Medical Coding/APC Analyst/CPC Coder
|February 20, 2013 - May 20, 2013|
|Location:||Salt Lake City, UT|
|Benefits:||Medical, Dental, Life, Disability, Flex Spending, 401K, Paid Time Off, Paid Holidays, EAP Program, Flexible schedule|
|Employment Type:||Full Time|
|Description:||Review hospital and physician claims for correct assignment of billing codes to assure compliance with payer and government standards by performing the following duties.|
|Duties:||1. Evaluates pre or post payment outpatient claims for coding/pricing errors using the accurate HCPCS, ICD-9-CM, and CPT codes. |
2. Works cross functionally with other departments to investigate questionable data, elicit information, and correct errors or omissions on the claims.
3. Works with clients on special projects and prepares written reports on findings.
4. Acts as a guide in answering outpatient/physician coding appeal questions.
5. Investigates data errors to improve product development.
6. Prepares revenue reports for management teams.
7. Serves as the Subject Matter Expert (SME) for the outpatient/physician coding service line.
8. Utilizes official coding guidelines and resources as required including CMS directives and bulletins.
1. Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).
2. Three to five years claims/coding experience.
3. Musts have prior experience with APC coding.
4. Bachelor's degree (B. A.) from four-year college or university preferred.
1. Broad knowledge of all coding type edits and associated reimbursement structures.
2. Advanced proficiency with medical terminology, medical procedures, medical conditions and illness and treatment practices.
3. Extensive experience in principles of coding and guidelines; federal/state regulations and policies pertaining to documentation, coding and billing.
4. Experience in applying compliance coding and auditing principles as they relate to billing.
5. Must be able to work independently while maintaining close attention to detail.
6. Must be highly motivated and have the ability to set and reach goals.
7. Ability to deal with highly sensitive and confidential information and adhere to data security and HIPAA confidentiality procedures.
Highly Desirable Skills:
1. Familiarity with automated medical claims payment systems/working knowledge of payer systems (i.e. EZ-Cap, FACETS).
2. Experience providing guidance to other employees on coding regulations and reimbursement structures.
3. Ability to read and interpret medical contracts.
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