Billing and Coding Review Analyst
Company Name:
Real Careers
We are looking for a local Medical Billing and Coding Review Analyst.
Position
Summary: Primarily responsible for thorough review of managed care contracts and comparison of such contracts against healthcare claims to identify underpayments for the assigned client.
General Purpose: Problem resolution; critical thinking; auditing; coding; billing
Essential Duties and
Responsibilities:
Research, communicate and educate others on coding changes that impact reimbursement
Identify areas of opportunity that occur as a result of a coding or billing error
Review insurance contracts to gain thorough understanding of payment methodologies
Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation
Contact insurance company to obtain missing information, explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client
Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and presentations
Maintain regular contact with necessary parties regarding claims status including payors, clients, managers, and other personnel
Build strong, lasting relationships with clients, payors and personnel
Attend client, department and company meetings
Comply with federal and state laws, company policies and procedures
Essential Skills and
Experience:
Coding certification through AAPC or AHIMA
Minimum of 1 year coding experience in an operational setting, preferably outpatient hospital
Familiarity with hospital billing guidelines and requirements
Ability to read and interpret an extensive variety of documents such as contracts, claims, medical records, EOB's, policies and procedure in written (English) and diagram form
Familiarity with CDM and its impact on reimbursement
Ability to define problems, collect data, establish facts and draw valid conclusions
Strong organization and time management skills
Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook
Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division
Strong customer service orientation
Excellent interpersonal and communication skills
Strong team player
Commitment to company values
High school diploma or equivalent
Nonessential Skills and
Experience:
Related Professional License/Certifications
Associate or Bachelor's Degree
Bottom Line Requirements:
1. Coding certification through AAPC or AHIMA.
2. Minimum of 1 year coding experience in an operational setting, preferably outpatient hospital.
3. Familiarity with hospital billing guidelines and requirements
4. Local.Estimated Salary: $20 to $28 per hour based on qualifications.
Real Careers
We are looking for a local Medical Billing and Coding Review Analyst.
Position
Summary: Primarily responsible for thorough review of managed care contracts and comparison of such contracts against healthcare claims to identify underpayments for the assigned client.
General Purpose: Problem resolution; critical thinking; auditing; coding; billing
Essential Duties and
Responsibilities:
Research, communicate and educate others on coding changes that impact reimbursement
Identify areas of opportunity that occur as a result of a coding or billing error
Review insurance contracts to gain thorough understanding of payment methodologies
Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation
Contact insurance company to obtain missing information, explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client
Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and presentations
Maintain regular contact with necessary parties regarding claims status including payors, clients, managers, and other personnel
Build strong, lasting relationships with clients, payors and personnel
Attend client, department and company meetings
Comply with federal and state laws, company policies and procedures
Essential Skills and
Experience:
Coding certification through AAPC or AHIMA
Minimum of 1 year coding experience in an operational setting, preferably outpatient hospital
Familiarity with hospital billing guidelines and requirements
Ability to read and interpret an extensive variety of documents such as contracts, claims, medical records, EOB's, policies and procedure in written (English) and diagram form
Familiarity with CDM and its impact on reimbursement
Ability to define problems, collect data, establish facts and draw valid conclusions
Strong organization and time management skills
Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook
Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division
Strong customer service orientation
Excellent interpersonal and communication skills
Strong team player
Commitment to company values
High school diploma or equivalent
Nonessential Skills and
Experience:
Related Professional License/Certifications
Associate or Bachelor's Degree
Bottom Line Requirements:
1. Coding certification through AAPC or AHIMA.
2. Minimum of 1 year coding experience in an operational setting, preferably outpatient hospital.
3. Familiarity with hospital billing guidelines and requirements
4. Local.Estimated Salary: $20 to $28 per hour based on qualifications.
|
|
 | |
