ProFee Edits / Denials Specialist

POSITION: Professional Edits/Denials Specialist

STATUS: Full-Time

LOCATION: Remote

SCHEDULE: Monday through Friday

FLSA STATUS: Non-Exempt / Eligible for Overtime

POSITION SUMMARY:

Review front-end edits and back-end denials and/or code physician records to determine appropriate designation of diagnosis, procedure, and wRVUs while maintaining compliance with coding guidelines and client guidelines.

POSITION RESPONSIBILITIES:

• Analyze, evaluate, and review client medical records to ensure accuracy of code assignment.
• Identify issues and remediate denials received by clients. Work and fix edits as requested by the client.
• Code professional fee charts as needed by the client.
• Prepare daily edits/denials logs.
• Demonstrate proficiency in coding including both ICD-10 and CPT while maintaining a 95% accuracy.
• Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client-specific policies.
• Maintain productivity based on national standards and/or client-specific standards.
• Work as a team player in a dynamic environment on multiple projects.
• Other duties as assigned based on company needs and client projects.

CERTIFICATION(s) / EXPERIENCE:

• CPC/COC/CCS, or CCS-P – active and in good standing with AHIMA or AAPC
• Basic knowledge and experience in Microsoft Office applications (Excel, Office, Word, Sharepoint, etc…), required.
• Minimum of 5 years of physician/ProFee or payer Rejection/Denials Remediation experience, preferred.
• E/M code assignment knowledge, preferred.
• Experience with Cerner Powerchart, preferred.
• Experience with EHR / Billing systems (example; Allscripts), preferred.
• Experience with Soarian Billing system, a plus.
• Surgical coding background, a plus.

BENEFITS:

We offer a comprehensive and robust benefit package.

• 401(k) Retirement
• 401(k) Retirement Company Matching
• Bonuses (per clients’ request)
• Collaborative Team Environment
• Company Supplied Equipment
• Continuous Education with Approved CEs
• Cross-Training Opportunities for Career Growth
• Dental Insurance
• Disability Insurance (Short-Term and Long-Term)
• Health Insurance (Nationwide Coverage)
• Holiday Shift Differential Pay (per clients’ request)
• Life Insurance
• Overtime Pay (per clients’ request)
• Paid Holidays, Sick, and Vacation Time
• Vision Insurance

EQUAL EMPLOYMENT OPPORTUNITY:

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. We are a participant of E-Verify.