Coder – Edits/Denials

Job not on LinkedIn

🕒 May 26

🎸 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

• Review medical records to determine appropriate billing codes and necessary documentation • Perform advanced coding and appeal activities • Investigate payer issues, completing charge corrections, and timely filing of appeals to insurance companies • Review the documentation in the record to identify pertinent facts for appealing the claims denied by third-party payers or holds in host systems or billing clearinghouse • Create appropriate letters to substantiate the validity of claims • Meet with facility liaison to review documentation, resolve coding, and tagging files for follow-up • Investigate and problem-solve reimbursement issues in collaboration with coding staff and faculty • Work directly with facility liaison or other clinical staff as needed to provide documentation feedback and to develop appeals • Research payer policies and processes • Review clinical documentation in the medical record to identify necessary facts to select comprehensive diagnoses and procedures

🎯 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 • CCS, AHIMA, CCS-P, CPC, AAPC, CPC-A, or AAPC Credentials • Three or more years of Coding experience

🏖️ Benefits

• Must have experience working in a remote environment • Reliable high-speed internet connection is required for all remote/hybrid positions • A HIPAA-compliant work environment 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