Coding Payment Resolution Colleague

Overview

Must Haves: 1. Must possess a knowledge of professional/physician coding rules for inpatient, hospital outpatient, clinic, and/or emergency settings, as normally obtained through a Bachelor’s Degree within a healthcare related area, and at least 2 years of physician/professional or hospital outpatient coding experience or minimum of 3 years of relevant hospital inpatient coding experience including DRG assignment. 2. Must be a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC). 3. Must have experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting. 4. Possesses detailed understanding of principles, methods, and techniques related to compliant healthcare billing/collections. 5. Possesses expertise in medical terminology, disease processes, patient health record content and the medical record coding process. 6. Must be comfortable operating in a collaborative, shared leadership environment. 7. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of client What you need to know: 1. Under the direction of a Clinical / Coding Payment Resolution Supervisor, provides detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, ICD-10- PCS codes, and CPT-4 procedural codes for UB-04 outpatient or inpatient claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, regulations. 3. Interprets data, draws conclusions, and reviews findings with Payment Resolution Trainee I and Payment Resolution Trainee II for further review. 4. Takes initiative to continuously learn all aspects of Payment Resolution Specialist Role to support progressive responsibility. 5. Other duties as needed and assigned by the Clinical / Coding Payment Resolution Supervisor. 6. Maintains a working knowledge of applicable Federal, State and local laws/regulations; the clients Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Benefits

Company

Large health care system.