Reliant Medical Group is seeking a coding specialist to join our exciting and innovative organization!
Position: Full time 38.75 hours per week
Hours: Monday through Friday 8:30AM-5:00PM
No Weekends, No Holidays
Responsible for the follow up process on those charges that are denied from the insurance company for coding reasons.
Must be able to determine what is wrong with the claim and take the steps necessary to resubmit for payment.
The denials must be worked following the guidelines in the department.
Contacts providers or their representatives regarding inappropriate, incomplete or unclear coding.
Follows up on outstanding coding related receivables following standard Revenue Operations policy/procedure/process and based upon payer filing deadlines.
Ensures appropriateness of payer rejections and denials for coding related reasons.
Contacts payers/governmental agencies regarding coding related denials and appeals as appropriate following established Revenue Operations policy/procedure/process.
Responds to coding related inquiries from providers and support staff and others as requested.
Must keep current of governmental and other payor coding and reimbursement rules and requirements.
Maintains productivity, quality standards and processing timelines as established by Revenue Operations Metrics.
Ensures compliance with payer filing deadlines
Cooperates fully with all governmental and third party insurer audits.
Adheres to all governmental and third party compliance issues as directed.
Complies with health and safety requirements and with regulatory agencies such as DPH, etc.
Complies with established departmental policies, procedures, and objectives.
Enhances professional growth and development through educational programs, seminars, etc.
Attends a variety of meetings, conferences, and seminars as required or directed.
Performs other similar and related duties as required or directed
High School graduate, Certified Coder – Billing and Coding preferred, Certified or Eligible for certification: CPC, CCS-P, CCS, CPC-A, CPC-H. Demonstrated knowledge and experience in ICD-9&10, CPT and HCPCS coding or successful completion of related college course. Medical terminology certificate or demonstrated knowledge. Demonstrated knowledge of third party billing. Excellent organizational and communication skills. Ability to work independently and as part of a team. Must demonstrate a professional and courteous manner when interacting with physicians/providers, clinical department staff and co-workers. Must show proficiency in current billing software within six (6) months