Professional Fee Coder

About Us

At Ovation Healthcare (formerly QHR Health), we’ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare by providing independent hospitals and health systems with the support, guidance, and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. Our vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer-focused behavior.

We’re looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare and ruralMED, you will collaborate with highly skilled subject matter specialists and operations executives in a collegial atmosphere of professionalism and teamwork. Our corporate headquarters is located in Brentwood, TN.

Responsibilities

• Receive and review charge entry data from practice sites; identify and investigate incomplete or missing charges.
• Abstract clinical information and translate medical documentation into diagnoses and procedural codes using currently accepted coding and classification systems; sequence codes according to established guidelines.
• Thoroughly analyze and interpret medical information, medical diagnoses, and coding/classification systems to ensure accuracy for prospective payment system reimbursement.
• Conduct training for physicians and staff on coding and/or documentation practices.
• Maintain current knowledge of coding rules and regulations as designated by the AMA, Centers for Medicare and Medicaid Services (CMS), and other payers.
• Maintain proficient knowledge of EHR and other systems required for performing job duties.
• Review and research coding denials; advise on appeal verbiage and coding changes.
• Communicate issues to management, including payer, system, or escalated account issues.
• Identify medical necessity denial trends and provide suggestions for resolution.
• Perform other billing functions including claim submission, unpaid claims follow-up, and denial resolution.
• Participate in department meetings, in-service programs, and continuing education programs.
• Maintain a professional attitude with patients, visitors, physicians, office staff, and hospital personnel.
• Ensure confidentiality of patient information, maintaining compliance with policies and procedures.
• Perform other duties as assigned.

Requirements

• Ability to perform each essential job duty satisfactorily; reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Knowledge, skill, and/or ability in coding, classification systems, and medical documentation interpretation.