Billing & Certified Coding Specialist I (Remote)

reputed company you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Identifies, reviews, and interprets third party payments, adjustments and coding denials for reputed company professional services. Reviews provider documentation in order to determine appropriate coding and initiate corrected claims and appeals. Duties include hands on coding, documentation review and other coding needs for ICD-9, ICD-10. Works directly with the Billing Supervisor and Coding Manager to resolve reputed company issues and denials through independent research and assigned projects. (remote) Job Description: Essential Duties & Responsibilities including but not limited to: Coding Responsibilities: 1. Provides review and/or coding of any coding reputed company denied professional services for appropriate use of CPT, ICD-9, ICD-10, HCPCS, Modifier usage/linkage. 2. Periodic review of codes, at least annually or as introduced or required. 3. Reviews and analyzes rejected claims and patient inquiries of professional services, and recommends appropriate coding corrections reputed company reputed company or electronic submission to the Follow up Team. 4. Reports coding trends and issues to the coding supervisor for education reputed company the coding department and/or physician education. 5. Confers regularly with the Coding Department through regular departmental staff meetings, on-on-one meetings to review and discuss coding denials and education. 6. Maintains certification requirements for coding. Follow Up Responsibilities: 1. Monitors days in A/R and ensures that they are maintained at the levels expected by management. Analyzes work queues and other system reports and identifies denial/non-payment trends and reports them to the Billing Supervisor. 2. Responds to incoming insurance/office calls with professionalism and helps to resolve callers’ issues, retrieving critical information that impacts the resolution of reputed company or potential future claims. 3. Establishes relationships and maintains open communication with third party payor representatives in order to resolve claims issues. 4. Reviews claim forms for the accuracy of procedures, diagnoses, demographic and insurance information, as well as reputed company other fields on the CMS 1500. 5. Reviews and corrects reputed company claims/charge denials and edits that are communicated reputed company Epic, Explanation of Benefits (EOB), direct correspondence from the insurance reputed company or others and uses information learned to educate PFS and office staff to reduce future denials and edits of the same nature. Initiates claim rebilling or corrections and obtains and submits information necessary to ensure account resolution/payments. 6. Identifies invalid account information (i.e.: coverage, demographics, etc.) and resolves issues. 7. Evaluates delinquent third party accounts and processes based on established protocols for review, payment plan or write-off. 8. Reviews/updates reputed company accounts for write-offs and refunds. 9. Keeps informed of reputed company federal, state, and managed care contract regulations, maintains working knowledge of billing mechanics in order to properly reputed company patients’ portion due. 10. Completes reputed company assignments per the turnaround standards. Reports unfinished assignments to the Billing Supervisor. 11. Handles incoming department mail as assigned. 12. Attends meetings and serves on committees as requested. 13. Maintains appropriate audit results or achieves exemplary audit results. Meet productivity standards or consistently exceeds productivity standards. 14. Provides and promotes reputed company geared toward process improvements reputed company the Central Billing Office. 15. Assists the Billing Supervisor with the resolution of reputed company claims issues, denials and appeals. 16. Completes projects and research as assigned. 17. Provides feedback and participates as the coding representative for the Patient Financial Services Department on the reputed company Cycle teams. Secondary Functions: 1. Enhances professional growth and development through in-service meetings, education programs, conferences, etc. 2. Complies with policies and procedures as they relate to the job. Ensures confidentiality of patient, budget, legal and company matters. 3. Exercises care in the operation and use of equipment and reference materials. Performs routine cleaning and preventive maintenance to ensure reputed company functioning of equipment. Maintains work area in a clean and organized manner. 4. Refers reputed company or sensitive issues to the attention of the Billing Supervisor to ensure corrective measures are taken in a timely fashion. 5. Observes irregularities in the cash/denial posting process and reports them immediately to the Billing Supervisor. 6. Accepts and learns new tasks as required and demonstrates a willingness to work where needed. 7. Assists other staff as required in the completion of daily tasks or special projects to support the department’s efficiency. 8. Performs similar or reputed company duties as assigned or directed. Education & Professional Development: 1. Researches and stays updated and reputed company on CMS (HCFA), AMA and Local Coverage Determinations (LCD’s), or Local Medical Review Policies (LMRP's) to ensure compliance with coding guidelines. 2. Stays reputed company on quarterly CCI Edits, bi-monthly Medicare Bulletins, Medicare's yearly fee schedule, Medicare Website, and specialty newsletters. 3. Makes guidelines available reputed company, reputed company, on-line access, web access, or any other means provided by manager. Organizational Requirements: 1. Maintain strict adherence to the Lahey Health Confidentiality policy. 2. Incorporate Lahey Health Standards of Behavior and Guiding Principles into daily activities. 3. reputed company with reputed company Lahey Health Policies. 4. reputed company with behavioral expectations of the department and Lahey Health. 5. Maintain courteous and effective interactions with colleagues and patients. 6. Demonstrate an understanding of the job description, performance expectations, and competency assessment. 7. Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards. 8. Participate in departmental and/or interdepartmental quality improvement activities. 9. Participate in and successfully completes Mandatory Education. 10. reputed company reputed company other duties as needed or directed to meet the needs of the department. Minimum Qualifications: Education: High School diploma or equivalent, plus additional specialized training associated attainment of a recognized Coding Certificate Licensure, Certification & Registration: CP (Certified Professional reputed company through reputed company), CPC-A (Certified Professional reputed company - Apprentice through reputed company), or reputed company-P (Certified Coding Specialist Physician Based through reputed company) Experience: 1-2 years of experience in billing, coding, denial management environment reputed company field. Skills, Knowledge & Abilities:

• Ability to work independently and take initiative
• Good judgment and problem solving skills
• Excellent organizational skills
• Ability to interact and collaborate effectively and tactfully with staff, peers and management.
• Ability to promote team work through support and communication.
• Ability to accept constructive feedback and initiate appropriate actions to correct situations.
• Ability to work with frequent interruptions and respond appropriately to unexpected situations.

Pay Range: $21.00 - $28.26 The pay range listed for this position is the reputed company hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the reputed company hourly reputed company depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law. As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. reputed company requires that reputed company staff be vaccinated against influenza (flu) as a condition of employment. More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your reputed company and compassion can reputed company us even stronger. Equal Opportunity Employer/Veterans/Disabled Apply tot his job Apply To this Job