Specialist Inpatient Coder

Virtual Vocations Inc; United States; À distance; USD 65 000 - 90 000; Plein temps

Résumé du poste

Virtual Vocations Inc. is hiring a full-time Revenue Integrity Coding Billing Specialist to work remotely. The role focuses on reviewing and resolving Medicare and third-party payer accounts, handling pre-bill edits and denials, and ensuring accurate coding.

You will review clinical documentation to assign ICD-10, CPT, and HCPCS codes, verify medical necessity, and comply with federal and state guidelines for payer billing.

Qualifications

• 5+ years of Revenue Integrity experience.
• Proficiency in ICD-10, CPT, and HCPCS Level II coding.
• Experience applying medical necessity based on provider documentation.
• AAPC or AHIMA coding certification.
• High School Diploma or higher education may substitute for formal training.

Responsabilités

• Resolve daily claims with Revenue Integrity pre-bill edits and hold codes in the hospital billing scrubber.
• Review clinical documentation to validate and apply appropriate ICD-10, CPT, and HCPCS codes.
• Ensure compliance with Federal/State guidelines and maintain knowledge of Medicare, Medicaid, and third-party payer billing requirements.

Connaissances

Revenue Integrity

Coding & Billing

ICD-10 coding

CPT coding

HCPCS coding

Medical necessity assessment

Formation

High School Diploma

Description du poste

Providing revenue cycle support services, the full-time Revenue Integrity Coding Billing Specialist will efficiently review and resolve assigned Medicare and third-party payer accounts remotely, focusing on claim edits and denials.

Key responsibilities

• Resolve daily claims with Revenue Integrity pre-bill edits and specific hold codes in the hospital billing scrubber
• Review clinical documentation to validate and apply appropriate ICD-10, CPT, and HCPCS codes
• Ensure compliance with Federal/State guidelines and maintain knowledge of Medicare, Medicaid, and third-party payer billing requirements

Required qualifications

• High School Diploma (relevant experience may substitute formal education)
• 5+ years of Revenue Integrity experience
• AAPC or AHIMA coding certification
• Experience in ICD-10, CPT, and HCPCS Level II coding
• Proficiency in determining medical necessity based on provider documentation