Healthcare Accounts Receivable / Coder

Job Duties

• Appeals claims denied by third-party payers.
• Creates appropriate letters and compiles documentation to substantiate the validity of claims.
• Investigates and problem solves reimbursement issues in collaboration with other coding staff and faculty.
• Works directly with physicians and other clinical staff as needed to provide documentation feedback and to develop appeals.
• Researches payer policies and processes.
• Reviews clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment.
• Works with coders and IBC staff on medical terminology and policy interpretation as required.
• Codes evaluation and management services at the appropriate CPT code level.
• Ensures ICD codes are linked appropriately to services provided.
• Works assigned Epic Work queues, CRM tasks, and reviews remittance advice for rejections and accuracy of payment amounts as needed.
• Identifies invoices that have been rejected per department criteria.
• Performs accounts receivable (AR) functions in the Epic billing system, including updating insurance information and demographics.

Qualifications

• Certification as a Certified Procedural Coder (CPC) required or RHIT/RHIA certification.
• This team primarily supports OB/GYN, Pediatrics, Physical Therapy, and Ophthalmology candidates who have coding, billing, AR, collections, or revenue cycle experience within one or more of these specialties.
• Must be able to keep goals and the Department in mind when making decisions and solving problems.
• Maintain a highly professional demeanor as a representative of the Department.
• Excellent verbal and written communication skills and teamwork strategies are critical.
• Maintain patient confidentiality regarding all financial and medical information.

About the Role

The ideal candidate for this role will have experience in Healthcare Accounts Receivable (AR) and collections, as well as proficiency in Epic.