Senior Medical Coding Specialist: Denials & Policy

MercyHealth Javon Bea Hospital Rockton; United States; Remote; USD 33,000 - 49,000; Full time

Job summary

Mercyhealth seeks a skilled Medical Coding Specialist to review documentation and ensure accurate code assignment across outpatient and inpatient settings. You will address pre-bill edits, educate partners, and resolve complex denials using AMA and CMS guidelines.

Strong Epic billing knowledge and a track record in denial management are expected, with collaboration across departments to meet productivity goals.

Qualifications

• High School graduate or equivalent.
• Three years of experience coding professional or hospital services in outpatient or clinic setting preferred.
• Certified in professional or hospital coding (CPC, CPC-H) or other equivalent coding certification.

Responsibilities

• Review and correct discrepancies between documentation and codes; educate partners.
• Resolve pre-bill claim edits identified by claims scrubbing software.
• Educate partners on CMS policies for outpatient, inpatient, and professional coding.
• Research and resolve complex billing and denial issues per AMA, CMS and payer guidelines.
• Maintain deep knowledge of Epic billing and hospital modules.
• Collaborate with staff to meet productivity goals.

Skills

Problem solving

Communication skills

Analytical skills

Research skills

Root cause analysis

Team collaboration

Education

High school diploma

Tools

Epic billing system

Claims scrubbing software

Job description

Mercyhealth seeks a skilled Medical Coding Specialist to review documentation and ensure accurate code assignment across outpatient and inpatient settings. You will address pre-bill edits, educate partners, and resolve complex denials using AMA and CMS guidelines.

Strong Epic billing knowledge and a track record in denial management are expected, with collaboration across departments to meet productivity goals.