Job Description

Overview:

Serves as the dynamic denial management coding analyst to maintain a low denial rate and high reimbursement rate at an enterprise level. To maintain a high coding standard within the enterprise. Organizes and plans projects to improve effectiveness of dynamic coding, reimbursement rates, and appeal turnover rates. Performs analysis for denial trend improvement to include EPIC system edits, coding validation, CDM processes that affect reimbursement, authorization trends and performance improvement, and payer denial trends. Educates departments on appropriate charging/billing/coding issues to ensure regulatory compliance. Works with managed care and compliance to resolve issues with departments and payers.

Qualifications:

Minimum Education and Experience Requirements:
High school graduate required with CPC, COC, RHIT, RHIA, CCS and 1-2 years coding experience, 1-2 years insurance experience, denial experience.
* Prefer Associate's degree or higher in a health or business-related field and 3 years coding or billing, insurance follow up, collections or denial management in a hospital /clinical setting.

Knowledge, Skills, Abilities:
* Demonstrated knowledge of:
o Hospital billing and reimbursement
o Denials and appeals
o Third-party contracts
o Federal and state regulations governing the healthcare industry
* Excellent critical thinking and analytical skills
* Attention to detail and ability to complete the job with minimal errors and work independently.
* Proficient organizational skills
* Excellent writing and communication skills
* Ability to prioritize and manage time effectively.
* Proficient in Microsoft Office Products such as: Outlook, Word, Excel
* Knowledge of HIPPA guidelines
* Ability to read and interpret EOB's.
* Strong research and problem-solving skills
* High level of comfort with computer systems

Motor Vehicle Operator Designation:
Will not operate vehicles for an assigned business purpose.

Licensure/Certification/Registration:
None

Job Tags

Full time,

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