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Contributes to the identification and reduction of the Company’s coding compliance risks, billing inaccuracies, and/or denials by coordinating independent reviews and assessments of the organization's professional coding and billing transactions, processes, and internal controls for coding completeness and accuracy.
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The Denials Management Specialist reviews inpatient CMS and third party denials for medical necessity and tracks outcomes regarding appeal process. Reviews all Inpatient Retroactive Denials in the Denials Management Work Queues for Medical Necessity and Late-Pick-Up/Notification that are entered by Case Management and Business Office.
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Must be familiar with health care billing and collection, general knowledge of medical records and coding compliance, Fair Debt Collection Practices Act, and legal compliance. This position is responsible for implementing and monitoring productivity standards, resolving issues, managing denials and appeals, reporting on payer performance, and ensuring adherence to Valleywise Health's policies and procedures.
$86,444 - $127,504 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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2+ years of experience with medical terminology and medical coding. Ensures timely and accurate filing of claims, performs accounts receivable management, and follows up on denials and non-payments.
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Maintains professional knowledge regarding medical billing and coding procedures, insurance carriers, federal programs, etc. Knowledge of basic medical coding and third-party operating procedures and practices.
$41,790.26 - $63,936.48 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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In addition, the Sr Coding Specialist position is responsible for reviewing, correcting and appealing coding related claim denials and mentoring and cross training Coding Specialists.
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Comprehensive knowledge of ICD-10 coding, CPT coding, HCPCS coding, modifiers, and government and commercial payer guidelines. Additional experience in insurance collections including resolution of denials and the filing of claim appeals.
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Knowledge of medical and surgical coding and billing: CPT/HCPCS, ICD-10 Codes, modifiers, etc. Thorough knowledge of ICD-10 and CPT procedure coding practices, rules and industry standards.
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2+ years of medical revenue cycle management experience; this can include experience in billing, denials management, auditing, consulting, edit configuration, edit building, and negotiations.
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Ability to review, resolve, and prevent coding denials effectively. Medical coding: 2 years (Preferred) As a Medical Coder, you will play a crucial role in accurately abstracting medical records and assigning appropriate codes, ensuring compliance with industry standards and regulations.
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This includes verification of patient information, assigning procedure and diagnosis codes, entering charges, submitting claims to insurance carriers, creating statements and posting payments and adjustments, working denials, patient collections and all aging.
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3+ years of experience in healthcare billing, coding, denials management, or revenue cycle-related role. Your responsibilities will include reviewing claims, communicating with office staff, analyzing clinical documentation, tracking denials, and serving as a coding consultant to care providers.
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Key areas of responsibility include scheduling, registration, insurance verification, financial counseling, charge master, charge capture, HIM/Coding, clinical documentation improvement, patient financial services, provision of charity, and overall collection of patient service revenues across the revenue cycle.
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If you are a dedicated professional with a passion for healthcare billing and denials management, we invite you to apply for this exciting opportunity. We are currently seeking an experienced Billing and Denials Specialist to join our revenue cycle team.
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Work from home remotely, full-time position for Certified Medical Coder. Billing office personnel are responsible for the day to day tasks of the revenue cycle of the medical practice. Family Medicine and eCW experience strongly preferred.
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