Job Summary:The Coding & Charge Edits Specialist II will be responsible for the review and resolution of all coding related prebilling edits and/or rejections to ensure prompt and accurate reimbursement. This position initiates medical record review and recommends proper action. This job role will also review and analyze all charge correction requests and then process any needed adjustments/edits. The individual is the point person within the department responsible for making all charge corrections. Follows organizational policies and procedures to ensure consistency of charge capture processes and reimbursements.Job Responsibilities:
- Review and resolve all assigned tasks / encounters associated with coding discrepancies as it relates to pre-billing system edits and and/or claims with outstanding balances.
- Reduces accounts receivable by reviewing claims with outstanding balances.
- Research and respond to insurance coding requests.
- Assist with claim issues, including preparing coding appeals.
- Analyze charge correction requests that are submitted.
- Execute charge corrections in order to ensure to achieve account resolution.
- Research accounts and request any needed supporting documentation.
- Resolve all correction requests accurately and in a timely approach.
- Review and analyze denials and reach out to payers in attempt to settle accounts.
- Act as a point of escalation and monitor supervisory or secondary work queues
- Responsible for performing edits on high dollar accounts.
- Assist Coding & Charge Edits Specialist Is with questions and concerns coding and edits.
Job Qualifications:
- High school graduate or GED certificate is required.
- A minimum of 1 years' experience in a physician billing or third party payer environment.
- Candidate must demonstrate working knowledge of contracts, insurance benefits, exclusions and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations.
- Candidate must demonstrate the ability to understand and navigate the payer adjudication process.
- Patient financial and practice management system experience in Epic and/or other electronic billing systems is preferred.
- Knowledge of medical terminology is preferred.
- Previous experience in an academic healthcare setting is preferred.
- Knowledge of CPC is preferred.
Hourly Rate Ranges: $23.56 - $31.25Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education.61st Street Service CorporationAt 61st Street Service Corporation we are committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a competitive comprehensive Benefit package to eligible employees; including Healthcare and various other benefits including Paid Time off to promote a healthy lifestyle.We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.