Coding Reimbursement Specialist III - Post Claim Denials

Atrium Health • Charlotte, NC

4d • $25 - $37 • Remote

About The Position

Subject matter expert in at least one specialty, e.g., oncology, gynecology, surgical coding (not including primary care procedures) and infusion coding including chemotherapy and infusions involving multiple drugs. Assigns CPT and ICD codes in cases of moderate to high complexity. Reads, interprets and assigns CPT codes from provider documentation, e.g., infusion record or operative report. Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered. Appends all modifiers. Ranks CPT codes when multiple codes apply. Assigns Evaluation and Management (E/M) codes. Performs reconciliation process to ensure all charges are captured. Processes automated or manually enters charges into applicable billing system. Researches and analyzes coding and payer specific issues. Processes charges on a timely basis and communicates with team members and practice management on an ongoing basis. Communicates with providers related to coding issues that are of moderate to high complexity. Including face to face interaction, explaining coding rationales, and education with providers. Performs duties of moderate to high complexity, analyzes denial data, reports and work queues to depict trends and offer solutions.

Requirements

• Minimum of 2 years of coding experience required.
• CPC or equivalent coding credential required.
• Maintain coding certification (CPC, CCS, RHIT, RHIA).
• Extensive knowledge of coding, medical terminology, anatomy, and physiology.
• Extensive knowledge of and the ability to apply the payer specific rules regarding coding, bundling, and adding appropriate modifiers.
• High School Diploma or GED required.

Nice To Haves

• Will Support Atrium Health Patient Accounting Experience desired: HB Outpatient Post Claim Denials

Responsibilities

• Assigns CPT and ICD codes in cases of moderate to high complexity.
• Reads, interprets and assigns CPT codes from provider documentation, e.g., infusion record or operative report.
• Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered.
• Appends all modifiers.
• Ranks CPT codes when multiple codes apply.
• Assigns Evaluation and Management (E/M) codes.
• Performs reconciliation process to ensure all charges are captured.
• Processes automated or manually enters charges into applicable billing system.
• Researches and analyzes coding and payer specific issues.
• Processes charges on a timely basis and communicates with team members and practice management on an ongoing basis.
• Communicates with providers related to coding issues that are of moderate to high complexity. Including face to face interaction, explaining coding rationales, and education with providers.
• Performs duties of moderate to high complexity, analyzes denial data, reports and work queues to depict trends and offer solutions.

Benefits

• Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:
• Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance
• Benefits and more Paid Time Off programs Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability Flexible Spending Accounts for eligible health care and dependent care expenses Family benefits such as adoption assistance and paid parental leave Defined contribution retirement plans with employer match and other financial wellness programs Educational Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees