What are the responsibilities and job description for the Coding QA & Denials Specialist-RCCB position at SimonMed?
Join the fastest growing outpatient radiology practice in the Nation- SimonMed Imaging! Our commitment to excellence and improving patient care paired with the best-in-class technology allows us to be an industry leader in the constantly evolving health care environment. Secure your spot now and take advantage of a unique career opportunity to advance your skills while working alongside a dedicated team of board-certified subspecialty radiologists. We can’t wait to meet you!
LOCATION Remote
Travel % (if applicable): 10%
As a Radiology Coder/Auditor, you will be responsible for facilitating the continuous attainment of accurate and timely coding while also providing feedback to upper management related to the quality of coding performed by our coding vendors/partners and our AI tool.
ESSENTIAL FUNCTIONS:
- Assign appropriate procedure and diagnoses codes according to the AMA coding guidelines and/or payer specific guidelines, with the highest level of specificity based on the medical record.
- Works from an assigned coding and/or denial queue, completing or re-assigning encounters as required.
- Reports coding effectiveness and shortfalls and makes suggestions for process improvement.
- Analyzes and corrects coding errors and provides feedback related to denied claims and claims rejections.
- Reviews provider documentation and prepares feedback to the Sr. Coding Manager.
- QA review of charts coded by vendors and the AI coding tool for coding accuracy and appropriate MIPS quality measure application.
- Adheres to policies, procedures, and guidelines relative to departmental operations.
OTHER DUTIES: Please note that this job description is not designed to cover or contain a comprehensive listing of all activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time and/or without notice.
BENEFITS: Your health, happiness, and future matters! At SimonMed Imaging, we offer medical, vision and dental insurance, 401(k) eligibility, paid holidays plus PTO, Sick Time, opportunity for growth, and much more!
MINIMUM QUALIFICATIONS:
Education:
- Bachelor’s degree preferred but may substitute with experience.
License/Certification:
- Certified Professional Coder (CPC) or Radiology Certified Coder (RCC), required.
- Certified Professional Medical Auditor (CPMA), preferred.
- Radiology Certified Coder-IR (RCC-IR), a plus.
Experience:
- 5 years of recent radiology coding experience, required.
- Highly organized
- Excellent oral and written communication skills
- Imagine Billing experience, preferred.
- Aideo/Gemini AI coding platform experience, preferred.
- Excellent computer skills including Microsoft Excel and Word
PHYSICAL DEMANDS: This position may require duties including lifting and carrying up to 40 pounds, sitting for prolonged periods of time, with frequent standing and walking.
DRESS ATTIRE: Business Casual or scrubs dependent on department.
We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law. Employment is contingent upon successful completion of drug and background screening. Some positions will require a favorable driving record.
