Certified Coding Specialist (CPC)
TalentPath Group
 Crescent Springs, KY

POSITION: Certified Coding Specialist (CPC)

LOCATION: Crescent Springs, KY

SUMMARY:

Primarily responsible for thorough review of managed care contracts and comparison of such contracts against healthcare claims to identify underpayments for the assigned client.

DUTIES:

  • Research, communicate, and educate others on coding changes that impact reimbursement
  • Identify areas of opportunity that occur as a result of a coding or billing error
  • Review insurance contracts to gain a thorough understanding of payment methodologies
  • Examine claims and calculate reimbursement based on contract terms to determine the accuracy of payment through the use of various reports and supporting documentation
  • Contact insurance company to obtain missing information, explain and resolve underpayments, and arrange for payment or adjustment processing on behalf of client
  • Prepare and submit correspondence such as letters, emails, faxes, online inquiries, appeals, adjustments, reports, and presentations
  • Maintain regular contact with necessary parties regarding claims status including payors, clients, managers, and other personnel
  • Support and direct claims to all departments and client onsite analysts
  • Build strong, lasting relationships with clients, payors, and personnel
  • Attend client, department, and Company meetings
  • Comply with federal and state laws and Company and department policies and procedures
  • Keep informed of new products and developments
  • Request orders for replacement parts
  • Perform a variety of marginal duties not listed, to be determined and assigned as needed
  • Identify, troubleshoot, and resolve hardware, software, and basic network related problems encountered by end-users of the network
  • Have a basic understanding of IPV4 and how to assign a computer an IP address


REQUIREMENTS:

  • Minimum 3 years of experience working with hospital claims in some capacity
  • CPC Coding certification
  • 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
  • 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
  • Mathematical skills: ability to calculate rates using addition, subtraction, multiplication, and division
  • Strong customer service orientation
  • Excellent interpersonal and 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 and most up-to-date resume.