[Hiring] Revenue Cycle and Coding Specialist @Central Health

Role Description

Under the supervision of the Revenue Cycle Supervisor, responsible for revenue cycle functions including:

• Coding/edit charge review
• Accurate timely submission of insurance claims
• Failed claims/follow-up resolutions
• Training and education
• Research and denial appeals
• Resolving unpaid medical claims
• Cash posting
• Processing billing calls and inquiries
• May serve as an intermediary between healthcare providers, clients, patients, and health insurance companies

Adheres to internal coding policies and expectations set forth by management and acts as a trainer and resource:

• Reviewing clinical documentation to assign appropriate ICD-10, CPT, HCPCS, and other relevant codes
• Ensuring that all codes assigned align with the services rendered, diagnoses, and treatments documented in the patient's medical records
• Making necessary adjustments to codes in cases where discrepancies or errors are identified
• Collaborating with healthcare providers to clarify documentation and coding as needed
• Adhering to all applicable coding guidelines, including those provided by AHIMA and AAPC

Process accurate code assignments for paper and/or electronic claims and required billing data elements prior to charges being processed for payment and revenue reporting, including coding/edit reviews. Ensures all professional aspects of the assignment of diagnostic and procedural coding is carried out in compliance with applicable Medicare, Medicaid, and third-party payer guidelines. Ensures accurate posting from remits to ensure proper work queue routing and required billing data elements to ensure an accurate accounting processed for payment and revenue reporting.

Remote: Individuals in this position may work at an approved off-site location; however, they may be required to occasionally visit an on-site location in Austin, Texas.

To be considered for this position, you must reside in one of the following states: Texas, Connecticut, Michigan, Ohio, North Carolina, Georgia, Florida, or Arizona. Applicants residing in other states will not be considered at this time.

Qualifications

• High School Diploma
• 4 years of experience in medical coding, medical auditing, or billing in a multi-specialty outpatient/professional billing setting
• Certified Coding Specialist (CCS) through governing body AHIMA OR Certified Coding Specialist - Physician (CCS-P) through governing body AHIMA OR Certified Professional Coder (CPC) through governing body AAPC

Requirements

• Knowledge of revenue cycle, billing and collections processes and procedures
• Demonstrated knowledge of Epic or other medical billing software
• Demonstrated knowledge of ICD-10, CPT, and HCPCS coding
• Demonstrated knowledge of Medicare, Medicaid, and other third-party insurers
• Demonstrated knowledge of policies, procedures/rules, and regulations used in interpreting proper billing and coding processes and techniques
• Attention to detail and accuracy
• Verbal and written communication skills
• Skill at building relationships and providing excellent customer service
• Demonstrated proficiency and experience in the use of computer and commonly used software including but not limited to Microsoft Office Suite, electronic medical record or practice management system
• Ability to multitask