[Hiring] Coding Denial Specialist @RadNet

Role Description

The Coding Denial Specialist will ensure charges are accurately and compliantly reflected on claims submitted to payors for adjudication following all regulations, payor coding guidelines, and contractual agreements within appeal timeframe. Charges will be coded using the appropriate combination of CPT/CPCS/ICD-10 codes as indicated by the radiology report and clinical documentation; following payor specific guidelines and/or as defined in contractual agreements.

• Applies knowledge to assign accurate codes to each individual procedure and diagnosis, condition, problem or other reason.
• Meets productivity standards of coding required number of charges including ICD-10 and CPT-4 codes.
• Meets quality standards set forth for denial coding team.
• Contacts imaging centers and/or hospitals when addendums or information is needed to accurately code an exam.
• Communicates as required with radiologists when the final radiology report does not contain evidentiary language to support performed procedure(s).
• Collaborates with physicians, clinical operations, technologists, transcriptionists and production coding team to improve quality and completeness of clinical documentation.
• Reads and interprets accurately and efficiently all medical documentation to identify all diagnoses, conditions, problems or other reasons for the physician-patient visit.
• Assesses the adequacy of medical records documentation to ensure it supports the diagnoses, conditions, problems or other reasons for the physician-patient visit.

Qualifications

• Must hold one of the following national coding certifications: Radiology Certified Coder (RCC), Certified Professional Coder (CPC), or Certified Coding Specialist-Physician (CCS-P).
• Must obtain Radiology Certified Coder (RCC) within 9 months of hire.
• Minimum two years of prior coding experience in a medical billing environment, preferably in radiology.

Requirements

• Ability to excel with change, respond appropriately, even in challenging situations, and to motivate others in a positive manner.
• Ability to work with limited direct supervision.
• Ability to effectively and efficiently work in a fast-paced environment with a high volume of activity and rapid change.

Ideal Candidate will possess:

• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, coworkers, patients, visitors, and vendors.
• Demonstrates initiative, personal awareness, professionalism, and integrity, and exercises confidentiality in all areas of performance.
• Follows all local, state, and federal laws concerning employment including but not limited to: I-9, Harassment, EEOC, Civil rights, and ADA.
• Follows OSHA regulations, RadNet, and site protocols, policies, and procedures.
• Follows HIPAA, compliance, privacy, safety, and confidentiality standards at all times.

Benefits

• Pay rate: $22.00 - $24.00 per hour