Senior Coding Denials Analyst

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

📋 Description

• Conduct research and analysis on coding-related claim edits, denials, internal edits, PFS inquiries and concerns, as well as coding compliance software audit notifications.

• Enhance reimbursement processes for Sanford.

• Communicate with payers to pinpoint issues associated with specific denials and propose solutions for final resolution.

• Recognize patterns in edits, mistakes, and coding denials.

• Extract diagnoses and treatments from documentation to ensure accurate ICD-10 and CPT/HCPCS coding.

• Deliver findings and trend data to enterprise coding denial leadership to facilitate coder education and communication.

• Advocate for the creation of coding edits that provide real-time alerts during the coding process.

• Offer insights and guidance on software edits, denial matters, reimbursement trends, and billing/coding inaccuracies to Coding Denial Leadership.

• Educate others to achieve optimal accuracy.

⛳️ Requirements

• An associate degree in Health Information Technology or a Certification in Coding is mandatory.

• Comprehensive understanding of diagnostic and procedural terminology, ICD-10, CPT-4, and HCPCS coding systems.

• Qualifications typically obtained through RHIA, RHIT, LPN, CPC, CPC-H, CCS, or CCS-P programs or certifications.

• Maintain certification in RHIA, RHIT, CCS, CCS-P, CPC, or CPC-H by completing continuing education requirements.

• A foundational knowledge of anatomy, physiology, and pathophysiology is essential.

• Up-to-date knowledge of coding schemes, prospective payment systems, clinical practices, and technology is required.

• Familiarity with payer Remark and Reason codes and remittance advice is necessary.

• Proficient computer skills and information systems knowledge are required.

• Capability to effectively train others.

• Awareness of state and federal laws, rules, and regulations is essential.

• A minimum of two years of coding experience for professional charges is preferred.

• At least two years of experience with Medicare and other third-party reimbursements is favored.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and advancement.

• Supportive work environment encouraging collaboration and growth.