Remote Coder

Description:

Responsible for reviewing all post-billed denials (inclusive of coding-related denials) for coding accuracy and appealing them based upon coding expertise and coding judgment within the Hospital and/or Medical Group revenue operations ($3-5B NPR) of a Patient Business Services (PBS) center. Serves as part of a team of coding payment resolution colleagues at a PBS location responsible for identifying and determining root causes of denials. Responsible for leveraging coding knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing of appeals as required by payers. in addition to promoting departmental awareness of coding best practices. This position reports directly to the Supervisor Clinical/Coding Payment Resolution. • Provides detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, ICD-10-PCS codes, and CPT-4 procedural codes for UB-04 outpatient or inpatient claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, regulations as directed by the Supervisor Clinical / Coding Payment Resolution. • Interprets data, draws conclusions, and reviews findings with all level of Payment Resolution Specialist for further review. • Takes initiative to continuously learn all aspects of Payment Resolution Specialist role to support progressive responsibility. • Other duties as needed and assigned by the Supervisor Clinical / Coding Payment Resolution. • Maintains a working knowledge of applicable Federal, State and local laws/regulations the Trinity Health Integrity and Compliance Program and Code of Conduct as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional behavior.

Skills:

Coding, Medical coding, Medical billing, Medical, Icd-10, Cpc, denials, payment resolution, Inpatient coding, Medical terminology, Health care, customer service skills, call center experience

Top Skills Details:

Coding,Medical coding,Medical billing,Medical,Icd-10,Cpc,denials,payment resolution,Inpatient coding,Medical terminology,Health care,customer service skills

Additional Skills & Qualifications:

• High school diploma or Associate degree in Accounting or Business Administration or related field, and a minimum of four (4) years' experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or customer service activities or an equivalent combination of education and experience. Experience in a complex, multi-site environment preferred. • Must possess comprehensive knowledge of professional/physician diagnostic and procedural coding, as normally obtained through a coding certificate program and least one (1) year of physician/professional or hospital outpatient coding experience or minimum of two (2) years of relevant hospital inpatient coding experience including DRG assignment. • Must be a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC). • Must have experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting. • Possesses detailed understanding of principles, methods, and techniques related to compliant healthcare billing/collections. • Possesses expertise in medical terminology, disease processes, patient health record content and the medical record coding process. • Must be comfortable operating in a collaborative, shared leadership environment. • Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

Experience Level:

Intermediate Level

About Aston Carter:

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At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.

Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit AstonCarter.com. Aston Carter is a company within Allegis Group, a global leader in talent solutions.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call 888-237-6835 or email astoncarteraccommodation@astoncarter.com for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.

Salary : $3 - $0