Coding Reimbursement Specialist Senior Revenue Cycle Atrium Health - REMOTE

Atrium Health; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

A leading health system is seeking candidates for the role of Enterprise Revenue Cycle - PFS: Quality and Analytics. The position requires extensive coding experience, focusing on hospital-based outpatient coding, post-claim denials, and the ability to mentor others. Ideal candidates will possess strong communication skills and coding certification. This role offers competitive compensation and benefits in a fast-paced healthcare environment.

Benefits

Paid Time Off programs

Health and welfare benefits

Flexible Spending Accounts

Educational Assistance Program

Qualifications

• Minimum of five years of coding experience required.
• Extensive knowledge of coding, medical terminology, anatomy, and physiology.
• Maintain coding certification (CPC, CCS, RHIT, RHIA) and understand regulatory guidelines.

Responsibilities

• Subject matter expert in multiple areas of coding, assign CPT and ICD codes.
• Perform reconciliation process to ensure all charges are captured.
• Mentor teammates and coach providers on documentation improvement.

Skills

Hospital-based OP coding experience

Post-claim denials expertise

Strong communication skills

Mentorship ability

Education

High School Diploma or GED

CPC or equivalent coding credential

Job description

Position

10286 Enterprise Revenue Cycle - PFS: Quality and Analytics

Job Details

Status: Full time

Benefits Eligible: Yes

Hours Per Week: 40

Schedule Details/Additional Information: M-F

Looking for candidates that have hospital-based OP coding experience, post-claim denials and ideally Epic. Strong focus on claim denials.

Pay Range

$26.10 - $39.15

Essential Functions

• Subject matter expert in multiple areas of coding, e.g., surgical coding (not including primary care procedures).
• Assign CPT and ICD codes in cases of high complexity, judgment and scope.
• Read, interpret and assign CPT codes from provider documentation, e.g., operative report.
• Perform ICD and CPT coding of provider (professional) services and verify that all requisite charge information is entered.
• Append all modifiers.
• Rank CPT codes when multiple codes apply.
• Assign Evaluation and Management (E/M) codes.
• Perform reconciliation process to ensure all charges are captured.
• Process automated or manual entry of charges into applicable billing system.
• Research and analyze coding and payer-specific issues.
• Adhere to department guidelines for timeliness of processing charges and communicate with team members and practice management to ensure these guidelines are met.
• Mentor teammates and coach providers on documentation improvement.

Physical Requirements

Works in a fast-paced office/hospital environment. Work consistently requires sitting and some walking, standing, stretching, and bending.

Education, Experience and Certifications

High School Diploma or GED required. Minimum of five years of coding experience required. CPC or equivalent coding credential required. Effectively communicates, either verbally or in writing, with providers related to coding issues that are of high complexity, including face-to-face interaction, explaining coding rationales, and education with providers. Maintain coding certification (CPC, CCS, RHIT, RHIA). Extensive knowledge of coding, medical terminology, anatomy, and physiology. Extensive knowledge of and the ability to apply payer-specific rules regarding coding, bundling, and adding appropriate modifiers. In-depth knowledge of claim editing rationale and revenue cycle. Basic knowledge of Relative Value Units. Understanding of and familiarity with regulatory guidelines including NCDs and LCDs. Excellent written and verbal communication skills.

Commitment to You

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in career development and more.

Compensation

• Base compensation listed within the pay range based on qualifications, skills, relevant experience, and/or training.
• Premium pay such as shift, on-call, and more based on job.
• Incentive pay for select positions.
• Opportunity for annual increases based on performance.

Benefits and more

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and short- and long-term disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. It serves nearly 6 million patients and employs 155,000 teammates across 69 hospitals and over 1,000 care locations.

Note

Performs coding duties of high complexity, judgment, and scope. Independently able to interpret and analyze documentation and assign all relevant coding rationale.