• Review and resolve hospital-based claim edits for both inpatient and outpatient services
• Provide specific education on these claim edits to hospital coders through a variety of mediums, including direct interactive learning sessions individually or in group settings, written guides, protocols, etc.
• Facilitate training, education, and support to hospital coders which may be based on detailed analysis of general or coder-specific trends, focus-recommended edits, or support teams
• Provide support to all areas of Management, internal Coding, and Billing

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED