Ovationhealthcare

Compensation

Full Description

Duties and Responsibilities: • Reviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse. Creates appropriate letters to substantiate the validity of claims. • Meets with facility liaison to review documentation, resolve coding, and tagging files for follow-up. Investigates and problem-solves reimbursement issues in collaboration with other coding staff and faculty. Works directly with facility liaison or other clinical staff as needed to provide documentation feedback and to develop appeals. • Researches payer policies and processes. • Reviews clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment. • Works assigned work queues and tasks and reviews remittance advice for rejections and accuracy of payment amounts as needed. Identifies invoices or claims that have been rejected per billing edits/criteria. Knowledge, Skills, and Abilities: • Knowledge of ICD-10 and CPT Coding • Must be comfortable working with AR teams to resolve issues. • Must be able to pass a coding assessment. • Must be proficient inMicrosoft Office, including Outlook, Excel, and Teams. • Ability to multi-task and have excellent communication skills. • Must meet and maintain a 95% quality accuracy rate and productivity standards. • Must be able to apply official coding guidelines, NCCI edits, CPT Assistants, and Coding Clinics. • Must have experience working in a remote environment.