Enterprise Denial Coding Analyst

The ideal candidate serves as a dynamic denial management coding analyst to maintain a low denial rate and high reimbursement rate at an enterprise level while maintaining a high coding standard within the enterprise.

Responsibilities

• Organize and plan projects to improve effectiveness of dynamic coding, reimbursement rates, and appeal turnover rates.
• Perform analysis for denial trend improvement to include EPIC system edits, coding validation, CDM processes that affect reimbursement, authorization trends and performance improvement, and payer denial trends.
• Educate departments on appropriate charging/billing/coding issues to ensure regulatory compliance.
• Work with managed care and compliance to resolve issues with departments and payers.

Qualifications

• High school diploma or GED required with CPC, CPC, RHIT, RHIA, CCS and 1-2 years of coding experience, 1-2 years insurance experience, and denial experience.
• Prefer Associate's degree or higher in a health or business-related field and 3 years coding or billing, insurance follow up, collections or denial management in hospital/clinical setting.
• Ability to read and interpret EOB's.
• Fluency in Outlook, Word, Excel.