[Hiring] MULTISPECIALTY DENIALS CODING SPECIALIST @Professional Credit Service

Role Description

The Multispecialty Denials Coding Specialist will review documentation and coding guidelines for professional fee-based coding, evaluation and management services, procedures, and diagnoses. Responsibilities include:

• Researching claim denials, submitting appeals, following up on outstanding claims, and handling claims correspondence.
• This is a full-time remote employee opportunity.

Qualifications

• Proficiency with MS Office Suite and Athena software
• Profee multispecialty, E/M coding: 2 years
• Physician based Denials: 5+ years
• (AAPC) CPC and/or (AHIMA) CCS, CCS-P, or RHIT certification
• Knowledge of medical terminology, insurance and appeals processes, and medical record management
• High level of accuracy and attention to detail
• Strong written and verbal communication skills

Requirements

• Research payer denials related to referral, pre-authorization, eligibility/registration, notifications, medical necessity, non-covered services, and billing resulting in denials and delays in payment.
• Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines as well as client’s policies and procedures.
• Submit retro-authorizations in accordance with payor requirements in response to authorization denials.
• Demonstrate knowledge and understanding of insurance billing procedures as evidenced by the identification of root-causes of claim issues and proposed resolutions to ensure timely and appropriate payment.
• Ensure appropriate revenue is captured; to prevent federal and payer audits, malpractice litigation, and health plan denials.

Benefits

• Flexible schedules to balance your work and personal goals
• Remote working environment with virtual team socials and collaboration opportunities
• Growth potential, both personally and professionally
• Great benefits (health, dental & vision Insurance)
• Traditional 401k/Roth Plan with discretionary matching
• Paid Time Off for Full-Time and Part-Time Employees
• Yearly Stipend for Educational CEU Resources
• Paid Volunteer and Community Outreach Program that allows you to ‘help others’ in the community
• This is a full-time remote job opportunity working 35-40 hours per week

Company Description

Ensource RCM partners with hospitals, physician groups, health systems, and legal teams nationwide to deliver trusted revenue cycle management solutions.