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Senior Coder

Company: coronis health
Location: Frederick
Posted on: June 12, 2021

Job Description:

Senior Medical Coder & Clinical Denial Specialist- Coronis Health

Job title: Certified Medical Coder w/ AR experience

Reporting to: Manager, Coding Department

Salary: Dependent upon certification/experience

Hours: Full Time 40 hrs a week

Location: Frederick, MD

Medical Coder

  • Translating medical terminology into unique and professional codes for medical personnel and insurance companies to understand and interpret while carrying out their duties.

  • Research denials and initiate the appeal process.

Job Description

  • Accurately follows coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies.

  • Determines the final diagnoses and procedures stated by the physician or other health care providers are valid and complete.

  • Quantitative analysis - Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and all other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered.

  • Qualitative analysis - Evaluates the record for documentation consistency and adequacy. Ensures that the final diagnosis accurately reflects the care and treatment rendered. Reviews the records for compliance with established reimbursement and special screening criteria.

  • Analyzes provider documentation to assure the appropriate Evaluation & Management (E&M) levels are assigned using the correct CPT code

  • Enters codes in a computer software program that compiles and organizes information for each patient.

  • Performs other related duties, which may be inclusive, but not listed in the job description

Denial/Appeal Responsibilities

  • Research payer denials related to referral, pre-authorization, medical necessity, non-covered services, and billing resulting in denials and delays in payment.

  • Initiate appeals with insurers appropriately.

  • Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines.

Credentials & Skills

  • Experience in Epic and Encoder is required.

  • High School Diploma

  • Medical Coding Certificate - CPC, CCS or RHIT certification is required.

  • Knowledge and understanding of Excel.

  • Computer competency

Personal Qualities/Traits

  • Detail-oriented

  • Hard-working

  • Adaptable

  • Dependable

  • Self- Starter

  • Able to work alone and as a team

  • Able to focus

  • Good written and verbal communication skills

  • Able to take direction.

Keywords: coronis health, Frederick , Senior Coder, Other , Frederick, Maryland

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