Professional Coding, Revenue Recovery Coordinator

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

📋 Description

• Deliver expert coding education and quality oversight to coding personnel and providers concerning CPT, HCPCS, ICD-10-CM, evaluation and management coding, NCCI edits, documentation standards, payer requirements, and relevant regulatory updates.

• Conduct coding and documentation quality assessments to pinpoint accuracy, compliance, reimbursement, and workflow risks.

• Create targeted educational initiatives and corrective measures based on identified issues.

• Examine denial, write-off, audit, and reimbursement patterns to uncover root causes and suggest enhancements to documentation, coding, billing, and revenue cycle processes.

• Investigate intricate coding and reimbursement denials.

• Prepare well-founded appeals and facilitate escalation through payer reconsideration and relevant external review processes.

• Collaborate with physicians, advanced practice providers, coding teams, billing teams, patient representatives, and payers to address documentation and reimbursement discrepancies.

• Develop specialty-specific coding materials.

• Relay emerging coding trends, payer policy modifications, denial patterns, and reimbursement risks to promote consistent practices and avert recurring issues.

⛳️ Requirements

• Certified Professional Coder (CPC) or Certified Coding Specialist-Physician-based (CCS-P).

• Certified Professional Medical Auditor (CPMA) or Certified Evaluation and Management Coder (CEMC).

• Bachelor’s degree in health information management, Healthcare Administration, Business Administration, or a related field is preferred.

• At least five years of experience in professional medical coding, coding quality auditing, revenue recovery, insurance appeals, or denial management.

• Proficient in using electronic health record (EHR) and professional billing systems such as Cerner, Allscripts, Epic Resolute, or similar platforms.

• Comprehensive knowledge of ICD-10-CM, CPT, HCPCS, E/M guidelines, NCCI edits, payer reimbursement policies, and regulatory compliance standards.

• Excellent analytical, critical thinking, communication, problem-solving, and relationship-building abilities.

• Ability to work effectively in collaboration with clinical and operational teams.

• Sufficient vision, hearing, manual dexterity, and verbal and written communication skills.

• Must adhere to organizational privacy, information security, safety, and infection-prevention protocols when dealing with protected health information or present in clinical environments.

🏝️ Benefits

• Comprehensive health insurance options.

• Generous paid time off policy.

• Retirement savings plan with employer contributions.

• Professional development opportunities and training.

• Supportive work environment with a focus on work-life balance.