Coder – Edits/Denials

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Analyze medical records to ascertain appropriate billing codes and required documentation.

• Conduct advanced coding and manage appeal processes.

• Investigate payer-related issues, perform charge corrections, and ensure timely submission of appeals to insurance companies.

• Examine documentation within the record to pinpoint relevant facts for appealing claims denied by third-party payers or held in host systems or billing clearinghouses.

• Draft suitable letters to validate the legitimacy of claims.

• Collaborate with facility liaison to review documentation, resolve coding discrepancies, and tag files for follow-up.

• Investigate and troubleshoot reimbursement challenges in conjunction with coding staff and faculty.

• Work closely with facility liaison or other clinical personnel as necessary to provide feedback on documentation and to formulate appeals.

• Research payer policies and procedures.

• Review clinical documentation in medical records to extract essential facts for selecting comprehensive diagnoses and procedures.

⛳️ Requirements

• Familiarity with ICD-10 and CPT Coding.

• Must be adept at collaborating with AR teams to resolve issues.

• Ability to successfully pass a coding assessment.

• Proficiency in Microsoft Office suite, including Outlook, Excel, and Teams.

• Capability to manage multiple tasks while possessing excellent communication skills.

• Must achieve and sustain a 95% quality accuracy rate and meet productivity standards.

• Must be able to apply official coding guidelines, NCCI edits, CPT Assistants, and Coding Clinics.

• CCS, AHIMA, CCS-P, CPC, AAPC, CPC-A, or AAPC credentials are required.

• A minimum of three years of coding experience is necessary.

🏝️ Benefits

• Experience in a remote work environment is essential.

• A reliable high-speed internet connection is mandatory for all remote/hybrid roles.

• A HIPAA-compliant work setting is required, including a secure workspace free from unauthorized access or interruptions.

• Attention Ovation will never contact applicants via Chatwork or any other messaging platform outside of our official channels.