Offer summary

Qualifications:

High school graduate with CPC, COC, RHIT, RHIA, or CCS certification and 1-2 years of coding and insurance experience., Preferred Associate's degree or higher in a health or business-related field with 3 years of relevant experience., Demonstrated knowledge of hospital billing, denials, appeals, and federal/state regulations in healthcare., Excellent critical thinking, analytical, and communication skills, with proficiency in Microsoft Office products..

Key responsabilities:

Maintain low denial rates and high reimbursement rates at an enterprise level.

Perform analysis for denial trend improvement and educate departments on coding and billing issues.

Organize and plan projects to enhance coding effectiveness and appeal turnover rates.

Collaborate with managed care and compliance to resolve issues with departments and payers.

Job description

Overview

Serves as the dynamic denial management coding analyst to maintain a low denial rate and high reimbursement rate at an enterprise level. To maintain a high coding standard within the enterprise. Organizes and plans projects to improve effectiveness of dynamic coding, reimbursement rates, and appeal turnover rates. Performs analysis for denial trend improvement to include EPIC system edits, coding validation, CDM processes that affect reimbursement, authorization trends and performance improvement, and payer denial trends. Educates departments on appropriate charging/billing/coding issues to ensure regulatory compliance. Works with managed care and compliance to resolve issues with departments and payers.

The option is available to work on-site in Gainesville or Jacksonville. Must live in Florida to work remote.

Qualifications

Minimum Education and Experience Requirements:

High school graduate required with CPC, COC, RHIT, RHIA, CCS and 1-2 years coding experience, 1-2 years insurance experience, denial experience.

Prefer Associate
s degree or higher in a health or business-related field and 3 years coding or billing, insurance follow up, collections or denial management in a hospital /clinical setting.

Knowledge, Skills, Abilities

Demonstrated knowledge of:
Hospital billing and reimbursement
Denials and appeals
Third-party contracts
Federal and state regulations governing the healthcare industry
Excellent critical thinking and analytical skills
Attention to detail and ability to complete the job with minimal errors and work independently.
Proficient organizational skills
Excellent writing and communication skills
Ability to prioritize and manage time effectively.
Proficient in Microsoft Office Products such as: Outlook, Word, Excel
Knowledge of HIPPA guidelines
Ability to read and interpret EOB
s.
Strong research and problem-solving skills
High level of comfort with computer systems