Under the direction of the Manager of Patient Financial Services and in collaboration with the audit appeals specialist, this role provides hospital billing support through efficient review and timely resolution of Medicare and third-party payer accounts subject to pre-bill claim edits, hospital bill hold edits, and claim denials.
The position handles edits including CCI, MUE, medical necessity edits, and various payer payment policies. It requires strong knowledge of coding rules and regulations, medical record documentation, payer payment policies, NCDs, LCDs, CMS Coverage Articles, and billing regulations.
Requirements & Qualifications
Education
- High school graduate
- Additional post-secondary education preferred
- CPC or CCS coding credential required
- RHIT or RHIA considered with at least 5 years of coding experience
Experience
- 3 years of experience with hospital outpatient or professional coding
- Healthcare billing experience preferred
- Experience interpreting and applying payer payment policies preferred
- Epic experience preferred
Skills and abilities
- Detail oriented and able to manage multiple priorities concurrently
- Strong computer proficiency and keyboarding skills
- Ability to read medical record documentation and payer websites
- Strong verbal communication, organizational, and time management skills
- Ability to maintain confidentiality
- Ability to work independently and prioritize tasks without daily coaching or direction
Location
Buffalo, New York, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago