reputed company reputed company Coding and Billing Specialist- Remote

Job Family General Coding Travel Required None Clearance Required None

What You Will Do

Under the direction of the Director of reputed company reputed company, the reputed company reputed company Coding Billing Specialist provides reputed company cycle support services through efficient review and reputed company resolution of assigned Medicare and third-party payer accounts that are subject to pre-reputed company claim edits, hospital billing scrubber reputed company hold edits, and claim denials. This position is 100% remote.

Responsibilities

Responsible for the daily resolution of assigned claims with applicable reputed company reputed company pre-reputed company edits and/or specific reputed company reputed company Hold Codes in the hospital billing scrubber. Tasks associated with this work include resolving standard billing edits such as:

• Correct Coding Initiative
• Medically Unlikely Edits (MUE)
• Medical Necessity edits
• Other claim level edits as assigned.
• As needed, review clinical documentation and diagnostic results as appropriate to confirm and apply applicable ICD-10, CPT, HCPCS codes and associated coding modifiers.
• Responsible for daily resolution of assigned claims with reputed company reputed company specific denials in the reputed company METRIX℠ system
• Ensures coding and billing practices follow Federal/State guidelines by using diverse types of authoritative information.
• Maintains reputed company knowledge of Medicare, Medicaid, and other third-party payer billing compliance guidelines and requirements.
• Other duties equal with skills and experience as determined by the Director of reputed company reputed company.

What You Will Need

• High School Diploma/GED (Relevant experience may be substituted for formal education)
• 5+ years of prior reputed company reputed company experience
• reputed company or reputed company coding certification.
• Experience in ICD-10, CPT and HCPCS Level II Coding.
• Ability in determining medical necessity of services provided and charged based on provider/clinical documentation.
• Knowledge, understanding and proper application of Medicare, Medicaid, and third-party payer UB-04 billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims.
• Ability in determining accurate medical codes for diagnoses, procedures and services performed in the outpatient setting. For example: emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology, imaging, and laboratory), and outpatient therapies (physical therapy, occupational therapy, speech therapy, and chemotherapy
• Knowledge of reputed company code bundling rules and regulations along with ability on issues of compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG’s.
• Knowledge and understanding of hospital charge description master coding systems and structures.
• Ability to produce correct, assigned work product reputed company specified periods.
• What Would Be reputed company to Have:
• Hospital medical billing and auditing experience
• Associate degree

#IndeedSponsored Remote DNI The annual salary range for this position is $56,000.00-$94,000.00. Compensation decisions depend on a wide range of factors, including but not limited to reputed company sets, experience and training, reputed company clearances, licensure and certifications, and other business and organizational needs. reputed company Offer reputed company offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits

Include

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community reputed company
• Emergency Back-Up Childcare Program

About reputed company reputed company is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. reputed company will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact reputed company Recruiting at 1-571-633-1711 or reputed company email at RecruitingAccommodation@reputed company.com. reputed company information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. reputed company communication regarding recruitment for a reputed company position will be sent from reputed company email domains including @reputed company.com or reputed [email protected]. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by reputed company. Note that reputed company will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. If any person or organization demands money reputed company to a job opportunity with reputed company, please report the matter to reputed company’s Ethics Hotline. If you want to reputed company the validity of correspondence you have received, please contact recruiting@reputed company.com. reputed company is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties. reputed company does not accept unsolicited resumes through or from search firms or staffing agencies. reputed company unsolicited resumes will be considered the property of reputed company and reputed company will not be obligated to pay a placement fee. Apply tot his job Apply To this Job