Certified Coder/Denial Analyst

HANNIBAL REGIONAL HEALTHCARE SYSTEM INC; Hannibal (MO); On-site; USD 55,000 - 75,000; Full time

Job summary

Hannibal Regional Healthcare System Inc. is seeking a coding/billing professional to perform comprehensive reviews of denied visits to assure accurate billing and data capture. You will stay within department guidelines, rules, regulations and all billing requirements while maintaining confidentiality.

The role requires RHIT/RHIA or AHIMA/AAPC certification, deep PPS knowledge, and strong analytical skills with a focus on reimbursement policies and medical terminology.

Qualifications

• High School Diploma or equivalent.
• Professional coding certification through AHIMA or AAPC, or RHIT/RHIA with experience.
• Thorough knowledge of PPS and third‑party reimbursement.
• Knowledge of ancillary testing and medical terminology.
• Understanding of ethical coding practices and regulations.
• Ability to analyze complex financial data.
• Ability to maintain confidentiality and cooperative relationships.
• Proficiency with computer applications and encoding systems.

Responsibilities

• Collaborates with coding and billing to review denied visits for accurate billing and data capture.
• Ensure compliance with departmental guidelines, regulations, and all billing requirements.

Skills

Analytical skills

Problem solving

Financial data assessment

Confidentiality

Computer proficiency

Coding knowledge

Reimbursement policies

Ethical coding practices

Regulatory knowledge

Anatomy/physiology knowledge

Education

High School Diploma or equivalent

Professional coding certification (AHIMA/AAPC/RHIT/RHIA)

Tools

Encoding software

Billing systems

Job description

Collaborates with coding and billing department to perform a comprehensive review of the denied visit. The comprehensive review should ensure accurate billing and reimbursement and completed data capture. Stays within departmental guidelines, rules, regulations and all billing requirements.

• High School Diploma or equivalent required
• Current coding certification through AHIMA (American Health Information Management Association) or AAPC (American Academy of Professional Coders), or RHIT/RHIA with coding experience required
• Thorough knowledge of the related prospective payments systems (PPS)
• Knowledge of ancillary testing (laboratory, x-ray, EKG)
• Knowledge of anatomy, physiology and medical terminology
• Understanding of ethical coding practices and guidelines
• Knowledge of applicable federal, state and laws and regulations
• Knowledge of all aspects of third‑party reimbursement policies and practices
• Excellent analytical and problem‑solving skills
• Ability to assess and evaluate complex financial data
• Ability to maintain cooperative, working relationships, maintain friendly positive attitude, and the ability to maintain confidentiality
• Proficiency with computer applications, encoding system and ability to learn various software programs required