[Hiring] Denials Coder @CommonSpirit Health

Role Description

As a Medical Coder, you will ensure precise communication with insurance companies so that services are documented correctly and payments are processed efficiently.

• Accurately translate patients’ medical records into standardized codes for diagnoses and treatments.
• Ensure compliance with legal, regulatory, and organizational standards.
• Combine accuracy and attention to detail with a strong knowledge of coding standards and healthcare regulations.
• Maintain clear communication with providers and staff.
• Efficiently manage records to ensure claims are processed correctly and on time.
• Apply a thorough understanding/interpretation of Explanation of Benefits (EOBs) and remittance advices.
• Communicate effectively over the phone and through written correspondence regarding outstanding balances, denials, and underpayments.
• Review patient medical records to compare documentation and coding; change coding based on documentation.
• Communicate with providers to resolve claims that require a written appeal or second level appeal.
• Resubmit claims with necessary information when requested through paper or electronic methods.
• Anticipate potential areas of concern within the follow-up function; identify issues/trends and conduct staff training to address and rectify.
• Recognize when additional assistance is needed to resolve insurance balances and escalate appropriately and timely.

Qualifications

• High School Graduate General Studies and 1+ years coding experience, upon hire or
• High School GED General Studies and 1+ years coding experience, upon hire and
• Associates in a related field and Insurance follow-up experience, upon hire and
• Completion of college-level courses in medical terminology, anatomy and physiology, disease processes, and pharmacology, upon hire and
• Completion of ICD-10 or CPT coding course, upon hire
• Certified Professional Coder, upon hire or
• Certified Professional Coder Hospital Apprentice, upon hire or
• Certified Professional Coder Apprentice, upon hire or
• Certified Coding Associate, upon hire or
• Cardiology Coding, upon hire or
• Certified Coding Specialist, upon hire or
• Certified Coding Specialist - Physician Based, upon hire or
• Certified Cardiovascular and Thoracic Surgery Coder, upon hire or
• Certified Health Care Compliance, upon hire or
• Certified Interventional Radiology Cardio Coder, upon hire or
• Certified Professional Coder Hospital, upon hire or
• Radiology Certified Coder, upon hire or
• Registered Health Information Administrator, upon hire or
• Registered Health Information Technician, upon hire