MULTISPECIALTY DENIALS CODING SPECIALIST

Professional Credit Service; United States; Remote; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health insurance

Dental & vision Insurance

401k plan

Job summary

Ensource RCM is seeking a Multispecialty Denials Coding Specialist for a full-time remote role serving hospitals and health systems nationwide. The role involves reviewing documentation, applying coding guidelines for professional services, and researching payer denials to prepare detailed appeals and follow-up on outstanding claims.

Ideal candidates have 2+ years in profee multispecialty/E&M coding, 5+ years in physician denials, and proficiency in MS Office and Athena.

Qualifications

• Proficiency with MS Office Suite and Athena software.
• Profee multispecialty, E/M coding: 2 years of experience.
• Physician based Denials: 5+ years of experience.

Responsibilities

• Review documentation and coding guidelines for professional fee-based coding.
• Research payer denials and submit appeals.
• Submit retro-authorizations in response to payor denials.
• Demonstrate knowledge of insurance billing procedures and root-cause analysis.
• Ensure revenue is captured and denials are minimized.

Skills

Denials coding

MS Office

Athena software

E/M coding

Education

CPC Certification

CCS

RHIT

Job description

Ensource RCM partners with hospitals, physician groups, health systems, and legal teams nationwide to deliver trusted revenue cycle management solutions.We recognize and understand some of the challenges and feelings of isolation that can come with remote work, so we’ve dialed in on what makes working remotely successful for our valued employees.What you'll do:The Multispecialty Denials Coding Specialist will review documentation and coding guidelines for professional fee-based coding, evaluation and management services, procedures, and diagnoses. Researching claim denials, submitting appeals, following up on outstanding claims, and handling claims correspondence. This is a full-time remote opportunity.Essential Job duties and Responsibilities:Research payer denials related to referral, pre-authorization, eligibility/registration, notifications, medical necessity, non-covered services, and billing resulting in denials and delays in payment.Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines as well as client’s policies and procedures.Submit retro-authorizations in accordance with payor requirements in response to authorization denials.Demonstrate knowledge and understanding of insurance billing procedures as evidenced by the identification of root-causes of claim issues and proposed resolutions to ensure timely and appropriate payment.Ensure appropriate revenue is captured; to prevent federal and payer audits, malpractice litigation, and health plan denials.Requirements:Proficiency with MS Office Suite and Athena softwareProfee multispecialty, E/M coding: 2 yearsPhysician based Denials: 5+ years(AAPC) CPC and/or (AHIMA) CCS, CCS-P, or RHIT certificationKnowledge of medical terminology, insurance and appeals processes, and medical record managementHigh level of accuracy and attention to detailStrong written and verbal communication skillsReasons to Join Our Team:Flexible schedules to balance your work and personal goalsRemote working environment with virtual team socials and collaboration opportunitiesGrowth potential, both personally and professionallyGreat benefits (health, dental & vision Insurance)We offer a traditional 401k/Roth Plan with discretionary matching.Paid Time Off for Full-Time and Part-Time EmployeesYearly Stipend for Educational CEU ResourcesPaid Volunteer and Community Outreach Program that allows you to ‘help others’ in the communityThis is a full-time remote job opportunity.Apply today to get your career started with Ensource!