Coding Denials Specialist - Radiology

RightReadMD; Remote; USD 50,000 - 70,000; Full time

Job summary

A leading medical billing company is seeking a Radiology Coding Denials Specialist to contribute to the success of their Coding Department. This role involves monitoring claim denials and requires 3+ years of Radiology coding experience. Successful candidates will have a high school diploma or GED, knowledge of CPT and ICD-10 coding, and must maintain active coding certification. Proficiency in Microsoft Office and strong problem-solving skills are crucial. This position is primarily clerical and sedentary, suited for someone with a meticulous work ethic.

Benefits

Competitive benefits

Career development tools

Qualifications

• 3+ years of Radiology coding experience required.
• Knowledge of CPT and ICD-10 coding as well as compliance rules.
• Must maintain required Coding Certification with CEU requirements.

Responsibilities

• Monitor coding-related claim denials.
• Implement denial process improvements.
• Attend coding department meetings and webinars.

Skills

Attention to detail

Problem-solving skills

Excellent verbal communication

Proficiency in Microsoft Office

Education

High school diploma or GED

Completed courses in medical terminology

Active coding certificate from AAPC, RCCB or AHIMA

Tools

Microsoft Office Word

Microsoft Office Excel

Microsoft Office Outlook

Job description

MSN Healthcare Solutions, LLC is a leading national medical billing and practice management company providing innovative, efficient and compliant revenue cycle services to 100+ physician group practices. Backed by a highly experienced leadership team, cutting-edge technology and a "no shortcuts" approach, MSN is a trusted partner in redefining healthcare services. We offer competitive benefits and career development tools designed to promote continued professional growth.

POSITION SUMMARY:

The Radiology Coding Denials Specialist is a key contributor to the overall success of the Radiology Coding Department. This position reports directly to the Coding Denials Manager and indirectly to the Director of the Radiology Coding Department. The primary function of this position is to monitor coding related claim denials.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements below are representative of the knowledge, skill and/or ability required.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Denial process improvements
• Clearinghouse coding rejections
• Coding denial automations
• Maintenance of LCD/NCD & medical policy library
• CMS post-payment review process tracking
• Denials coding SOP updates
• Medical necessity and down-code client feedback
• Analysis of appeals
• Denial trending
• Must maintain the required Coding Certification and complete monthly CEU requirements
• Attending Coding department meetings, to include bi-monthly webinars and annual meetings
• Other duties as assigned

EDUCATION AND WORK EXPERIENCE:

• High school diploma or GED required
• Completed course(s) in medical terminology, anatomy and physiology or related medical courses with excellent knowledge of CPT and ICD-10 coding, as well as CMS rules, LCD's and compliance as it pertains to coding
• Minimum of 3 years of Radiology coding experience required AND
• Active coding certificate from AAPC, RCCB or AHIMA, preferred. If not certified, will be required to complete certification training and obtain certification within 12 months of hire

REQUIRED KNOWLEDGE AND SKILLS:

The Coding Denial Specialist position requires constant mental alertness, attention to detail, and high degree of accuracy in completing all assignments. This position is best suited for an individual with strong problem-solving skills and an exceptional work ethic. Must be able to work well in a group setting and independently.

• Knowledge of payor policies and denials
• Proficiency with Microsoft Office Word, Excel and Outlook
• Ability to work independently and carry assignments to completion within the parameters of instruction provided, prescribed routines and standard accepted practices
• Excellent verbal and written communication skills, including ability to effectively communicate with internal and external contacts
• Must be able to work in a high-volume environment with attention to constraints to meet deadlines while maintaining positivity and professionalism

PHYSICAL REQUIREMENTS:

This position is primarily clerical and sedentary in nature. The essential functions of the position are performed in a typical office or home office environment.

• Must be able to perform the essential duties and responsibilities with or without reasonable accommodation, to include meeting qualitative and/or quantitative productivity standards
• Must be able to listen and speak clearly when using a telephone
• Ability to maintain regular punctual attendance unless protected under the provisions of the ADA, FMLA or other Federal, State or Local regulations