Support the Facility Coding & Reimbursement Team by researching, analyzing, and resolving complex facility coding and reimbursement issues across all lines of business.
This role contributes to contract development, system configuration, code maintenance, medical policy implementation, claim editing, provider disputes, appeals, coding updates, and claims adjudication.
You will collaborate with Claims, Provider Network Management, Medical Policy, Clinical Coding Review, IT, and Customer Service teams to support payment accuracy, compliance, and reimbursement solutions.
Requirements & Qualifications
- Bachelor's degree or equivalent work experience.
- 3+ years of experience with medical/clinical coding.
- Coding certification from a nationally recognized organization such as AAPC CPC/CPC-H or AHIMA CCS-P/CCS, or willingness to obtain certification within two years.
- Experience with facility coding and reimbursement, including inpatient and outpatient payment methodologies.
- Experience with claims processing, reimbursement research, regulatory guidance, claims editing, and payment integrity reviews.
- Knowledge of MS-DRGs, APCs, revenue codes, facility billing requirements, contract reimbursement methodologies, and payer reimbursement systems preferred.
- Strong analytical, problem-solving, organizational, and communication skills.
- Proficiency in Microsoft Office applications.
- Ability to work independently and within a team environment.
Location
Tennessee, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago