You’ll need
Certifications
✓Maintain expertise in coding guidelines, regulatory changes, and best practices through continuing education and professional certification requirements.
Education
✓Completion of a Health Information Technician program, Health Information Administrator program, equivalent allied health education, or other post-high school training in a related field
Qualifications
✓3-4 years of healthcare coding experience in a multi-specialty clinic or hospital setting
✓Experience with coding denials, payer rejections, Medicare National Correct Coding Initiative (NCCI) edits, and Medicare National and Local Coverage Determinations (NCDs/LCDs)
✓Strong knowledge of CPT, HCPCS, ICD-10-CM, modifiers, coding regulations, and payer policies
✓Excellent analytical, problem-solving, and communication skills
✓Ability to work independently while collaborating effectively with cross-functional teams
Benefits
401(k) with matchPaid time offTuition assistanceWellness and mental health resources
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About the role
Review, analyze, and resolve coding-related professional and hospital billing denials using CPT, HCPCS, ICD-10-CM, and modifier guidelines.
What you’ll do
Review, analyze, and resolveReview, analyze, and resolve coding-related professional and hospital billing denials using CPT, HCPCS, ICD-10-CM, and modifier guidelines
Identify denial trends, rootIdentify denial trends, root causes, and opportunities for coder, clinician, and departmental education to prevent future denials
Collaborate with prior authorizationCollaborate with prior authorization, revenue integrity, billing, and insurance follow-up teams to support denial mitigation strategies
Serve as a codingServe as a coding resource by interpreting coding regulations, payer policies, and industry updates while supporting Revenue Cycle leadership and coding staff
Maintain expertise in codingMaintain expertise in coding guidelines, regulatory changes, and best practices through continuing education and professional certification requirements