CPC Denials and Escalations Analyst (Remote)

Allied Digestive Health, LLC; Long Branch (NJ); Remote; USD 60,000 - 90,000; Full time

Job summary

An established industry player in gastroenterology is seeking a dedicated CPC Denials and Escalations Analyst to join their team. This exciting role offers the chance to work fully remote, conducting vital medical coding audits and ensuring compliance with regulatory guidelines. You'll be integral in developing policies and serving as a subject matter expert in coding and billing topics. If you have a passion for healthcare and a strong background in auditing, this is a fantastic opportunity to make a meaningful impact in a fast-growing organization that prioritizes quality patient care.

Qualifications

• 3+ years of experience in a professional audit capacity required.
• CPC, CRC, CGIC, CGOC from AAPC strongly preferred.

Responsibilities

• Conduct medical coding audits to ensure compliance with regulations.
• Prepare reports of findings and recommendations for improvement.

Skills

Medical Coding Audits

Compliance Audits

Policy Development

Subject Matter Expertise

Denials and Escalation Knowledge

Education

High School Diploma or equivalent

Tools

MS Office

MS Excel

Job description

CPC Denials and Escalations Analyst (Remote)

Join to apply for the CPC Denials and Escalations Analyst (Remote) role at Allied Digestive Health.

Allied Digestive Health is one of the largest integrated networks of gastroenterology care centers in the nation with over 200 providers and 60 locations throughout New Jersey and New York. As a fast-growing physician-led organization, our dynamic structure encourages physician input and decision-making, while simultaneously offering operational support. Our dedicated, compassionate team of providers prioritize personalized treatment plans for patients that deliver the highest quality of care. All of our doctors are board-certified in gastroenterology and hepatology. Several of them serve as chief of gastroenterology at nearby hospitals, and a number of them have been recognized as top-quality physicians in publications, including but not limited to: Best Doctors in America and Top Doctors New Jersey, and US News Health – US News & World Report.

We are excited to announce that we are looking for a Full-Time, CPC Denials and Escalation Analyst at our Corporate Office in West Long Branch, NJ. This position can be fully remote with working hours, Monday-Friday, 6:00am-2:30pm EST.

Responsibilities

• Conducting medical coding audits to evaluate compliance with regulatory guidelines.
• Conducting coding, billing, and documentation compliance audits within established timeframe. Identifies need for new policy development/changes to meet regulatory requirements.
• Preparing a report of findings and recommendations for improvement for each audit.
• Serving as a subject matter expert on coding/billing topics.
• Creating SOPs and leading Vendors.

Qualifications and Experience

• High School Diploma or equivalent.
• 3+ years of relevant experience in a professional audit capacity required.
• CPC, CRC, CGIC, CGOC from AAPC strongly preferred. If not, must be willing to obtain after hire.
• Strong technical knowledge of Institute of Internal Auditing (IIA) standards and Centers for Medicare & Medicaid Services (CMS) regulatory guidelines, including ICD-10 CM, CPT, and HCPCS Procedure Coding.
• Proficiency in MS Office products - intermediate to advanced knowledge of MS Excel.
• Knowledge of Denials and Escalation.

Job Type: Full-Time

Seniority Level

• Mid-Senior level

Employment Type

• Full-time

Job Function

• Business Development and Sales
• Industries: Medical Practices