Denial Resolution Certified Coder

Hannibal-Regional-Healthcare-System; Hannibal (MO); On-site; USD 32,000 - 51,000; Full time

Job summary

Hannibal-Regional-Healthcare-System is seeking a medical billing coder reviewer to collaborate with coding and billing teams. The role focuses on comprehensive reviews of denied visits to ensure accurate billing, reimbursement, and complete data capture while adhering to all guidelines and regulations.

The ideal candidate will have a high school diploma and current coding credentials (AHIMA/AAPC or RHIT/RHIA) with PPS knowledge and strong analytical skills.

Qualifications

• High School Diploma or equivalent required.
• Current coding certification through AHIMA or AAPC, or RHIT/RHIA with coding experience required.
• Thorough knowledge of prospective payment systems (PPS).
• Knowledge of laboratory, x-ray, EKG concepts.
• Understanding of anatomy, physiology and medical terminology.
• Adherence to ethical coding practices and guidelines.
• Knowledge of federal, state laws and regulations related to coding.
• Familiarity with third-party reimbursement policies and practices.
• Excellent analytical and problem-solving skills.
• Ability to analyze complex financial data.
• Ability to maintain confidentiality and collaborate well with teams.
• Proficiency with computer applications and encoding systems.

Responsibilities

• Collaborates with coding and billing department to perform a comprehensive review of the denied visit.
• The review ensures accurate billing, reimbursement and complete data capture.
• Adheres to departmental guidelines, rules, and all billing requirements.

Skills

Analytical skills

Problem solving

Confidentiality

Financial data analysis

Cooperative relationships

Education

High School Diploma or equivalent

AHIMA/AAPC certification or RHIT/RHIA

Tools

Coding software

Job description

Hannibal-Regional-Healthcare-System is seeking a medical billing coder reviewer to collaborate with coding and billing teams. The role focuses on comprehensive reviews of denied visits to ensure accurate billing, reimbursement, and complete data capture while adhering to all guidelines and regulations.

The ideal candidate will have a high school diploma and current coding credentials (AHIMA/AAPC or RHIT/RHIA) with PPS knowledge and strong analytical skills.