Job Description

Responsibilities:

• Review provider medical coding of services rendered for medical claim submission

• Review and respond to medical coding inquiries submitted by providers and staff

• Work directly with providers to resolve specific medical coding issues

• Analyze data for errors and report data problems

• Partner with billing staff to correct and resubmit claims based on review of the records, provider input, and payor input

• Work with clinical and non-clinical groups to identify undesirable coding trends

• Ensure claims are medically coded consistently by following CPT, ICD-10 and HCPCS rules and guidelines; escalate issues that may impact this immediately to the Compliance Committee

• Abide by HIPAA and Coding Compliance standards

• Collect data from various sources, maintain electronic records and logs, file paperwork, and operate office equipment

• Accomplish other tasks as assigned

Qualifications:

• 2+ years coding

• 2+ years medical billing experience (preferred but not required)

• Experience with insurance and revenue cycle management processes

• Ability to read and understand insurance EOB’s

• Proficient in reviewing edits between CPT, ICD10, and HCPCS codes

• Experience in reviewing insurance review denials and payer policies

• Professional coder certification through a recognized organization such as AAPC (preferred) or AHIMA

• Leadership qualities with the ability to effectively educate providers remotely

• Acute attention to detail with a strong, self-sufficient work ethic

• Excellent organization and use of time management skills

• Ability to prioritize workload and have a strong sense of urgency when time sensitive situations arise

• Proficient with computers and navigating within multiple applications

• Proficient in MS Office (specifically Teams, Outlook, Excel, and Word)

• Strong verbal and written communication, as well as customer service skills; must be able to listen and communicate effectively with leadership, providers, and co-workers

• Goal-oriented and a consistent performer

• Must be self-motivated, punctual, dependable, and able to work independently

• Must be trustworthy, honest and have a positive and professional attitude

Experience with wound care (preferred but not required)

Experience with insurance and revenue cycle management processes

Benefits:

• Compensation: $21.00 - $23.00 hourly

• This position is classified as: Hourly, Non-Exempt; Part-time employment (20-25 hours)

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