Invasive Coding Analyst - Ortho

Carilion Clinic

Roanoke (VA)

On-site

USD 60,000 - 80,000

Full time

14 days+

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Benefits offered by this job

Comprehensive Medical, Dental, & Vision Benefits

Employer Funded Pension Plan

Paid Time Off

Onsite fitness studios

Discounts on childcare

Continued education and training

Job summary

Carilion Clinic in Roanoke, Virginia is hiring an Invasive Coding Analyst to identify and analyze denials, recommend solutions, and educate physicians on coding requirements. The role requires a minimum of 3 years' coding proficiency and certifications like RHIT or CPC. Responsibilities include managing denial trends and improving revenue opportunities in Orthopaedic Services. Benefits include medical coverage, pension plans, and paid time off, emphasizing well-being and continued education.

Qualifications

Minimum of 3 years of demonstrated proficiency in coding required.
Licensure/certification: RHIT, RHIA, CCA, CCS, CPC, or CPC-H required.
Maintains working knowledge of computer systems used for healthcare operations.

Responsibilities

Identifies coding-related revenue and reimbursement improvement opportunities.
Assists with denial reviews and creation of denial trending reports for management.
Consults with and provides education to physicians regarding clinical documentation.

Skills

Effective oral and written communication skills

Analytical abilities

Detail-oriented

Team player

Initiative

Organizational skills

Education

High School education

Tools

Word

Excel

Job description

Job Title: Invasive Coding Analyst - Ortho

Description: The Invasive Coding Analyst identifies and analyzes denials, determines solutions and implements corrections to result in accurate processing/payment of claims. Investigates denial and coding issues as it relates to services provided and associated charges. May require a strong working knowledge of multiple payers knowing payer specific policies and procedures in order to serve as subject matter expert. Makes important decisions and determinations by the payers for claims. Works in a fast-paced, office environment with high productivity and accuracy standards that requires focus and concentration on tedious details and research. Investigates and identifies errors in billing, coding or procedures relating to patient accounts. Collaboration with leadership in recommending solutions to management related to insurance issues, departmental procedures, and operations. Retrieves and analyzes denial reports and provides recommendations based on findings.

Responsibilities

May act as coding and billing expert and resource.
Assists with denial reviews and creation of denial trending reports for management.
Identifies coding-related revenue and reimbursement improvement opportunities for Orthopaedic Services and reports these findings to management.
Consults with and provides education to physicians regarding clinical documentation as it relates to coding requirements.
Investigates and identifies errors in billing, coding or procedures relating to patient accounts.
Conducts analysis of complex accounts. Determines actions and completes action steps to resolve accounts.
Serving as a subject matter expert and provides guidance to RCM Specialists.
Collaboration with Orthopaedic Leadership in recommending solutions to management related to insurance issues, departmental procedures, and operations.
Reports any erroneous processing trends by payer to management.

What We Require

Education: High School education required.

Experience: Minimum of 3 years of demonstrated proficiency in coding required.

Licensure/certification: RHIT, RHIA, CCA, CCS, CPC, or CPC-H required.

Other Minimum Qualifications: Effective oral and written communication skills. Must be a team player with initiative, organizational skills, analytical abilities, detail oriented and the ability to work independently. Maintains working knowledge of computer systems used for healthcare operations. Must be proficient with Word, Excel and researching the web for coding and billing information. Must be able to provide own transportation for travel to other Carilion work sites.

This job description is only meant to be a representative summary of the major responsibilities and accountabilities performed by the incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Recruiter: EMILY ALLEN

Recruiter Email: efallen@carilionclinic.org

For more information, contact the HR Service Center at 1-800-599-2537.

Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 800-599-2537, 8:00 a.m. to 4:30 p.m., Monday through Friday.

For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies

Benefits, Pay and Well-being at Carilion Clinic

Carilion understands the importance of prioritizing your well-being to help you develop and thrive. That’s why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life – at work and when you’re away.

When you make your tomorrow with us, we’ll enhance your potential to realize the best in yourself. Below are benefits available to you when you join Carilion: