SPECIAL ACCOUNTS REPRESENTATIVE III- MEDICAL CODER - FULL TIME

Job Type

Full-time

Description

Must be able to plan and prioritize workflow and produce an acceptable volume of work accurately. Must possess strong analytical and research capabilities to review medical record documentation. Good problem-solving skills and the ability to communicate clearly in writing and verbally to assigned providers and support staff.

Follows up on open tasks / claims in accordance with established guidelines. Reviews and edit charges for accuracy of codes and modifier usage based on established billing guidelines and completeness of charges / diagnoses by specialties. Review and edit claims for completeness and compliance with billing guidelines according to payer specific policies.

Cross train in all areas within the Insurance Department. Assist Supervisor in the education of new employees.

Communicate coding changes and / or questions to provider offices and appropriate staff. Ability to communicate coding concepts to non-coding staff.

Stay informed and up to date on coding guidelines and carrier guidelines. Possess a comprehensive understanding of carrier specific, State and Federal billing guidelines. Must be skilled in writing appeals for complex coding denials.

Acts as liaison to the department to ensure any special projects and requests are completed efficiently and correctly. Acts as resource to peers.

Requirements

Education : High School Graduate or Equivalent. Must be a certified coder either through AAPC or an equivalent organization.

Experience : 3 or more years of experience in the medical coding field. Must have advanced knowledge of medical terminology, anatomy, diagnosis and procedure codes. Experience with the claims adjudication process for multiple governmental agencies and private insurance carriers.

Additional Eligibility Qualifications

Must have at least 3 years of experience insurance claim review and appeal experience. An aptitude to retain detailed information. Ability to multi-tasked oriented, to prioritize and to produce an acceptable volume of work. Excellent organizational and problem-solving skills. Excellent communication skills, oral and written. Basic knowledge of Windows base computer applications. Accurate typing rate of 40 wpm. Ability to operate the following equipment : computer, copier, fax, web-based payer sites, and 10 key calculators.