Coder I

Fresenius Medical Care • Waltham, MA

1d • $21 - $32

About The Position

The Coder I monitors denial work lists and performs assigned accounts receivable collection duties to help ensure timely claim payments, minimize unexpected bad debt, and collect past-due balances. The role collaborates with clinical, regional, divisional, and other appropriate partners to resolve issues, and supports Fresenius Medical Care North America’s mission, vision, core values, and customer service philosophy. The position follows the Fresenius Kidney Care Compliance Program and applicable regulatory and company policy requirements.

Duties may include addressing insurance changes and reverification, rebilling unpaid or underpaid claims, initiating appeals or reconsiderations under payer guidelines, transferring balances to the correct responsible party, and processing non-cash adjustments according to policy. The employee completes follow-up within payer filing limits, documents activities in eCube Financials, researches complex claims issues, escalates matters as needed, and communicates opportunities for improvement. Additional project and other duties may be assigned. Responsibilities may also focus on one or more departments or locations, as described in an applicable addendum.

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 requiring collaboration with other FKC partners, such as Managed Care, the Master File Team, Coding, Non-Contracted, and MFD.
• Identify insurance changes and complete reverification requests using an RIC-coded comment.
• Initiate rebilling of unpaid or underpaid claims.
• Initiate appeal or reconsideration requests according to 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, escalating 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.
• Perform additional department- or location-specific functions where applicable.

Benefits

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

What This Job Offers

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