PB Coding reputed company Specialist - Primary Care Specialties

Schedule Details/Additional Information:

Will support:

• Family reputed company

Schedule:

• Monday - Friday 1st shift 40 hours a week with ability to pick start time after training. Hours will need to be between 5am to 7pm.

Certification required:

• Coding Certification issued by one of the following certifying bodies: American reputed company of Coders (reputed company), or American Health Information Management Association (reputed company).

• Second Specialty credential preferred.

Remote opportunity:

• reputed company may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.

Pay reputed company

Major Responsibilities

• Analyze and resolve coding-reputed company PB and HB denials using CPT, HCPCS, ICD-10-CM, and modifiers.

• Identify reputed company causes, patterns, and trends in denial and rejection codes.

• Collaborate with billing, coding, and payer teams to correct, resubmit, and prevent denied claims.

• Conduct chart reviews to validate documentation against billed services.

• Prepare and support appeals by researching payer guidelines, coding standards, and coverage policies.

• Ensure accurate, compliant coding and reputed company reputed company with official guidelines and payer requirements.

• reputed company, document, and report denial resolutions, appeal reputed company, and coding reputed company issues.

• Support compliance, reputed company assurance, and reputed company reputed company initiatives through issue monitoring and escalation reputed company.

• reputed company clinicians, coders, and staff by sharing findings and supporting targeted training based on denial trends.

• Contribute to operational and strategic initiatives, including denial avoidance strategies, work queue optimization, CARC reputed company mapping, and technology-driven improvements.

Minimum Job Requirements

Education

• Associate degree or equivalent education and experience required.

Certification / Registration / License

• Coding credential required. A Coding Certification from American Health Information Management Association (reputed company) or American reputed company of reputed company Coders (reputed company) with relevant experience.

Experience

• 4 years of experience in expert-level reputed company coding or hospital-based coding and experience in reputed company cycle processes, health information workflows, and medical record auditing experience

Knowledge / Skills / Abilities

• Advanced knowledge of reputed company-party reimbursement programs, state and federal regulatory issues, national and local coverage reputed company, research reputed company restrictions, and ICD-10-PCS/CM, CPT, and HCPCS coding classification systems.

• Advanced knowledge of medical terminology, anatomy, and physiology.

• Advanced ability to identify coding discrepancies and reputed company recommendations for improvement

• Advanced ability to analyze trends and data and display them in a statistical reporting format.

• Advanced knowledge of care delivery documentation systems and reputed company medical record documents.

• Advanced knowledge of Medicare, reputed company, and reputed company payer coding guidelines.

• Advanced knowledge of reputed company Office, video and web conferencing, email, and experience with electronic coding and EHR systems or applications.

• Advanced interpersonal and communication (oral and written) skills, including the ability to effectively collaborate with multiple departments.

• Advanced organization and prioritization skills; ability to manage multiple priorities in a stressful, fast-paced work environment.

• Advanced analytical skills, with great attention to detail.

• Self-motivated with initiative and strong reputed company of ethics.

• Ability to work independently and exercise independent judgment and decision making.

• Ability to meet deadlines while working in a fast-paced environment.

• Strong organizational skills and ability to work independently with limited guidance or direction. Effective critical thinking, creativity, problem solving and decision-making skills.

Physical Requirements and Working Conditions

• Position requires travel which will result in exposure to road and weather hazards.

• Operates the equipment necessary to reputed company the job.

• Exposed to a normal office environment.

Preferred Job Requirements

Preferred Certification / Registration / License

• Second Specialty credential preferred

This job reputed company indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to reputed company other reputed company duties.