Returned Claims Coding Specialist (Remote)

Coronis Health; North Augusta (SC); Remote; USD 60,000 - 80,000; Full time

Job summary

Join a forward-thinking company as a Returned Claims Coding Specialist, where your expertise will enhance claim processing for FQHC-focused medical billing clients. In this full-time role, you will analyze returned claims, identify trends, and work closely with various stakeholders to minimize errors and improve client outcomes. Your contributions will play a crucial role in delivering exceptional service and fostering continuous improvement. This position offers a dynamic environment where your analytical and organizational skills will shine, making a meaningful impact in the healthcare billing landscape.

Qualifications

• Professional coding certification (e.g., CPC, CCA, CCS, CCS-P) required.
• Minimum of 2 years of work experience in an office setting, preferably in medical billing.

Responsibilities

• Review returned claim files to identify coding issues and trends.
• Collaborate with account managers to understand coding requirements.

Skills

Analytical Skills

Organizational Skills

Communication Skills

Education

High School diploma or equivalent

Associate's degree

Bachelor's degree

Tools

Microsoft Office Suite

Medical billing software

Job description

Returned Claims Coding Specialist (Remote)

Returned Claims Coding Specialist - FQHC

Location

Remote- USA

Reports to

Director, Revenue Cycle Operations

FLSA Classification

Non-Exempt

Full-Time or Part-Time:

Full-Time

Salary Range

$24 - $28

Starting pay varies based on location and experience, in compliance with specific state wage regulations. Competitive rates tailored to your geography and expertise.

Position Overview

As a Returned Claims Coding Specialist at Coronis Health, you will play a vital role in improving claim processing outcomes for our FQHC-focused medical billing clients. You will analyze returned claims, identify trends, and collaborate with account managers, the coding team, and other stakeholders to develop strategies to minimize claim errors. Your work will directly impact our commitment to delivering exceptional service and outcomes for our clients.

Key Responsibilities

1. Review returned claim files to identify coding issues, missing information, or system errors.
2. Track and analyze claim trends to determine recurring problems.
3. Respond to inquiries regarding inappropriate coding, denials, and billable services.
4. Prepare and distribute monthly summaries of returned claims trends for clients.
5. Collaborate with the Director of FQHC Compliance, Coding, & Client Regulatory Education to provide targeted education sessions.
6. Partner with account managers to understand payor-specific policies, coding requirements, and claims processing rules.
7. Maintain detailed records of returned claims trends, root causes, and corrective actions.
8. Provide regular reports to internal stakeholders to drive continuous improvement.
9. Assist in developing workflows to reduce returned claims and enhance coding accuracy.

Qualifications

1. High School diploma or equivalent required; Associate's or Bachelor's degree preferred.
2. Professional coding certification (e.g., CPC, CCA, CCS, CCS-P) required.
3. Minimum of 2 years of work experience in an office setting, with medical billing experience preferred.
4. Knowledge of medical coding and billing systems, as well as regulatory compliance requirements.
5. Strong analytical, organizational, and communication skills.
6. Proficiency in Microsoft Office Suite and familiarity with medical billing software.

Additional Information

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.

Coronis Health is committed to creating a diverse and inclusive environment where all employees are treated fairly and with respect. We are an equal-opportunity employer, providing equal opportunities to all applicants and employees regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or any other protected characteristic. We welcome and encourage applications from candidates of all backgrounds.