Denials Management Coder (WFH)
加入 Med-Metrix 时，请享受这些特殊的福利！· 8小时班级 · 1日 HMO 与你的两个依赖者免费获得保障 · 团体生命保险 · 医疗现金补贴 · 米津贴 · 服装补贴 · 假期礼物 · 丧失援助 · 付费休息时间 · 培训和人员发展 · 员工参与活动 · 内动性工作机会 负责审查拒绝申请编码相关错误并确定适当行动。否认管理编程师将负责对个人账户进行纠正，包括 CPT 和/或 ICD-10纠正，正确修改程序的应用等。编码器还负责确保政府和当地指南得到遵守。付款人包括但不限于医疗保险，医疗补助，蓝十字和商业健康保险运营商。职责和责任 ·阅读并解释保险运输商的 EOBs. ·审查医学报告，验证编码。·解决与编码相关的否认。·做任何必要的编码纠正。·生成替代索赔 （电子和纸质）·研究运营商特定的编码政策。·审查和解释运营商 NCD 和 LCD 政策。·向编码经理传达任何编码拒绝趋势。资格 · CPC/COC 认证 AAPC 或 AHIMA 获得 CCS 认证。·与需要专业相关的编码经验至少一年 （编码拒绝）· 医疗保险和医疗补助指南知识优先。· 管理护理，商业保险，医疗保养/医疗补救金实操了解。·理解和遵守 HIPAA 和 PHI 指导方针。·强有力的人际交往技能，在组织各级沟通能力。· 高水平的完整性和可靠性，具有强烈紧迫感和结果定向；· 要求优秀的书面和口头交流技巧。· 文件和数据输入技巧。·工作时间表：主要是日班；必须灵活以满足业务需求。·身体要求：在执行这项工作的职责时，员工偶尔需要移动工作区域；坐下来；做手动任务；操作工具和其他办公设备如计算机，电脑外围设备和电话；伸展臂；跪下；说话和听力。·心理要求：员工必须能够掌握
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Experience these exceptional benefits when you join Med-Metrix!
- 8-Hour Shifts
- Day 1 HMO with 2 of your dependents covered for FREE
- Group Life Insurance
- Medical Cash Allowance
- Rice Allowance
- Clothing Allowance
- Holiday Gift
- Bereavement Assistance
- Paid Time Off
- Training and Staff Development
- Employee Engagement Activities
- Opportunities for Internal Mobility
Job Purpose Responsible for reviewing denied claims for coding related errors and determining appropriate action. The Denials Management Coder will be responsible for corrections to individual accounts with include CPT and/or ICD-10 Corrections, applications of correct modifiers, etc. The coder is also responsible for ensuring that government and local guidelines are followed. Payers include but not limited to Medicare, Medicaid, Blue Cross, and commercial health insurance carriers.
Duties and Responsibilities
- Read and interpret insurance carrier EOBs.
- Review medical reports, verify coding.
- Resolve coding related denial.
- Make any necessary coding corrections.
- Generate replacement claims (electronic and paper)
- Research carrier specific coding policies.
- Review and interpret carrier NCD and LCD policies.
- Communicate any coding denial trends to coding manager.
Qualifications
- CPC/COC certification AAPC or CCS certification from AHIMA
- Minimum one (1) year of coding experience related to the specialty needed (Coding Denials)
- Knowledge in Medicare and Medicaid guidelines preferred.
- Working knowledge of managed care, commercial insurance, Medicare/Medicaid.
- Understanding and adherence to HIPAA and PHI Guidelines.
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
- Documentation and data entry skills
- Gracious and welcoming personality for customer service interaction
Working Conditions
- Work Set-up: Work From Home
- Work Schedule: Predominantly dayshift; must be flexible to accommodate business needs.
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
- Work Environment: The noise level in the work environment is usually minimal.
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
Originally posted on Himalayas