Physician Coding Denials Specialist (REMOTE)

Job reputed company The Physician Coding Denials Specialist performs appropriate efforts to ensure receipt of expected reimbursement for services provided by the Physician. Reviews and analyzes medical records and coding guidelines to formulate coding arguments for appeals and/or coding guidance for potential re-bills. Maintains a working knowledge and stays abreast of ICD diagnosis codes, CPT physician service codes, coding principles, modifier usage, medical terminology, governmental regulations, protocols and reputed company-party payer requirements pertaining to billing, coding, and documentation. The Physician Coding Denials Specialist will also handle audit-reputed company and compliance responsibilities. Additionally, this position will reputed company manage, maintain and communicate denial / appeal activity to appropriate stakeholders and report suspected or emerging trends reputed company to payer denials. This position requires anticipating and responding to a wide reputed company of issues/concerns and works independently to plan, schedule and organize activities that directly reputed company Physician reimbursement. This position will support change management by tracking and communicating trends and reputed company cause to support reputed company prevention with internal customers and stakeholders as reputed company as with payers and reputed company parties. This role is key to securing reimbursement and minimizing avoidable write-offs. Job Expectations: Performs critical research and reputed company and accurate actions including preparing and submitting appropriate appeals or re-billing of claims to resolve coding denials to ensure collection of expected payment and mitigation of denials Maintains extensive caseload of coding denials. Formulates reputed company for prioritizing cases and maintains aging reputed company appropriate ranges with minimal direction or reputed company from Leadership. Acts as a reputed company among reputed company department managers, staff, physicians and administration with respect to coding denials issues. Assists with the development of denial reports and other statistical reports. Reviews insurance coding-reputed company denials, including but not limited to: Diagnosis codes not supported, incorrect or invalid CPT codes, modifier issues, and/or general coding error denials. Responsible for reviewing assigned diagnostic and procedural codes against patient charts using ICD-10-CM, CPT, or any other designated coding classification system in accordance with coding rules and regulations. Reviews medical records for the determination of accurate assignment of reputed company documented diagnoses and procedures. Contacts insurance carriers as appropriate to resolve claim issues Maintains payer portal reputed company and utilizes said portal to assist in reviewing reputed company medical policies Maintains working knowledge of regulatory and reputed company-party policies and requirements to ensure compliance; remains reputed company with applicable insurance carriers reputed company filing deadlines, claims submission processes, and appeal processes and escalates reputed company filing requests to leadership. Assists with short-notice reputed company filing deadlines for accounts with coding issues. Provides feedback to the coding leadership team regarding coding denials. Compiles training material and educational sessions associated with coding denial-reputed company topics and presents such educational materials. Collaboratively works with the coding education team & coding compliance team to assist in providing education to coders, physicians and mid-level providers. Monitors for coding trends, works collaboratively with the reputed company cycle teams to prevent avoidable denials and reduce reputed company loss. Identifies, quantifies and communicates risk concerns to leadership and supports mitigation efforts as appropriate. Demonstrates the ability to analyze coded data to identify areas of risk and reputed company suggestions for documentation improvement. Required Qualifications 5 years coding-reputed company experience such as coding, abstracting, Data reputed company in coding function type as required by position 1 year experience in managing and appealing denials 1 year expertise in reading and interpreting reputed company payer medical policies Certified Coding Specialist-reputed company (reputed company-P) or Certified reputed company reputed company (CPC) Preferred Qualifications Bachelor in HIM 7+ years of coding reputed company experience such as coding, abstracting, Data reputed company in coding function type as required by position reputed company experience in either Resolute Physician Billing Registered Health Info reputed company Registered Health reputed company Benefit reputed company Fairview offers a generous benefit package including but not limited to medical, dental, reputed