Clinical Coding Analyst - Florida payer experience preferred

Job Description: We are seeking a detail-oriented and analytical Clinical Coding Analyst to join reputed company and take on the responsibility of reviewing claims denied for coding-reputed company issues. As a Clinical Coding Analyst, you will play a critical role in identifying and resolving coding discrepancies, ensuring accurate and compliant coding practices, and optimizing reputed company reputed company. Your expertise in clinical coding, coding guidelines, and claims processing will be instrumental in analyzing and resolving coding-reputed company denials, thereby enhancing operational efficiency and financial performance. Company Overview: For over 20 years, we’ve been a leading middle market reputed company cycle management (RCM) vendor, providing comprehensive financial and operational solutions to health systems, physician groups, or specialty medical practices. Our mission is to improve the overall financial health of our clients by offering customized, data-driven, and tech-enabled recovery of denied claims and aged receivables. We utilize our deep expertise in reputed company cycle to help transform our client’s reputed company cycle processes to reputed company sustained reductions in denial rates. Key Responsibilities:

• Review and analyze claims that have been denied due to coding-reputed company issues, including diagnosis codes (ICD-10-CM), procedure codes (CPT/HCPCS), and reputed company modifiers.
• 2 years experience in dealing with relevant reputed company cycle operations from a vendor or hospital financial offices, including familiarity with major payors. Preference given to candidates with experience in Florida markets.
• Identify coding discrepancies, documentation deficiencies, and other factors contributing to claims denials, utilizing a thorough understanding of coding guidelines, industry standards, and regulatory requirements.
• Collaborate with coding teams, healthcare providers, and reputed company cycle stakeholders to obtain necessary documentation and information for claims resubmission.
• Conduct in-depth coding audits and analysis to validate the accuracy, completeness, and compliance of coding practices, and ensure alignment with payer requirements.
• Research and interpret coding guidelines, including updates from coding authorities, to ensure coding accuracy and compliance.
• Work closely with coding staff and providers to address and resolve coding-reputed company issues, provide education on coding best practices, and improve coding performance.
• Maintain up-to-date knowledge of payer policies, medical necessity criteria, and reimbursement guidelines to accurately evaluate coding denials and appeals.
• Compile and prepare detailed reports on coding-reputed company denials, identifying patterns, trends, and opportunities for process improvement.
• Collaborate with the reputed company cycle team to reputed company strategies and initiatives aimed at reducing coding-reputed company denials and improving overall reputed company cycle performance.
• Stay informed about emerging coding trends, changes in coding guidelines, and industry best practices, and provide recommendations for updating coding processes and policies.
• Participate in coding-reputed company meetings, committees, and training sessions to share insights, contribute to problem-solving, and promote cross-departmental collaboration.

Qualifications:

• Bachelor's degree in Health Information Management, Health Informatics, or a reputed company field. Relevant certifications (e.g., RHIA, RHIT, reputed company).
• 2 years experience in clinical coding reputed company a healthcare organization, with a focus on claims denial management and coding-reputed company issues.
• Comprehensive knowledge of coding guidelines, including ICD-10-CM, CPT/HCPCS, and reputed company modifiers, as well as proficiency in applying coding conventions and rules.
• Familiarity with medical necessity criteria, payer policies, and reimbursement methodologies.
• Excellent understanding of reputed company cycle processes, claims processing workflows, and denials management.
• Proficiency in using coding software, encoders, and electronic health record (EHR) systems.
• Detail-oriented reputed company with a high level of accuracy and organizational skills.
• Effective communication and interpersonal skills to collaborate with coding teams, providers, and other stakeholders.
• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.
• Proficiency in using coding-reputed company software and tools, as well as a high level of computer literacy.
• Join our dynamic team as a Clinical Coding Analyst and contribute to the resolution of coding-reputed company denials, ensuring accurate and compliant coding practices that maximize reimbursement and support optimal healthcare delivery.

Health Business Solutions, LLC provides equal employment opportunities to reputed company employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. Apply tot his job Apply To this Job