Responsible for coding and abstracting CPT and ICD-10 diagnosis codes for physician services, reviewing documentation in the electronic medical record, and monitoring charge capture, revenue integrity, and denial trends. The role supports denial prevention and resolution, acts as a subject matter expert for Epic Resolute PB, and analyzes workflows and configurations to identify the root causes of lost revenue or denials.
Key responsibilities include:
- Review, analyze, and interpret physician documentation, coding, charge entry, and claim edits.
- Monitor medical records for compliance with professional and payer policies.
- Track unbilled accounts and identify discrepancies in charge capture.
- Analyze denial reasons and develop strategies to overturn denials and accelerate payment resolution.
- Educate physicians on documentation improvement opportunities.
- Prepare reports and present trends, risks, and performance updates to leadership.
- Troubleshoot Epic PB-related issues affecting revenue and denial outcomes.
Requirements & Qualifications
Education and experience
- Bachelor's degree in business, health administration, mathematics, statistics, computer science, engineering, or a related field.
- 3+ years of experience in revenue cycle analysis, finance, consulting, healthcare accounts receivable, or professional coding.
- Working knowledge of medical terminology, anatomy, and physiology.
- Experience with Epic EHR/Epic Resolute PB preferred.
Skills and knowledge
- Strong knowledge of ICD-10-CM and CPT coding principles and guidelines.
- Working knowledge of HCPCS, ICD-10, payer-specific coding guidelines, NCCI edits, and healthcare billing/reimbursement processes.
- Expert-level Microsoft Excel skills, including VLOOKUP; SQL required.
- Strong analytical, organizational, communication, and critical thinking skills.
- Ability to work independently with general supervision.
Certification
- CPC, CCS, CPC-H, CCS-P, CCS-H, RHIA, RHIT, or equivalent coding certification required.
Benefits & Perks
- Medical, dental, vision, and prescription drug coverage
- Retirement savings plans with employer contributions
- Life insurance and disability coverage
- Paid time off, holidays, and family leave benefits
- Tuition reimbursement and professional development opportunities
- Employee Assistance Program (EAP)
- Wellness initiatives and employee discounts
Location
Atlanta, Georgia, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
3 weeks ago
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