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Company

Trinity Health · 5 hours ago

Coding and Reimbursement Specialist - Remote

Columbus, OH

Full-time

Remote

Mid, Senior Level

5+ years exp

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Responsibilities

Review and respond to post-payment inquiries from providers

Process pended claims to ensure integrity of claim payment to providers and members

Work with provider credentialing to ensure proper set-up in order to allow for accurate payments

Process and review requests from member for reimbursement

Proactively identify, through auditing and internal reporting, trends. Develop and present reports of findings to Health Plan leadership

Develop and maintain an effective working relationship with providers and their billing staff

Performs responsibilities of Claims Auditor as time and work load permit and dictate

Assist in the development of tools and presentations on documentation, coding, billing, and other topics of interest to our provider community

Attend coding and billing conferences, workshops and in-house education sessions to stay current with coding and billing regulations

Analyzes claims processes to identify potential areas of fraud, waste and abuse. Provides recommendations to improve processes

Assist with the release of claims pended for coding issues

Qualification

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CPC certificationClaims auditing experienceMedicare coding knowledgeICD-10 coding principlesCPT-4 coding principlesHCPC coding principlesMedical terminology knowledgeAnatomyPhysiology knowledgeMedicare regulations knowledge

Required

High School degree required

Minimum of 5 years experience in claims auditing, billing and/or coding

Must possess an in-depth knowledge of current Medicare coding and billing requirements

Advanced knowledge of current medical terminology, anatomy and physiology required

Advanced knowledge of current ICD-10, CPT-4, and HCPC coding principles and documentation guidelines

Extensive knowledge of Medicare regulations and policies pertaining to documentation, coding and billing

Must possess strong written and verbal communication skills in order to communicate in clear, concise terms to internal and external customers, including but not limited to, physicians, practice managers, billing managers and billing staff at all levels, including the ability to articulate complex regulatory information in layman's terms

Preferred

Bachelor's degree preferred

CPC, CPC-P or equivalent preferred

Benefits

Competitive compensation and benefits packages including medical, dental, and vision with coverage starting on day one.

Retirement savings account with employer match starting on day one.

Generous paid time off programs.

Employee recognition programs.

Tuition/professional development reimbursement.

Relocation assistance (geographic and position restrictions apply).

Discounted tuition and enrollment opportunities at the Mount Carmel College of Nursing.

Employee Referral Rewards program.

Mount Carmel offers DailyPay - if you’re hired as an eligible colleague, you’ll be able to see how much you’ve made every day and transfer your money any time before payday. You deserve to get paid every day!

Opportunity to join Diversity, Equity, and Inclusion Colleague Resource Groups.