Claims Editor, Denials Coder – Part Time

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e4health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🤝 B2B

☁️ SaaS

🤖 Artificial Intelligence

B2B • SaaS • Artificial Intelligence

e4health is a healthcare-focused services and technology firm that helps hospitals and health systems improve clinical data quality, coding accuracy, revenue integrity, and IT systems. They provide Health IT consulting, health information management (HIM), clinical documentation improvement (CDI), coding and auditing (including risk adjustment/HCC), legacy data migration and validation, interim staffing, and software and AI automation solutions. e4health serves more than 400 health systems with a mix of professional services, advisory engagements, and technology to optimize workflows, protect IT investments, and drive measurable outcomes.

📋 Description

• The Medical Coding Edit Specialist position is responsible for resolving coding account edits of multiple patient types prior to billing • Responsibilities will include assigning and/or correcting codes and modifiers with ICD-10-CM, CPT and HCPCS Level II Codes as appropriate from the documentation within the electronic medical record • The Coding Edit Specialist is expected to maintain consistent accuracy rate of 90% or better while also meeting agreed upon productivity standards • Reconcile held accounts by resolving the edit and dropping the account • Responsible for all account edits from various payors and vendors • Identify and report major edit issues • Assist in identifying problems and resolution thereof • Identify opportunities to reduce coding edits by providing proactive education • Communicates quality issues to management as appropriate • Notifies management when there is a compliance concern or incident • Demonstrates knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of patient information • Promotes confidentiality and using discretion when handling patient information • Attends educational conference calls • Provides additional support to the business as needed • Maintains required productivity and quality requirements • Maintains coding credential requirements

🎯 Requirements

• Candidate must possess an approved AHIMA or AAPC coding credential • Minimum 2 years’ coding experience preferred • Must have up to date knowledge of third-party rules and regulations • Epic & 3M experience preferred • Must have facility (HB) IP/OP experience with Claims/Denials

🏖️ Benefits

• excellent salary • full benefits package including 401(k) with company match and discretionary profit sharing • group medical, dental, vision, life, & short-term disability insurance • PTO policy