Medical Appeals Coder
Company: TeamHealth
Location: Akron
Posted on: April 17, 2024
Job Description:
Join a team of dynamic, results oriented professionals! Named
among "The World's Most Admired Companies" by Fortune MagazineNamed
among "America's 100 Most Trustworthy Companies" by Forbes
magazineNamed among "Great Places to Work" by Becker's Hospital
Review
- Career Growth Opportunities
- Benefit Eligibility (Medical/Dental/Vision/Life) the first of
the month following 30 days of employment
- 401K program (Discretionary matching funds available)
- Employee Assistance Program
- Referral Program
- Dental plans & Vision plans
- GENEROUS Personal time off
- Eight Paid Holidays per year
- Quarterly incentive plans
- Employee of the month awards with monetary gift and parking
space
- Training Programs
- Wellness programs
- Flexible work scheduleJOB DESCRIPTION OVERVIEW: The Rejection
Coder is responsible for reviewing ETM denials flowing directly to
coding or reassigned to coding from other departments. ESSENTIAL
DUTIES AND RESPONSIBILITIES:
- Research denials by utilizing coding policy, payer websites, or
payer phone calls.
- Complete contractual adjustments to invoices as needed.
- Request non-routine write-offs or complete adjustment as
appropriate.
- Provide correction suggestions to other departments so the
invoice can be resubmitted.
- Provide coding direction to appeal invoices and/or submit
appeals via payer website or fax, as directed.
- Complete reconsideration letters as needed.
- Complete audit tools, if assigned.
- Other projects or tasks as directed by management.
- Proficiency in ICD-9 and ICD-10 diagnostic coding and CPT-4
procedural coding.
- Extensive knowledge of medical terminology.
- Extensive knowledge of regulatory requirements.
- Extensive knowledge of physician billing and
reimbursement.
- Effective communication skills, able to interact effectively
with all levels.
- Ability to be flexible as it relates to changes in process
and/or job duties and assignments. QUALIFICATIONS / EXPERIENCE:
- Minimum high school diploma or equivalent of experience in
physician coding and billing relate field.
- CPC or CCS-P certification preferred
- 1-2 years of previous medical coding experience, emergency
medicine experience preferredSUPERVISORY RESPONSIBILITIES:
- NonePHYSICAL / ENVIRONMENTAL DEMANDS: High production volume,
fast paced working environment. This position may require manual
dexterity and/or frequent use of the computer, telephone, 10-key,
calculator, office machines (copier, scanner, fax) and/or the
ability to perform repetitive motions and/or meet production
standards to comply with the essential functions. Also, may require
physical and/or mental stamina to work overtime, additional hours
beyond a regular schedule and/or more than five days per week.
DISCLAIMER: Cooperative, positive, courteous and professional
behavior and conduct is an essential function of every position.
All employees must be able to work with others beyond giving and
receiving instructions. This includes getting along with
co-workers, peers and management without exhibiting behavior
extremes. Job functions may require personal leadership skills such
as conflict resolution, negotiating, instructing, persuading,
speaking with others as well as responding appropriately to job
performance feedback from the supervisor. Additionally, the
information contained in this job description has been designated
to indicate the general nature and level of work performed by
employees within this classification. It is not designed to contain
or be interpreted as a comprehensive inventory of all duties,
responsibilities and qualifications required of employees assigned
to this position.
Keywords: TeamHealth, Cuyahoga Falls , Medical Appeals Coder, Healthcare , Akron, Ohio
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