Coder I

Fresenius Medical Care • Waltham, MA

1d

About The Position

The Coder I monitors assigned denial work lists to support timely claim payments and minimize unexpected bad debt. The role performs accounts receivable collection duties as assigned by the Denials Supervisor, working with appropriate clinical, regional, and divisional staff to resolve issues and collect past-due balances. The position supports FMCNA’s mission, vision, core values, and customer service philosophy, and follows the Fresenius Kidney Care Compliance Program and applicable regulatory and company requirements.

Responsibilities may include work focused on one or more departments or locations, according to the applicable addendum. The position also assists with projects assigned by the direct supervisor and performs other duties as assigned.

Requirements

• High school diploma required.
• Three years of healthcare billing or collections experience.
• Working knowledge of Windows-based software applications, such as Word and Excel.
• Excellent written and verbal communication skills.
• Good interpersonal skills and a team-oriented approach.
• Ability to work independently.
• Well organized and detail oriented.

Responsibilities

• Monitor work lists specific to the Denials Management Specialist role.
• Escalate work-list items that require collaboration with other FKC partners, such as Managed Care, Master File Team, Coding, Non-Contracted, and MFD.
• Identify the need for insurance changes and submit requests for reverification using the RIC coded comment.
• Initiate rebilling of unpaid or underpaid claims.
• Initiate appeals or reconsideration requests in accordance with payer guidelines.
• Transfer balances to the correct responsible party when applicable.
• Process non-cash-related adjustments according to established policies and procedures.
• Identify and communicate improvement opportunities to denial management leadership to support timely and accurate payment.
• Complete follow-up within established payer filing limits.
• Research complex claims issues and discrepancies and escalate them to a supervisor for resolution as needed.
• Complete and document follow-up activities in eCube Financials according to established guidelines.
• Assist with projects assigned by the direct supervisor and perform other duties as assigned.

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• 401(k) with company match
• Paid time off
• Parental leave
• Potential performance-based bonuses, depending on company and individual performance, for bonus-eligible positions

What This Job Offers

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