Medical Coding & Payment Recovery Specialist

Dignity Health; Phoenix (AZ); On-site; USD 69,781,000 - 103,699,000; Full time

Job summary

Dignity Health Medical Group in Phoenix, AZ is seeking a Payment Recovery Specialist to review records for coding errors and correct diagnostic and procedural codes in the billing system to optimize reimbursement. You will analyze denial trends and communicate payer and system insights to management.

The role requires a strong knowledge of ICD-10-CM, CPT, HCPCS, and modifiers, with a focus on accurate, compliant billing and timely issue resolution.

Qualifications

• High School graduate required.
• Three (3) years prior experience in medical coding and/or billing for physician office services.
• Proficiency assigning ICD-10-CM, CPT, HCPCS and modifiers.
• Certified Professional Coder (CPC).
• CPC-HA certified.
• CPCA certified.
• CCA certified.
• CCC certified.
• CCS certified.
• CCS-P certified.
• RHIA certification.
• Ability to read and comprehend an EOB.
• Proficient in guidelines, CCI, LMRP, coding, use of modifiers.
• Ability to research CPT/ICD-10 codes to bill appropriately.
• Proficient in all aspects of reimbursement (benefit investigations, payer reimbursement policies, regulatory and administrative rules).
• Adept in physician and insurance reimbursement and billing concepts and procedures, as well as laws and regulations affecting payment compliance, denials and appeals recovery.
• Proficient understanding of medical coding systems affecting the adjudication of claims payment.

Responsibilities

• Utilizes Centricity and related modules to obtain, analyze and interpret coding denials and other reimbursement data to support compliance and billing concepts and procedures.
• Manages and corrects denied claims for coding issues to facilitate payment and resolution.
• Ensures all coding corrections reflect services provided, dates of service, provider identity, and accurate diagnosis.
• Analyzes, investigates and follows up on denied claims; manages denial work files and addresses denials timely.
• Reviews and adheres to Dignity Health coding policies and procedures.

Skills

ICD-10-CM

CPT

HCPCS

Modifiers

CPC

CPC-HA

CPCA

CCA

CCC

CCS

CCS-P

RHIA

EOB reading

Denials analysis

Reimbursement rules

Coding compliance

Education

Associates degree

Job description

Dignity Health Medical Group in Phoenix, AZ is seeking a Payment Recovery Specialist to review records for coding errors and correct diagnostic and procedural codes in the billing system to optimize reimbursement. You will analyze denial trends and communicate payer and system insights to management.

The role requires a strong knowledge of ICD-10-CM, CPT, HCPCS, and modifiers, with a focus on accurate, compliant billing and timely issue resolution.