Job Opening Summary

This is a remote position within Florida.
Serves as the dynamic denial management coding analyst to maintain a low denial rate and high reimbursement rate at an enterprise level to maintain a high coding standard within the enterprise. Organizes and plans projects to improve effectiveness of dynamic coding, reimbursement rates and appeal turnover rates. Performs analysis for denial trend improvement to include Epic system edits, coding validation, CDM processes that affect reimbursement, authorization trends, performance improvement and payer denial trends. Educates departments on appropriate charging, billing and coding issues to ensure regulatory compliance. Works with managed care and compliance to resolve issues with departments and payers.
The option is available to work on-site in Gainesville or Jacksonville. Must live in Florida to work remote.

Job Opening Qualifications

Minimum Education and Experience Requirements:

• High school graduate required with CPC, COC, RHIT, RHIA, CCS and one to two years of coding experience, insurance experience and denial experience.
• Prefer associate's degree or higher in a health or business-related field and three years of coding or billing, insurance follow-up, collections or denial management in a hospital/clinical setting.

Knowledge, Skills & Abilities:

• Demonstrated knowledge of:
  • Hospital billing and reimbursement.
  • Denials and appeals.
  • Third-party contracts.
  • Federal and state regulations governing the health care industry.
• Excellent critical thinking and analytical skills.
• Attention to detail and ability to complete the job with minimal errors and work independently.
• Proficient organizational skills.
• Excellent writing and communication skills.
• Ability to prioritize and manage time effectively.
• Proficient in Microsoft Office products such as Outlook, Word and Excel.
• Knowledge of HIPPA guidelines.
• Ability to read and interpret EOB's.
• Strong research and problem-solving skills.
• High level of comfort with computer systems.