Physician Coding and Denial Specialist (11045)

CULLMAN REGIONAL•Cullman, AL

6d•Onsite

About The Position

Summary: Analyzes claim denials and executes follow up to recover maximum reimbursement Performs patient billing and insurance claims filing Analyzes medical records to assign appropriate diagnosis codes following coding guidelines Analyzes medical records to assign appropriate procedure codes following coding guidelines Performs analysis of medical records to rectify charge entry and modifiers based on documentation Assists with claim submission, follow-up, and reporting needs throughout the clinically-driven revenue cycle Submits payer appeals as necessary and completes follow-up for final resolution Assists in the clinical revenue cycle to achieve the maximum appropriate reimbursement Retrieves paper and electronic claims and remittance advice reports where necessary to overcome denials Enters accurate and thorough documentation of pertinent events regarding the handling of the denial Meets established production standards Works in a collaborative fashion with the office, billing, and coding staff to improve overall processes Qualifications

Requirements

Education: High school diploma or equivalent required. Completion of Medical Coding from an approved Health Information Technology Program, currently a Certified Coding Associate (CCA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Registered Health Information Technician (RHIT), or Registered Health Information Administrator (RHIA).
Experience: Minimum three (3) years working in Medical Billing & Coding.
Must be self-directed / self-motivated; must have good communication and interpersonal skills.
Must be able to: (1) perform a variety of duties often changing from one task to another of a different nature without loss of efficiency or composure; (2) work independently; (3) recognize the rights and responsibilities of patient confidentiality; (4) relate to others in a manner which creates a sense of teamwork and cooperation; and (5) maintain a customer focus and strive to satisfy the customer's perceived need.

Responsibilities

Analyzes claim denials and executes follow up to recover maximum reimbursement
Performs patient billing and insurance claims filing
Analyzes medical records to assign appropriate diagnosis codes following coding guidelines
Analyzes medical records to assign appropriate procedure codes following coding guidelines
Performs analysis of medical records to rectify charge entry and modifiers based on documentation
Assists with claim submission, follow-up, and reporting needs throughout the clinically-driven revenue cycle
Submits payer appeals as necessary and completes follow-up for final resolution
Assists in the clinical revenue cycle to achieve the maximum appropriate reimbursement
Retrieves paper and electronic claims and remittance advice reports where necessary to overcome denials
Enters accurate and thorough documentation of pertinent events regarding the handling of the denial
Meets established production standards
Works in a collaborative fashion with the office, billing, and coding staff to improve overall processes