The #1 Site for IT and Engineering Jobs - search all IT and Engineering  jobs.
Id82yx6mbfkjdk1zzqn

Coding Payment Resolution Specialist

Job Description

Job Title: Coding Payment Resolution Specialist

Location; Columbus, Ohio

Start Date: ASAP

Duration: Full Time

Background:

  • Responsible for reviewing all post-billed denials (inclusive of coding-related denials) for coding accuracy and appealing them based upon coding expertise and coding judgment within the Hospital and/or Medical Group revenue operations ($3-5B NPR) of a Patient Business Services (PBS) center. Serves as part of a team of coding payment resolution colleagues at a PBS location responsible for identifying and determining root causes of denials.
  • Responsible for leveraging coding knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing of appeals as required by payers. in addition to promoting departmental awareness of coding best practices. This position reports directly to the Supervisor Clinical/Coding Payment Resolution.

Responsibilities:

  • Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
  • Provides detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, ICD-10-PCS codes, and CPT-4 procedural codes for UB-04 outpatient or inpatient claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, regulations as directed by the Supervisor Clinical / Coding Payment Resolution.
  • Interprets data, draws conclusions, and reviews findings with all level of Payment Resolution Specialist for further review.
  • Takes initiative to continuously learn all aspects of Payment Resolution Specialist role to support progressive responsibility.

Our partnership is only as strong as the relationship built. We’re your trusted partner for IT hiring, recruiting and staffing needs.  For over 16 years, Eight Eleven has established and maintained relationships that are designed to meet your IT staffing needs. Whether it’s contract, contract-to-hire, or permanent placement work, we customize our search based upon your company's unique initiatives, culture and technologies. With our national team of recruiters placed at 21 major hubs around the nation, Eight Eleven finds the people best-suited for your business. When you work with us, we work with you. That’s the Eight Eleven promise.

Eight Eleven Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, national origin, age, sex, citizenship, disability, genetic information, gender, sexual orientation, gender identity, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws.  l times.

Job Requirements

Minimum Qualifications:

    • High school diploma or Associate degree in Accounting or Business Administration or related field, and a minimum of four (4) years' experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or customer service activities or an equivalent combination of education and experience. Experience in a complex, multi-site environment preferred.
    • Must possess comprehensive knowledge of professional/physician diagnostic and procedural coding, as normally obtained through a coding certificate program and least one (1) year of physician/professional or hospital outpatient coding experience or minimum of two (2) years of relevant hospital inpatient coding experience including DRG assignment.
    • Must be a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).
    • Must have experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
    • Possesses expertise in medical terminology, disease processes, patient health record content and the medical record coding process.

Job Snapshot

Location US-OH-Columbus, OH
Employment Type Full-Time
Pay Type Hour
Pay Rate N/A
Store Type Health Care
Apply

Company Overview

Brooksource

Brooksource is an IT Services Company, specializing in the recruitment and placement of high level IT professionals. We offer competitive compensation, paid holidays, 401k, health benefits, flexible work schedules and just about anything a top tier candidate would demand. Our diverse client base covers all industries and provides us the opportunity to place you, the candidate, in positions that span the entire IT spectrum. Learn More

Contact Information

US-OH-Columbus, OH
Callie Smallwood
Snapshot
Brooksource
Company:
US-OH-Columbus, OH
Location:
Full-Time
Employment Type:
Hour
Pay Type:
N/A
Pay Rate:
Health Care
Store Type:

Job Description

Job Title: Coding Payment Resolution Specialist

Location; Columbus, Ohio

Start Date: ASAP

Duration: Full Time

Background:

  • Responsible for reviewing all post-billed denials (inclusive of coding-related denials) for coding accuracy and appealing them based upon coding expertise and coding judgment within the Hospital and/or Medical Group revenue operations ($3-5B NPR) of a Patient Business Services (PBS) center. Serves as part of a team of coding payment resolution colleagues at a PBS location responsible for identifying and determining root causes of denials.
  • Responsible for leveraging coding knowledge and standard procedures to track appeals through first, second, and subsequent levels, and ensuring timely filing of appeals as required by payers. in addition to promoting departmental awareness of coding best practices. This position reports directly to the Supervisor Clinical/Coding Payment Resolution.

Responsibilities:

  • Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions.
  • Provides detailed understanding or aptitude for resolving denials based on ICD-10-CM diagnosis codes, ICD-10-PCS codes, and CPT-4 procedural codes for UB-04 outpatient or inpatient claims, or other coding reasons and processing charge corrections based on medical record reviews, contracts, regulations as directed by the Supervisor Clinical / Coding Payment Resolution.
  • Interprets data, draws conclusions, and reviews findings with all level of Payment Resolution Specialist for further review.
  • Takes initiative to continuously learn all aspects of Payment Resolution Specialist role to support progressive responsibility.

Our partnership is only as strong as the relationship built. We’re your trusted partner for IT hiring, recruiting and staffing needs.  For over 16 years, Eight Eleven has established and maintained relationships that are designed to meet your IT staffing needs. Whether it’s contract, contract-to-hire, or permanent placement work, we customize our search based upon your company's unique initiatives, culture and technologies. With our national team of recruiters placed at 21 major hubs around the nation, Eight Eleven finds the people best-suited for your business. When you work with us, we work with you. That’s the Eight Eleven promise.

Eight Eleven Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, national origin, age, sex, citizenship, disability, genetic information, gender, sexual orientation, gender identity, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws.  l times.

Job Requirements

Minimum Qualifications:

    • High school diploma or Associate degree in Accounting or Business Administration or related field, and a minimum of four (4) years' experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting, performing medical claims processing, financial counseling, financial clearance, accounting or customer service activities or an equivalent combination of education and experience. Experience in a complex, multi-site environment preferred.
    • Must possess comprehensive knowledge of professional/physician diagnostic and procedural coding, as normally obtained through a coding certificate program and least one (1) year of physician/professional or hospital outpatient coding experience or minimum of two (2) years of relevant hospital inpatient coding experience including DRG assignment.
    • Must be a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC).
    • Must have experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
    • Possesses expertise in medical terminology, disease processes, patient health record content and the medical record coding process.
Mwt2td5z6kzxt6hfr4z
Sologig Advice

For your privacy and protection, when applying to a job online: Never give your social security number to a prospective employer, provide credit card or bank account information, or perform any sort of monetary transaction.Learn More

By applying to a job using sologig.com you are agreeing to comply with and be subject to the workinretail.com Terms and Conditions for use of our website. To use our website, you must agree with theTerms & Conditionsand both meet and comply with their provisions.
Coding Payment Resolution Specialist Apply now