Medical Coding Edit Specialist - Remote

Job Description:

At e4health, we Empower Better Health. The e4health Team is on a relentless mission to care for those teams who care for others. We bring our passion, ingenuity, and expertise to every engagement. In joining our Team, we want your help to provide our customers with powerful solutions in the pursuit of quality, integrity, clinical and financial value across healthcare.

Our People make the difference. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. e4health solutions streamline clinical, financial, and health information data and workflows, optimize coding, quality, and clinical documentation integrity processes, and address health IT operational challenges to deliver material results for healthcare organizations across the country. Learn more about us at www.e4.health.

Medical Coding Edit Specialist - Remote

Job Summary:

The Medical Coding Edit Specialist position is responsible for resolving coding account edits of multiple patient types prior to billing. These types of edits may contain NCCI, OCE, Medical Necessity LDC/NCD and diagnosis code rejections. Other types of edits may be included. Responsibilities will include assigning and/or correcting codes and modifiers with ICD-10-CM, CPT and HCPCS Level II Codes as appropriate from the documentation within the electronic medical record. The Coding Edit Specialist is expected to maintain consistent accuracy rate of 90% or better while also meeting agreed upon productivity standards.

ESSENTIAL DUTIES AND RESPONSIBILITIES: 

• Reconcile held accounts by resolving the edit and dropping the account
• Responsible for all account edits from various payors and vendors
• Identify and report major edit issues
• Assist in identifying problems and resolution thereof. Identify opportunities to reduce coding edits by providing proactive education
• Communicates quality issues to management as appropriate. Notifies management when there is a compliance concern or incident
• Demonstrates knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information
• Promotes confidentiality and using discretion when handling patient information
• Attends educational conference calls
• Provides additional support to the business as needed
• Maintains required productivity and quality requirements
• Maintains coding credential requirements

REQUIRED QUALIFICATIONS:

• Candidate must possess an approved AHIMA or AAPC coding credential
• Minimum 2 years’ coding experience preferred
• Must have up to date knowledge of third-party rules and regulations
• Specific client systems experience may be preferred as per client needs

• Must have knowledge of Maryland rules and denial management.

KEY SUCCESS ATTRIBUTES: 

• Demonstrates strong collaboration skills
• Has strong analytic and problem-solving abilities and techniques
• Exhibit consistent initiative with strong drive for results and success
• Demonstrate commitment to a team environment 
• Well-developed written, verbal, and presentation communication skills including deep listening and attention to detail.
• Ability to self-motivate and self-direct
• Possess strong time management and organizational skills 
• Commitment and adherence to company Core Values

CORE COMPETENCIES:

• High level of integrity & ethical judgement
• Communication
• Consistency and Reliability
• Meeting Standards

BENEFITS:

We offer an excellent salary, full benefits package including 401(k) with company match and discretionary profit sharing, group medical, dental, vision, life, & short-term disability insurance, and PTO policy.

PHYSICAL DEMANDS OF THE ESSENTIAL FUNCTIONS:

Sitting, talking, hearing and near vision are required over 90% of the time, while walking is required frequently throughout the day. Standing is required over 10% of the time. Feeling is required 90% of the time and reaching is required about 50% of the time. Bending, twisting and climbing are required, as in far vision, but only for 10% or less of the time. Low levels of lifting (10 pounds of less) is required about 25% of the time, while medium levels (20 to 40 pounds) of lifting and carrying are required less than 5% of the time. Ability to travel to field sites may be required up to 15% of the time.

WORKING CONDITIONS WHILE PERFORMING ESSENTIAL FUNCTIONS:

Over 90% of the time is spent indoors, with protection from weather conditions. Exposure to noise levels that may be distracting or uncomfortable is present in only unusual situations.

e4health is an equal opportunity employer and will consider all applications without regard to race, color, religion, national origin, ancestry, marital status, veteran status, age, disability, pregnancy, genetic information, gender, sexual orientation, gender identity or any other legally protected category.

Applicants for U.S. based positions with e4health must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available for this position.