Billing and Coding Specialist-Outpatient

About the role

Performs retrospective outpatient coding and billing reviews in coordination with internal staff in our mission to capture full, fair, and accurate reimbursement for our hospital clients.

Responsibilities

• Support internal and external customers by providing accurate and timely responses to coding and billing questions.
• Perform retrospective coding and billing reviews on outpatient hospital claims and assist with outpatient claims.
• Provide correction recommendations to internal associates or clients, and support recommendations with rationale that may include coding guidelines, industry standard billing guidelines, or payer specific guidelines.
• Research and stay current on industry changes with regards to coding guidelines and payer specific billing guidelines for commercial and government payers.
• Comprehend payment methodologies and how they apply to billing and coding scenarios.
• Build strong, lasting relationships with Revecore personnel.
• Attend department and company meetings as required.
• Comply with federal and state laws, company and department policies and procedures.
• Aid with other related responsibilities to meet the needs of the business.
• Perform other duties as assigned.

Requirements

• AAPC or AHIMA Coding certification required, with 1+ years hospital coding/auditing experience (e.g., CPC, COC, CIC, CCS-P, CCS).
• Understanding of Managed Care, Medicare and Medicaid billing and reimbursement guidelines.
• Understanding of inpatient and outpatient hospital reimbursement methodologies.
• Mathematical skills sufficient to apply the concepts of claim payment methodologies.
• Ability to read and interpret an extensive variety of documents such as claims, instructions, policies and procedures in written (in English) and diagram form.
• Ability to present ideas on complex, detailed issues with ease.
• Ability to define problems, collect data, establish facts and draw valid conclusions.
• Strong team player, with willingness to adapt to changing priorities.
• Commitment to company values.

Qualifications

• High school diploma or equivalent required.
• Working knowledge of Microsoft Office suite (Word, Excel).
• Eagerness to learn new technologies and develop proficiency in internal applications.
• Strong computer navigation skills and experience using multiple software programs simultaneously to complete work.

Benefits

• We offer paid training and incentive plans.
• Medical, dental, vision, and life insurance benefits are available from the first day of employment.
• We enjoy excellent work/life balance.
• Employee Resource Groups build community and foster a culture of belonging and inclusion.
• We match 401(k) contributions.
• We offer career growth opportunities.
• We celebrate 12 paid holidays and generous paid time off.

Pay

Compensation is commensurate with experience.

Schedule

The role is remote within the United States.