Coder II (Denials) - FT - Days

#REF!•Arlington, TX

1d•Remote

About The Position

Are you looking for a rewarding career with a top-notch health care company? We’re looking for a qualified Coder II (Denials) like you to join our Texas Health family. This is a full-time, remote position within the HIMS Coding Department. Once training is complete, there will be flexible hours/scheduling, work-life balance, and opportunities for advancement.

Requirements

H.S. Diploma or Equivalent REQUIRED
Associates's Degree Related field preferred
2 Years Professional (Profee) Coding experience.
Completion of advanced level training in medical terminology, anatomy and physiology, or similar REQUIRED
CPC - Certified Professional Coder Upon Hire REQUIRED or CCS-P - Certified Coding Specialist - Physician-based Upon Hire REQUIRED
Advanced knowledge of procedural and clinical diagnosis coding pertaining to professional billing.
Knowledge of third-party regulations/ payor billing requirements.
Must be able to communicate effectively.
Must be detail oriented and have strong organizational skills.
Must possess a strong work ethic and a high level of professionalism.
Must have proficient computer skills, with the ability to learn internal application systems.

Nice To Haves

Other Specialty certification such as CGSC, COSC, CCC, etc. Upon Hire Preferred

Responsibilities

Accurately abstracts information from the medical records and assigns Profee codes using ICD-10-CM, CPT, and HCPCS in compliance with established guidelines. Provides codes to various departments upon request.
Reviews supporting medical record documentation to ensure accurate Profee code assignment (ICD-10-CM, CPT, HCPCS) of professional charges in compliance with third party payer, NCCI guidelines and THPG policies. Maintains documentation to record/track coding variance.
Performs charge reconciliation.
Performs charge reconciliation of facility charges posted against OR/scheduled procedures to identify missed charges. Notifies leadership regarding discrepancies, collaborates with practice staff and providers to obtain information needed to complete coding and enter appropriate Profee charges.
Participates in special projects and completes other duties as assigned (e.g., Charge correction requests, research of payor policies, Accounts Receivable & Denials management of Profee charges)