Coding Reimbursement Specialist III - Post Claim Denials

Remote Monday-Friday Core business hours

Will Support Atrium Health Patient Accounting

Experience desired:  HB Outpatient Post Claim Denials  

Advocate Health may approve those who wish to work out of the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IN, IL, 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 Range

• Subject matter expert in at least one specialty, e.g., oncology, gynecology, surgical coding (not including primary care procedures) and infusion coding including chemotherapy and infusions involving multiple drugs.
• Assigns CPT and ICD codes in cases of moderate to high complexity.
• Reads, interprets and assigns CPT codes from provider documentation, e.g., infusion record or operative report.
• Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered.
• Appends all modifiers.
• Ranks CPT codes when multiple codes apply.
• Assigns Evaluation and Management (E/M) codes.
• Performs reconciliation process to ensure all charges are captured.
• Processes automated or manually enters charges into applicable billing system.
• Researches and analyzes coding and payer specific issues.
• Processes charges on a timely basis and communicates with team members and practice management on an ongoing basis.
• Communicates with providers related to coding issues that are of moderate to high complexity. Including face to face interaction, explaining coding rationales, and education with providers.

Education, Experience and Certifications

• Minimum of 2 years of coding experience required.
• CPC or equivalent coding credential required.
• Maintain coding certification (CPC, CCS, RHIT, RHIA).
• Extensive knowledge of coding, medical terminology, anatomy, and physiology.
• Extensive knowledge of and the ability to apply the payer specific rules regarding coding, bundling, and adding appropriate modifiers.
• High School Diploma or GED required.

Physical Requirements
Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.

#REMOTE

#LI-REMOTE

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program