Medical Coding Analyst
7 days ago
Job Title: Medical Coding Specialist
Description:
We are seeking a detail-oriented and highly organized Medical Coding Specialist to join our team. In this role, you will be responsible for conducting research and identifying Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content) for our automated claims editing solution.
The clinical content could include additions, deletions or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service limitations and other clinical content criteria.
Duties and Responsibilities:
- Conduct research and identify Medicare, Medicaid, and other medical coding and billing documents to identify claim denial or covered criteria (clinical content)
- Provide written and oral presentations to medical directors (physicians) and other clinical colleagues to obtain consensus on proposed denial criteria
- Provide clinical content support to customers as needed
- Perform data entry of clinical content updates into the database
- Solve problems related to the interpretation of inpatient coding or ICD-10-CM coding conventions/guidelines for inclusion or exclusion within business rules
Requirements:
- Bachelor's Degree in Nursing
- Active RN (PRC) License
- AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC)
- At least 5 years of experience in areas of CPT Coding, HCPCS, Medical Billing, Claims Denials and/or Chart Review/Auditing
- Previous experience working with US health insurance payers in claims, appeals or coding capacity
- Experience in denial management or claim review management is a plus/advantage
- Excellent communication skills enabling effective communication with all areas of the business
- Proficient in using MS Office Applications
- Amenable to work on night shift and remote work setup
Benefits:
- Competitive salary
- Opportunity for career growth and professional development
- Collaborative and dynamic work environment
Contact Information:
Please apply through our website with your resume and cover letter.
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