Guidehouse
Birmingham, AL
Medical Coding Specialist Review multi-specialty inpatient and outpatient and clinical Charge Correction requests for ICD-10, CPT and HCPCS coding for accuracy and make necessary corrections. Review LCD and NCD criteria and insurance billing guidelines. Report any changes as necessary to collections teams. Electronically file replacement claims and some payment posting as needed. M-F onsite training for approx. 3-6 months. After training hybrid with 90% being remote/working from home. High School Diploma/GED (relevant experience may be substituted for formal education) 1+ years of medical coding experience AAPC CPC or AHIMA CCS coding certification Experience in ICD-10, CPT and HCPCS Level II Coding Ability to determine medical necessity of services provided and charged based on provider/clinical documentation Knowledge, understanding and proper application of Medicare, Medicaid, and third-party payer HCFA-1500 billing and reporting requirements including resolution of CCI, MUE...