Performs coding related appeals based on specialty assignment(s) for all payers. Access all payer portals and pull payer policies. Works closely with AR staff to resolve denials.
 

Employee must be on-site for the first 90 days or so for training and probation before becoming fully remote. One day in office per month required afterwards. Employee must reside within Ohio.

Schedule: M-F (Day Shift)

 

 

Analyzes and reviews medical records and assigns appropriate codes for billing and statistical purposes. Ensures accuracy and compliance with coding guidelines and regulations.

 

 

Essential Functions:

• Analyzes medical records and utilizes coding books to accurately assign codes for diagnoses, procedures, and other medical services or charges.
• Reviews claims denials and appeals to identify coding errors. Performs coding and billing corrections and charge reconciliations.
• Researches newly identified diagnoses and procedures for code assignments.
• Maintains compliance with current coding guidelines and regulations.
• Communicates with physicians, parents, and third-party payors to ensure billing and reimbursement accuracy. Assists customers and staff with billing and coding questions.
• Conducts billing and coding audits to ensure accuracy and identify missed opportunities. Reports the results and recommends quality improvements.

Education Requirement:

As required by listed licensure and/or certification requirement.

Licensure Requirement:

(not specified)

Certifications:

RHIT, RHIA, CPC, CCS, CCS-P, or COC, required.

Skills:

(not specified)

Experience:

• Two years ofcoding experience, required.
• Three years computer experience in a data processing capacity, required.

Physical Requirements:

OCCASIONALLY: Bend/twist, Climb stairs/ladder, Lifting / Carrying: 0-10 lbs, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking

FREQUENTLY: (none specified)

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Flexing/extending of neck, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Peripheral vision, Problem solving, Repetitive hand/arm use, Seeing – Far/near, Sitting

Additional Physical Requirements performed but not listed above:

• Ability to multi-task within a demanding environment.

 

 

"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"