Charge Corrections Medical Coder

Guidehouse; Washington (District of Columbia); Hybrid; USD 38,000 - 64,000; Full time

Job summary

Join a leading company as a Charge Corrections Medical Coder. This role requires reviewing coding accuracy for a range of medical services and ensuring compliance with billing guidelines. You will participate in onsite training before moving to a hybrid work environment. The position offers a competitive salary and benefits package.

Benefits

Medical, Rx, Dental & Vision Insurance

401(k) Retirement Plan

Tuition Reimbursement

Short-Term & Long-Term Disability

Employee Referral Program

Qualifications

• 1+ years of medical coding experience required.
• Knowledge of billing regulations including Medicare and Medicaid.
• Experience with compliance issues and coding audits.

Responsibilities

• Review clinical charge correction requests for coding accuracy.
• File replacement claims and payment postings as necessary.
• Collaborate with collections teams to report changes.

Skills

ICD-10 Coding

CPT Coding

HCPCS Coding

Medical Necessity Determination

MS Excel

Education

High School Diploma/GED

AAPC CPC or AHIMA CCS certification

Job description

Join to apply for the Charge Corrections Medical Coder role at Guidehouse

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Join to apply for the Charge Corrections Medical Coder role at Guidehouse

What You Will Do

Review multi-specialty inpatient and outpatient and clinical Charge Correction requests for ICD-10, CPT and HCPCS coding for accuracy and make necessary corrections. Review LCD and NCD criteria and insurance billing guidelines. Report any changes as necessary to collections teams. Electronically file replacement claims and some payment posting as needed. M-F onsite training for approx. 3-6 months. After training hybrid with 90% being remote/working from home

Job Family

General Coding

Travel Required

None

Clearance Required

None

What You Will Do

Review multi-specialty inpatient and outpatient and clinical Charge Correction requests for ICD-10, CPT and HCPCS coding for accuracy and make necessary corrections. Review LCD and NCD criteria and insurance billing guidelines. Report any changes as necessary to collections teams. Electronically file replacement claims and some payment posting as needed. M-F onsite training for approx. 3-6 months. After training hybrid with 90% being remote/working from home

What You Will Need

• High School Diploma/GED (relevant experience may be substituted for formal education)
• 1+ years of medical coding experience
• AAPC CPC or AHIMA CCS coding certification
• Experience in ICD-10, CPT and HCPCS Level II Coding
• Ability to determine medical necessity of services provided and charged based on provider/clinical documentation
• Knowledge, understanding and proper application of Medicare, Medicaid, and third-party payer HCFA-1500 billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims
• Ability to determine accurate medical codes for diagnoses, procedures and services performed in the emergency department, inpatient and outpatient settings. For example: emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology, imaging, and laboratory), and outpatient therapies (physical therapy, occupational therapy, speech therapy, and chemotherapy.)
• Knowledge of current code bundling rules and regulations along with ability on issues of compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG’s
• Ability to recognize trends and voice them to management to be addressed on the front-end
• Ability to produce correct, assigned work product within specified periods
• Ability to use MS Excel
  
  

What Would Be Nice To Have

• 5 years’ experience in Revenue Integrity Coding and Billing
• Knowledge and understanding of physician charge description master coding systems and structures.
• Physician medical billing and auditing experience
  
  

The annual salary range for this position is $38,000.00-$64,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits Include

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program
  
  

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [e-mail]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [e-mail]. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact [e-mail]. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Business Consulting and Services

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