Physician Coding AR Specialist – Medical Specialties
Advocate Aurora Health
full-time
Posted on:
Location Type: Remote
Location: Remote • 🇺🇸 United States
Visit company websiteSalary
💰 $26 - $39 per hour
Job Level
Mid-LevelSenior
About the role
- In collaboration with Customer Service, analyze and resolve professional coding complaints in a timely manner using correct coding and payer guidelines to ensure patient satisfaction
- Identifies and analyzes coding denials for a specific population of charges and works in collaboration with the Production Coding team
- Coordinates coding rejection data collection activities used for reporting and accountability tracking
- Identifies potential trends or knowledge concerns and opportunities for improvement and prevention
- Researches and documents applicable regulatory, coding and billing rules
- Develops standardized processes and tools for the coding production team to utilize when dealing with insurance rejections and recommendations to avoid future denials
- Works with Professional Coding Leadership to develop monthly coding update reports to continually educate and communicate coding related recommendations based on monthly findings
- Maintains up-to-date information regarding coding denials and rejections and communicates the changes accordingly
- Identifies and problem solves trends and issues
- Collaborates with department leadership clinic operations managers, system contracting team to determine preventative measures, follow-up and resolve these issues
- Communicates with and acts as a resource for others regarding coding and appeal issues
- Provides regular statistical reports to leadership regarding rejection/denial volumes, response timeliness, success rates, identified trends, and recommendations to prevent future coding rejections/denials
- Maintains up-to-date knowledge of Medicare, Medicaid and other regulatory requirements pertaining to nationally and locally (i.e., NCD, LCD) accepted coding policies and standards.
Requirements
- Typically requires 5 years of professional coding experience
- At least 3 years of payer background experience in physician revenue cycle processes, health information workflows, and reimbursement in a large, complex clinic or medical group
- Advanced training beyond High School that includes completion of an accredited or approved program in Medical Coding Specialist
- Coding Associate (CCA) certification issued by AHIMA, or Coding Specialist - Physician (CCS-P) certification issued by AHIMA, or Health Information Administrator (RHIA) registration issued by AHIMA, or Health Information Technician (RHIT) registration issued by AHIMA, or Professional Coder (CPC) certification issued by AAPC, or Specialty Coding Professional (SCP) certification issued by BMSC
- Advanced knowledge of ICD, CPT and HCPCS coding guidelines
- Advanced knowledge of medical terminology, anatomy, and physiology
- Advanced ability to identify coding discrepancies and provide recommendations for improvement
- Advanced ability to analyze trends and data and display them in a statistical reporting format
- Advanced computer skills including the use of Microsoft Office, email and exposure or experience with electronic coding systems or applications
Benefits
- Paid Time Off programs
- Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
- Flexible Spending Accounts for eligible health care and dependent care expenses
- Family benefits such as adoption assistance and paid parental leave
- Defined contribution retirement plans with employer match and other financial wellness programs
- Educational Assistance Program
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
professional codingcoding denials analysiscoding rejection data collectionregulatory coding rulesstatistical reportingICD codingCPT codingHCPCS codingmedical terminologyanatomy and physiology
Soft skills
problem solvingcollaborationcommunicationtrend analysisrecommendation developmentcustomer serviceaccountability trackingeducational communicationresourcefulnesstimeliness
Certifications
Coding Associate (CCA)Coding Specialist - Physician (CCS-P)Health Information Administrator (RHIA)Health Information Technician (RHIT)Professional Coder (CPC)Specialty Coding Professional (SCP)