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MediRevv Certified Professional Coder - Denials Focus in Iowa City, Iowa

Title Certified Professional Coder

Department Coding Services

Wage Category Hourly, Non-exempt

Reports to Manager, Coding Services

Location TBD or remote

Salary range Commensurate with experience

Job Summary:

Under the directions of the Manager, Coding Services, this position will be responsible for CPT and ICD-10 coding and ensuring accuracy and maximum reimbursement.

Must have strong, demonstrated experience with EPIC, denials and follow up

Essential Functions:

  • Reviews and analyzes patient records according to current compliance policies and providers documents are compliant.

  • Assigns accurately and sequences appropriately ICD-10 and CPT codes and all applicable modifiers

  • Contacts clients as appropriate when documentation in the medical record is inadequate, ambiguous or unclear for coding purposes.

  • Monitors regulatory and payer changes as they apply to diagnostic and procedure coding

  • Researches and resolves coding related system edits, payer rejections and insurance denials.

  • Identify system edit, payer rejection and insurance denial trends for client policy and procedure improvement.

  • Participates in developing, implementing, and reviewing:

  • Programs for coding compliance monitoring

  • Criteria for benchmark comparisons

  • Organization’s policies and procedures

  • Providers clinical documentation improvement

  • Reports and applications supporting HCC/Risk Adjustment program

  • Maintains up to date knowledge of the current changes of coding practices by continuing education and reading resource material.

  • Other duties as assigned.

    Knowledge / Skills / Abilities:

  • Possess strong written and verbal communication skills to communicate effectively with individuals at all levels of the organization including the ability to effectively communicate and provide feedback to physicians

  • Ability to work under general supervision

  • Ability to work in a fast-paced department and handle multiple task, work with interruptions, and deal effectively with confidential information to meet departmental productivity expectations

  • Possess excellent telephone etiquette, presentation skills and problem resolution skills

  • Must have dependable transportation and valid driver’s license.

  • Computer skills including Microsoft Office Suite

  • Must be highly organized and detail-oriented

    Information Management:

  • Understands fully the requirements to meet HIPPA regulations. Must treat all patient information and data with complete confidentiality and takes all precaution to secure this information.

  • Cooperates fully in all risk management activities and investigations for QM purposes.

    Minimum Position Qualifications:

    Education :

    High School diploma or equivalent required

    Experience :

  • Must have Pro Fee coding experience

  • Understanding of all or a combination of ICD-10, CPT, HCPCS, modifiers, medical terminology and HIPAA compliance.

    License/Certification:

    Nationally recognized coding credential including, but not limited to: CPC, COC, CCS, CCS-P, RHIA or RHIT through AHIMA/AAPC

    Preferred Position Qualifications:

    EPIC experience highly desired and demonstrated experience with denials and follow up preferred

    Content experts in your specialty preferred

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