Coder, Denials

Job Purpose

The Coder utilizes coding skills to work invoice reviews and provide expert advice to billing staff.

Duties and Responsibilities

• Conduct audits and coding reviews to ensure all documentation is accurate and precise including our co source partners
• Assign and sequence all CPT and ICD-10 codes for services rendered when required
• Work with billing staff and system WQ’s to ensure proper payment of claims
• Comply with all Medicare policy requirements including coding initiatives and guidelines
• Work independently from assigned work queues
• Maintain confidentiality at all times
• Maintain a professional attitude
• Other duties as assigned by the management team
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications

• CPC certification AAPC or CCS certification from AHIMA
• High School graduate or equivalent
• Minimum two years of coding experience related to the specialty needed (IP DRG, OP, Denials, SDS, etc.)
• Knowledge of Microsoft Word, Outlook, Excel
• Must be able to use job-related software
• Surgical coding experience a plus
• Strong interpersonal skills, ability to communicate well at all levels of the organization
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results oriented 
• Excellent written and verbal communication skills required
• Gracious and welcoming personality for customer service interaction

Working Conditions

• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.