4 certified professional coder representative jobs found

Description At CrescentCare, we bring caregivers and the community together as partners in health and wellness for all. Our experience builds on more than 40 years of impact. In 2014, we became a Federally Qualified Health Center to offer an expanded range of health and wellness services for anyone and everyone who is seeking healthcare services in Greater New Orleans and Southeastern Louisiana.   Our Mission Strengthening our entire community through whole-person healthcare and education.   Position Summary This position is responsible for managing all aspects of the revenue cycle functions for CrescentCare a Federally Qualified Health Center.  These functions include, but are not limited to, claims submissions, managing denials and rejections, coding services, payment recording, credentialing services and collections.  This position is responsible for ensuring compliance with insurance billing and coding standards (Medicare, Medicaid,...

The position audits and reports on the accuracy of procedural billing, payment consideration and accuracy in reimbursement based on the correct interpretation and application of codes, modifiers and payment rules. The incumbent reviews and audits physician and institutional billing from multiple departments and entities across the organization, and assists in training departmental personnel in correct coding and documentation. This position is not responsible for providing patient care. Responsibilities Essential Functions Performs audits and reports on the accuracy of procedure coding, facility E&M coding, ICD-10 coding and billing. Reviews insurance payments for reimbursement accuracy, which is based on correct interpretation of clinical data and application of codes, modifiers and payment rules. Reviews and audits institutional coding and billing from multiple departments and entities across the organization. Assists in training personnel in...

Candidates must be able to work on-site. This position is not remote. GENERAL PURPOSE OF JOB: The Claims and Appeals Specialist II is a certified medical coder that performs audits for correct coding and claims payments and oversees the claims appeal process for provider and member appeals. This position also investigates Coordination of Benefit (COB) claims. The Claims and Appeals Specialist II reports to the Director of Claims Oversight. ESSENTIAL DUTIES AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate...