Denial Coding Coordinator

The Denial Coding Coordinator is a subject matter expert (SME) for the Denial Coding Team. As the SME for the team this role is responsible for coordinating workflows and assignments, and completing daily summary reports for the team’s operational metrics. This role is responsible for training and coaching new team members to ensure charges are accurately and compliantly reflected on claims submitted to payors for adjudication following all payor coding guidelines and within appeal timeframe. The Denial Coding Coordinator will be an active participant in meetings relevant to ensuring compliant processing of all denials timely. This role will be expected to meet operational metrics for processing charges with coding related denials and coding reviews requested.

• Maintains consistent daily workflow; create efficiency, improve process and identify and implement best practices.
• Engage, coach and train new team members to ensure the achievement of Company, RCO, and individual goals.
• Lead or participate in the development of appropriate workflows, processes, and training materials.
• Prepare, analyze and complete detailed daily and monthly summary reports of operational metrics. Respond proactively to trends of diminished performance, both individual and team.
• Determines “root cause” of coding denials. Updates documentation on patient accounts for tracking purposes. Assists with trending controllable denials. Ensure all team members are documenting according to standard operating procedures.
• Identifies payor related coding issues, and communicates through appropriate channels with specific details so issues can be reported during meetings with the managed care provider relations teams.
• Interacts with external business partners and associated teams to provide feedback on coding and payer guidelines ensuring productivity and accuracy standards are met successfully.

• Must hold one on the following national coding certifications; Radiology Certified Coder (RCC) or Certified Professional Coder (CPC) or Certified Coding Specialist-Physician (CCS-P). Must obtain Radiology Certified Coder (RCC) within 9 months of hire.
• Minimum two years of prior coding experience in a medical billing environment preferably in radiology.
• Ability to excel with change, respond appropriately, even in challenging situations and to motivate others in a positive manner.
• Ability to work with limited direct supervision.
• Ability to effectively and efficiently work in a fast-paced environment with a high volume of activity and rapid change.

• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, coworkers, patients, visitors, and vendors.
• Demonstrates initiative, personal awareness, professionalism, and integrity, and exercises confidentiality in all areas of performance.
• Follows all local, state, and federal laws concerning employment including but not limited to: I-9, Harassment, EEOC, Civil rights, and ADA.
• Follows OSHA regulations, RadNet, and site protocols, policies, and procedures.
• Follows HIPAA, compliance, privacy, safety, and confidentiality standards at all times.