Coder, Edit/Denials

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🕒 3 days ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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Ovation Healthcare

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 45 years

⚕️ Healthcare Insurance

☁️ SaaS

📚 Education

Healthcare Insurance • SaaS • Education

Ovation Healthcare is a leading provider of shared services for independent hospitals and health systems. With over 45 years of experience, the company enhances hospital and system performance through services like leadership advisory, supply chain management, revenue cycle management, technology services, and clinical care management. Ovation Healthcare is dedicated to supporting the financial and clinical needs of hospitals while preserving their focus on patient care and community wellness. Their educational programs and consulting services aim to strengthen hospital operations, making healthcare delivery more efficient and effective.

📋 Description

• Reviews the documentation in the record to identify all pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse • Creates appropriate letters to substantiate the validity of claims • Meets with facility liaison to review documentation, resolve coding, and tagging files for follow-up • Investigates and problem-solves reimbursement issues in collaboration with other coding staff and faculty • Works directly with facility liaison or other clinical staff as needed to provide documentation feedback and to develop appeals • Researches payer policies and processes • Reviews clinical documentation in the medical record to identify all pertinent facts necessary to select the comprehensive diagnoses and procedures that fully describe the patient's conditions and treatment • Works assigned work queues and tasks and reviews remittance advice for rejections and accuracy of payment amounts as needed • Identifies invoices or claims that have been rejected per billing edits/criteria

🎯 Requirements

• Knowledge of ICD-10 and CPT Coding • Must be comfortable working with AR teams to resolve issues • Must be able to pass a coding assessment • Must be proficient in Microsoft Office, including Outlook, Excel, and Teams • Ability to multi-task and have excellent communication skills • Must meet and maintain a 95% quality accuracy rate and productivity standards • Must be able to apply official coding guidelines, NCCI edits, CPT Assistants, and Coding Clinics • Must have experience working in a remote environment • CCS, AHIMA, CCS-P, CPC, AAPC, CPC-A, or AAPC Credentials • Three or more years of Coding experience

🏖️ Benefits

• Reliable high-speed internet connection is required for all remote/hybrid positions • HIPAA-compliant work environment