Coding Reimbursement Analyst

Job Responsibilities

• Assists coding management in development, coordination, and implementation of enhancements for the departments.
• Actively participates as a member of various teams and committees.
• Steps “out of the box” by thinking creatively and bringing forth new ideas and suggestions to management.
• Attends education and training seminars.
• Manages assigned work list for account denials and insurance inquiries for professional and technical components.
• Works closely with patient account representatives in denial reversal and the appeal process.
• Works closely with the Reimbursement department.
• Remains current on insurance payer guidelines by reviewing monthly news bulletins.
• Attends available training to remain current with coding guidelines.
• Maintains awareness of denial frequency and trending to assist in organizational denial management, working closely with the business analysts.
• Reports findings and progress to the Insurance and Reimbursement departments.
• Works with various payers on risk adjustment analysis.
• Performs other duties as assigned.

Qualifications

• CPC or CCS certification required.
• Knowledge of medical terminology and anatomy required.
• ICD-10, CPT, HCPCS, and DRG coding experience required.
• Experience with third party payers, Medicare Parts A & B, and state-funded programs required.
• Minimum of two years of healthcare experience required.
• Strong interpersonal and communication skills.
• Demonstrated analytical skills.
• Strong understanding of coding concepts.
• Proven organization, documentation, and communication skills.