Revenue Recovery Midwest Physician Billing Appeal Coder

Major Responsibilities:

• Provide comprehensive, consistent and accurate charge entry for assigned hospital departments.
•  Identify, investigate, communicate and mitigate inconsistent trends in clinical documentation or charging with specific departments. Escalate issues regarding revenue capture or documentation when appropriate.
• Perform analysis of charges that correlate with documented medical/nursing interventions and resolve identified charging and billing issues.
•  Collects, reports, and maintains appropriate data in relation to charge capture and/or quality. Collaborates with teammates to achieve shared goals and metrics.
•  Perform periodic retrospective charge capture reviews of assigned departments to identify charging/billing issues.
•  Verify and respond to questions from various departments, patients or leadership regarding charging accuracy.
•  Provide orientation, education training and information to newly hired teammates regarding charge capture, policies, procedures, and underlying processes.
•  Conduct quality audits of accounts processed by the team and report findings with department Quality and Education Coordinator.
•  Review, identify, and process late, missing or lost charges for various hospital departments on an as needed basis.

License/Registration/Certification:

• Certified Coding Associate (CCA) issued by American Health Information Management Association (AHIMA)

Education/Experience Required:

• Education: Associate's Degree or equivalent knowledge
• Experience: Typically requires 3 years of experience in hospital coding

Knowledge, Skills & Abilities Required:

• Certified Coding Associate (CCA) valid and current certification required.
• Knowledge of third-party healthcare insurance plans, government regulations, hospital billing and claims.
• Able to review medical records, analyze, and apply billing and coding rules.
• Strong computer skills including Microsoft Office and Windows applications. Familiarity with hospital applications.
• Ability to work under time pressure and meet deadlines.
• Excellent communication skills including ability to document progress of routine work.
• Must be able to work independently yet have strong desire to collaborate with peers to meet team goals and metrics.
• Willing to modify personal workload/workflows in support of evolving department process and procedures for improved efficiencies.
•  Ability to life 20 pounds and exposed to normal remote work environment.

#LI- remote

#LI- Coder

This job description 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 perform other related duties.