Coding Analyst Denials Appeals

CommonSpirit Health • Phoenix, AZ

1d

About The Position

Where You’ll Work Hello Humankindness Where Your Passion Meets Purpose: Join Dignity Health Medical Group Are you a healthcare professional who believes that every patient deserves not just treatment, but unwavering compassion? Do you envision a world where healthcare isn't just a service, but a fundamental right, delivered with integrity and innovation? If so, then Dignity Health Medical Group (DHMG) is where your career finds its true calling. At Dignity Health Medical Group, you're not just filling a role; you're becoming an architect of healthier communities. We are the employed physician group of Dignity Health Arizona, and our success isn't just measured in numbers, but in the lives we touch and the advancements we champion. Here's what sets us apart and why you belong with us: Impact that Resonates: You'll be part of a team delivering comprehensive clinical services, making a tangible difference in the lives of countless individuals. From cutting-edge diagnostics to life-changing treatments, your expertise will directly contribute to improved health outcomes. A Culture of Growth and Innovation: We don't just practice medicine; we advance it. Shaping the Future of Healthcare: DHMG is deeply invested in preparing tomorrow's healthcare providers. We seamlessly blend clinical services with translational and bench research, creating a dynamic environment that augments medical education for residents and students. Values-Driven Mission: We are united by a powerful set of principles. If you are deeply committed to social justice, health equity, and are prepared to deliver care in new, innovative ways, your values align perfectly with ours. We believe that everyone, regardless of background, deserves access to high-quality healthcare, and we actively work to make that a reality. A Supportive and Collaborative Environment: We believe in building a strong, inclusive team where everyone feels valued and respected. Are you ready to transcend the ordinary and join a healthcare family where your skills are celebrated, your voice is heard, and your passion for healing finds its ultimate expression? If you're eager to contribute to an organization that is making a profound difference, where innovation meets compassion, and where your commitment to social justice and health equity will be not just welcomed, but celebrated – then Dignity Health Medical Group is waiting for you.

Requirements

• High School Graduate
• Three (3) years prior experience in medical coding and/or billing for physician office services
• Proficiency assigning ICD-10-CM , CPT, HCPCS ,and modifiers
• Ability to read and comprehend an EOB
• Proficient in guidelines, CCI, LMRP, coding, use of modifiers
• Ability to research CPT/ICD10 codes to bill appropriately
• Proficient in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules)
• Adept in physician and insurance reimbursement and billing concepts and procedures, as well as laws and regulations affecting payment compliance, denials and appeals recovery
• Proficient understanding of medical coding systems effecting the adjudication of claims payment
• Proficiently utilizes Google Workspace
• One of the following Certifications: Certified Professional Coder, (CPC) Certified Professional Coder Apprentice (CPCA) Certified Coding Specialist (CCS) Certified Coding Specialist - Physician Based (CCS-P) Certified Cardiovascular and Thoracic Surgery Coder (CCVTC) Certified Health Care Compliance (CHC) Certified Interventional Radiology Cardio Coder (CIRCC) Radiology Certified Coder (RCC) Registered Health Information Administrator (RHIA) Registered Health Information Technician (RHIT)

Nice To Haves

• Associates degree
• Five (5) years work experience in medical billing and coding for physician office services

Responsibilities

• Accurately review records for coding errors and correct diagnostic and procedural codes in billing system for the purpose of reimbursement utilizing ICD-10-CM, CPT, HCPCS, and proper modifiers.
• Analyze and interpret complex data.
• Investigate, correct and resubmit medical claims that have been rejected or denied by an Insurance company.
• Work coding related denials for multiple specialties across the market.
• Accurately review medical records for coding errors and when appropriate, correct modifiers, ICD-10, CPT, or HCPCS codes in the practice management system for the purpose of accurate coding.
• Submit corrected claims, reconsiderations and appeals to the health plan.
• Identify and communicate payer and/or system trends to Management.
• Maintain thorough knowledge of payer contracts, regulations and guidelines, as well as state and federal laws relating to billing and collection practices to ensure accurate and compliant billing processes.
• Clearly communicate with coworkers, leadership and outside organizations to meet departmental goals and ensure timely reimbursement.

What This Job Offers

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