Certified Coding Specialist
TalentPath Group
 Cincinnati, OH

POSITION: Certified Coding Specialist

LOCATION: Cincinnati, OH

RELOCATION: No

SUMMARY:

Company is seeking a Coding Specialist whose primary responsibility is thorough review of managed care contracts and comparison of such contracts against healthcare claims to identify underpayments for the assigned client.

MANDATORY REQUIREMENTS UNLESS OTHERWISE NOTED AS PREFERRED:

  • Have one or more of the following certifications: Certified Coding Specialist (CCS), Registered Health Information Analyst (RHIA), Registered Health Information Technician (RHIT)
  • 2+ years of experience working with hospital claims
  • Experience with healthcare codes including CPT, HCPCS, ICD-9, ICD-10, DRG
  • Local or close enough for a short easy move


RESPONSIBILITIES:

  • Researches, communicates, and educates others on coding changes that impact reimbursement
  • Identifies areas of opportunity that occur as a result of a coding or billing error
  • Reviews insurance contracts to gain thorough understanding of payment methodologies
  • Examines claims and calculates reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation
  • Contacts insurance company to obtain missing information, explain and resolve underpayments, and arrange for payment or adjustment processing on behalf of client
  • Prepares and submits correspondence such as letters, emails, faxes, online inquiries, appeals, adjustments, reports, and presentations
  • Maintains regular contact with necessary parties regarding claims status including payors, clients, managers and other personnel
  • Supports and directs claims to all departments and client onsite analysts
  • Builds strong, lasting relationships with clients, payors, and personnel
  • Attends client, department, and Company meetings
  • Complies with federal and state laws, Company and department policies and procedures


QUALIFICATIONS:

  • Minimum 2-years of experience working with hospital claims in some capacity
  • Familiarity with hospital billing guidelines and requirements
  • Knowledge of healthcare codes including CPT, HCPCS, ICD-9, ICD-10, DRG and ability to correctly use and apply codes in an operational setting
  • Ability to read and interpret an extensive variety of documents such as contracts, claims, medical records, EOB's, policies and procedures in written (English), and diagram form
  • Familiarity with CDM and its impact on reimbursement
  • High School diploma or equivalent though college degree is preferable
  • Ability to define problems, collect data, establish facts, and draw valid conclusions
  • Strong organization and time-management skills
  • Moderate computer proficiency including working knowledge of MS Excel, Word, and Outlook
  • Ability to mathematically calculate rates
  • Strong customer service orientation with superb communication skills
  • Strong team player
  • Commitment to Company values


COMPENSATION & BENEFITS:

Competitive salary and benefits commensurate with experience and qualifications.

TO APPLY:

For immediate consideration, please send us your current resume.