Revenue & Coding Analyst - Radiology - (Medical coding experience needed) *AVAILABLE TO WORK R[...]

Yale New Haven Health; New Haven (CT); Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented Revenue and Coding Analyst to ensure accurate charge posting and reconciliation in a dynamic healthcare environment. This role involves monitoring and tracking charges in the EMR system, collaborating with various departments to resolve billing issues, and performing audits to optimize reimbursement. The ideal candidate will have a strong background in medical coding, excellent communication skills, and the ability to thrive in a fast-paced setting. Join a team dedicated to patient-centered care and make a significant impact on financial accuracy and efficiency.

Qualifications

• 3-5 years experience in Medical Coding with knowledge of Third Party payer requirements.
• Must be a Certified Professional Coder with relevant education or experience.

Responsibilities

• Reconciles and monitors all charge adjustments and identifies late charges.
• Ensures Imaging Exam codes in EPIC have appropriate CPT and EAP Codes.

Skills

Medical Coding

Communication Skills

Organizational Skills

Interpersonal Skills

Customer Service

Education

Associate degree in Secretarial Science, Business, or Healthcare

Certified Professional Coder

Tools

EPIC

Job description

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

Responsible for ensuring all charges from the Diagnostic Radiology have been appropriately prepared for posting on the patient's account. Working closely with the Business Services manager, this individual is accountable for the reconciliation of charge code exceptions on a daily basis. In addition, this position is responsible for monitoring and tracking all charges that have been released in the EMR (EPIC) for Billing and Coding. Investigates, reconciles, and follows up on all accounts being held in Work queues as Billing errors. Any variances are identified and reconciled in collaboration with Patient Financial Services, Revenue and Reimbursement, and the Hospital Billing Office. Individual works directly with Revenue and Reimbursement for updating, initiating, and auditing Revenue codes to ensure the appropriate CPT code has been assigned. The Revenue and Coding analyst works with Imaging managers and supervisors in reconciling and tracking Billing and Coding Edits and Denials for Imaging procedures ensuring optimal reimbursement. Works collaboratively with the Professional Billing leadership and coding team(s) to ensure the codes match for the Imaging procedure performed and the professional interpretation of the procedure. Understands and follows up on all Imaging procedures that have been assigned Modifiers that may impact reimbursement. Reviews and handles interventional procedures performed within Diagnostic Radiology, e.g., Breast Imaging procedures, Spine Injections, aspirations, etc., to ensure all codes have been appropriately assigned for optimum reimbursement under the direction of the Lead.

EEO/AA/Disability/Veteran

Responsibilities

• Reconciles and monitors all charge adjustments.
• Identifies late charges as identified in EPIC.
• Ensures Imaging Exam codes in EPIC have appropriate CPT and EAP Codes.
• Reviews exam charge edits or denials as identified by billing, coding, and/or revenue reimbursement.
• Reviews and documents Imaging charges released from EPIC Daily.
• Ensures all Work queues have been processed.
• Performs quarterly audits as identified by the Lead.

Qualifications

EDUCATION

Must be a Certified Professional Coder with an Associate degree in Secretarial Science, Business, or Healthcare related field required or equal number of years experience in a Healthcare / Third party payer environment.

EXPERIENCE

Minimum 3 to 5 years experience in Medical Coding with an understanding of Third Party payor requirements, Medicare Medical Necessity, LCDs, and ABNs.

SPECIAL SKILLS

Excellent telephone communications, interpersonal, coordination, and organizational skills. Ability to read computer screens, forms, and other documents and follow written and oral instructions. Moderate keyboarding skills. Ability to work in a fast-paced, changing environment. Ability to respond to unpredictable, changing situations and needs (including clinical crises in the section and otherwise stressful situations and interactions) with professionalism, good judgment, and ALWAYS excellent customer relation skills. Prior customer service coordination or clinical experience necessary. Excellent communication and people skills. Individual must be articulate and confident in both oral and written communications. Ability to remain calm and professional in high-stress situations.

PHYSICAL DEMAND

Primarily sedentary work sitting within typical office setting without exposure to adverse environmental conditions. Requires occasional ability to lift, push, and pull objects such as files and office supplies up to 30 pounds and/or continuously up to 10 pounds; and occasional moving about on foot to accomplish tasks, walking long distances or moving from one work site to another. Continuous use of telephones requiring ability to hear and speak to convey detailed or important instructions accurately, loudly, or quickly; and continuous use of computer and other office equipment requiring fingering and excellent keyboarding skills.

YNHHS Requisition ID

143444