Precision Denials Coder: Claims & Appeals Expert

CHI; Omaha (NE); On-site; USD 28,000 - 39,000; Full time

Job summary

CHI Health Clinic is seeking a Medical Coder to ensure precise communication with insurance companies so services are documented correctly and payments are processed efficiently.

Every day you will translate patients’ medical records into ICD-10 and CPT codes, maintain compliant documentation, and apply coding standards and regulations.

The role emphasizes detailed chart reviews, interaction with providers, and timely resubmissions and appeals to optimize outcomes.

Qualifications

• High School Graduate General Studies and 1+ years coding experience, upon hire
• High School GED Generals Studies and 1+ years coding experience, upon hire
• Associates Other in related field and Insurance follow up experience, upon hire
• Completion of college level courses in medical terminology, anatomy and physiology, disease processes and pharmacology., upon hire
• Completion of ICD-10 or CPT coding course., upon hire
• Certified Professional Coder, upon hire or
• Certified Professional Coder Hospital Apprentice, upon hire or
• Certified Professional Coder Apprentice, upon hire or
• Certified Coding Associate, upon hire or
• Cardiology Coding, upon hire or
• Certified Coding Specialist, upon hire or
• Certified Coding Specialist - Physician Based, upon hire or
• Certified Cardiovascular and Thoracic Surgery Coder, upon hire or
• Certified Health Care Compliance, upon hire or
• Certified Interventional Radiology Cardio Coder, upon hire or
• Certified Professional Coder Hospital, upon hire or
• Radiology Certified Coder, upon hire or
• Registered Health Information Administrator, upon hire or
• Registered Health Information Technician, upon hire

Responsibilities

• Applies a thorough understanding/interpretation of EOBs and remittance advice to ensure correct payment
• Communicates with providers to explain balance outstanding, denied or underpaid using EOB-based reasoning
• Review patient medical records, change coding based on documentation to include diagnosis codes, modifiers, place of service
• Resubmits claims with necessary information when requested
• Identifies trends and conducts staff training to address issues
• Escalates issues through defined channels when assistance is needed

Skills

Attention to detail

Communication skills

Medical coding experience

Education

High School Diploma

CDI/Coder certification

Certified Professional Coder

Certified Professional Coder Hospital Apprentice

Certified Coding Specialist

Certified Coding Specialist - Physician Based

Radiology Certified Coder

Registered Health Information Administrator

Registered Health Information Technician

Job description

CHI Health Clinic is seeking a Medical Coder to ensure precise communication with insurance companies so services are documented correctly and payments are processed efficiently.

Every day you will translate patients’ medical records into ICD-10 and CPT codes, maintain compliant documentation, and apply coding standards and regulations.

The role emphasizes detailed chart reviews, interaction with providers, and timely resubmissions and appeals to optimize outcomes.