Job Description
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Position Summary To accurately code all Physician Office and Hospital charges from all departments supported by the Ambulatory CBO while reducing the number of edits and denials to claims. The coding specialist will be responsible to ensure accurate coding for all services including, but not limited to procedures and surgeries. Responsible for ensuring quality and compliance as it relates to coding and insurance industry practices. Responsibilities will range from limited surgical involvement to major surgical involvement.
Accountabilities - Accurately code charges for input into the Practice Management System within 72 business hours of receipt.
- Identify incomplete routers and return them to the provider for completed coding.
- Reviews all claim edits related to charge entry requirements and corrects the error(s) within 48 business hours.
- Reviews claims for required documentation attachments and retrieves the information from the E.H.R or requests copies from the provider.
- Utilizes online services for patient eligibility review, claim status, prior authorizations, and payor requirements.
- Knows and follows all billing regulations and corporate compliance plans.
- Performs accurate charge entry if indicated and/or works in conjunction with charge entry staff to assure accurate charge entry.
- Provide feedback to management on issues that impede timeliness or quality of billing and work with management to resolve.
- Maintains current payor knowledge for effective claims management and follow up of unresolved claims.
- Routinely reviews workflows for process improvement and efficiencies and provides feedback to management for implementation of changes.
- Independently reviews assigned workloads and completion to ensure goals are being met.
- Acts as a resource for staff.
- Assist management with training new staff.
- Perform other duties as assigned.
Location: Remote REQUIRED QUALIFICATIONS
Education: Must have a high school diploma or equivalent. Skills: Must be able to pass internal coding test and 10-key test. Years of Experience: One (1) to five (5) years of previous coding experience or coding certification Certification: CPC, RHIT or RHIA certification required, or must obtain within 90-day probationary period.
Preferred experienced: surgery coding
We offer a competitive benefits package with coverage effective day one of employment which includes medical, dental, vision, company paid life insurance, paid time off, a 401k retirement plan, an employee assistance program and other voluntary coverage options and employee discounts.
Salary Range: $35,360 - $68,536
The above list of accountabilities is intended to describe the general nature and level of work performed by the incumbent; it should not be considered exhaustive.
ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio. For more information, please visit
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org
Equal Opportunity Employer/Drug-Free Workplace
Requisition ID: 92963
Job Tags
Full time, Remote job,