Required Skills & Experience
- 5 years minimum of Edit & Denials coding\n- Professional and facility coding.\n- Ability to operate across multiple clients.\n- Experience making changes in EHR systems\n- Experience reviewing and correcting coding edits.\n- Strong communication and collaboration skills.
Job Description
We are seeking an Edit & Denials Coder to review medical records to determine appropriate billing codes and necessary documentation. This role is responsible for performing advanced coding and appeal activities; investigating payer issues, completing charge corrections, and for timely filing of appeals to insurance companies.\n\nKey Responsibilities:\n•\tReviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse. Creates appropriate letters to substantiate the validity of claims.\n•\tMeets with facility liaison to review documentation, resolve coding, and tagging files for follow-up. Investigates and problem-solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with facility liaison or other clinical staff as needed to provide documentation feedback and to develop appeals.\n•\tResearches payer policies and processes.\n•\tReviews clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment.\n•\tWorks assigned work queues and tasks and reviews remittance advice for rejections and accuracy of payment amounts as needed. Identifies invoices or claims that have been rejected per billing edits/criteria.