Revenue Integrity Coordinator (Full-time, Monday - Friday, 8:00am-5:00pm)
About The Position
The role of the Appeals Coordinator reports to the Revenue Integrity Manager. This position is responsible for the management and resolution of claim denials. partnering with the coding department, business office and charge departments to resolve edits on failed claims and claim scrub reports. This position must ensure accurate CPT, UB codes and modifiers are appropriately reported on claims and is responsible for auditing charts for services provided to both inpatients and outpatients. The incumbent will perform focus bill audits when needed and will work with system staff on issues related to documentation in the medical records.
Requirements
- Bachelors in Health Information Services, preferred.
- RHIA, RHIT, CCA, CCS, CPC, COC, OR CPMA , required
- Minimum coding experience of 2-3 years or 3-5 years auditing clinical records, medical necessity, coverage policies and CMS and commercial insurance rules and regulations, required.
Responsibilities
- Resolve edits, claim scrub issues and hold bills
- Ensure CPT, UB codes and modifiers are accurately reported on claims
- Provide education to correct inappropriate use of CPT codes and modifier
- Partner with staff to correct issues related to documentation in medical records
- Perform focus bill audits as needed
- Prepare compliance related audits and provide information for reports, as requested
- Cross train to assist with other departmental duties, as requested
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
