Reimbursement specialist Jobs in Charlotte, NC

Salary : $26.10-$39.15 / hour

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Advocate Health offers a comprehensive suite of Total Rewards : benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more so you can live fully at and away from work, including :

Compensation

Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and / or training

Premium pay such as shift, on call, and more based on a teammate's job

Incentive pay for select positions

Opportunity for annual increases based on performance

Benefits and more

Paid Time Off programs

Health and welfare benefits such as medical, dental, vision, life, andShort- and Long-Term Disability

Flexible Spending Accounts for eligible health care and dependent care expenses

Family benefits such as adoption assistance and paid parental leave

Defined contribution retirement plans with employer match and other financial wellness programs

Educational Assistance Program

Job Summary

Performs coding duties of high complexity, judgment, and scope. Independently able to interpret and analyze documentation and assign all relevant coding rationale.

Essential Functions

• Subject matter expert in multiple areas of coding, e.g., surgical coding (not including primary care procedures).
• Assigns CPT and ICD codes in cases of high complexity, judgment and scope.
• Reads, interprets and assigns CPT codes from provider documentation, e.g., operative report.
• Performs ICD and CPT coding of provider (professional) services and verifies that all requisite charge information is entered.
• Appends all modifiers.
• Ranks CPT codes when multiple codes apply.
• Assigns Evaluation and Management (E / M) codes.
• Performs reconciliation process to ensure all charges are captured.
• Processes automated or manually enters charges into applicable billing system.
• Researches and analyzes coding and payer specific issues.
• Adheres to department guidelines for timeliness of processing charges and communicates with team members and practice management on an ongoing basis to ensure these guidelines are met.
• Mentors teammates and coach providers on documentation improvement.

Physical Requirements

Works in a fast-paced office / hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.

Education, Experience and Certifications

High School Diploma or GED required. Minimum of five years of coding experience required. CPC or equivalent coding credential required. Effectively communicates, either verbally or in writing, with providers related to coding issues that are of high complexity. Including face to face interaction, explaining coding rationales, and education with providers. Maintain coding certification (CPC, CCS, RHIT, RHIA). Extensive knowledge of coding, medical terminology, anatomy, and physiology. Extensive knowledge of and the ability to apply the payer specific rules regarding coding, bundling, and adding appropriate modifiers. In depth knowledge of claim editing rationale and revenue cycle. Basic knowledge of Relative Value Units. Understanding of and familiarity with regulatory guidelines including NCDs and LCDs. Excellent written and verbal communication skills.

3-5 years of experience preferred in denial management and appealing coding related denials

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