Coding Edits/Denial Specialist

CorroHealth • GA

103d

About The Position

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

Requirements

• All coders MUST be certified through either the AAPC (CPC or COC) or AHIMA (CCS or CCS-P).
• Must have at least a minimum of 6 months of on the job experience.
• Regular, predictable, and punctual attendance is required.
• Must have working knowledge and experience with systems such as EMR, Billing, etc.
• Must have a phone, reliable internet connection and current coding materials such as CPT and ICD-10-CM coding references.
• Will be required to maintain an ongoing productivity level and accuracy rate of 95% or higher.
• Will be required to maintain a quality score of 95% or higher.
• Must be proficient in Microsoft programs like Excel and Outlook.
• Ability to communicate effectively and professionally both verbally and written.
• Ability to coordinate, analyze, observe, make decisions, and meet deadlines.

Nice To Haves

• Ability to perform work at a computer terminal for 6-8 hours a day.
• Ability to function in an environment with constant interruptions.
• Ability to lift and move material weighing up to 20 lbs.
• Ability to manage stress during periods of increased activity and multiple deadlines.

Responsibilities

• Provide various components of coding services to support our clients.
• Strong experience in Hospital Outpatient (Facility) denials.
• Understanding of Remit & CARC codes.
• Review and resolve denials in EPIC.
• Research payer policies.
• Identify trending denial issues that can be escalated to management.
• Resolve Medical Necessity and CCI edits.
• Code surgical procedures typical of an ER setting to capture additional revenue when appropriate.
• Apply ICD-10-CM diagnosis codes to the highest level of specificity available.
• Accurately apply diagnosis codes utilizing ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS.
• Interpret coding guidelines for accurate code assignment.
• Identify the importance of documentation on code assignment and the subsequent reimbursement impact.
• Align conduct with AHIMA's Standards of Ethical Coding and the Company’s Code of Ethics and Business Conduct.
• Comply with all internal policies and procedures.
• Actively participate in Company provided training and education.
• Maintain at least one credential through either AAPC or AHIMA.
• Ensure individual compliance with all privacy and security rules and regulations.

What This Job Offers