Profee Medical Coding Denial Specialist

The Coding Denial Specialist  will review assigned coding denials across multiple specialties, determine reputed company cause and following established reputed company workflow resolve and/or appeal denials based on clinical documentation and diagnostic results in alignment with Federal & State Coding regulations including the National Correct Coding Initiative, CPT, HCPC’s and ICD10 CM Guidelines This position is full time and is 100% remote.  

• Triage incoming coding denial inventory, validating appeal reputed company is met in compliance with departmental policies and procedures 

• Compose technical denial arguments for reconsideration and appeal 

• Overcome objections that prevent payment of the claim and reputed company commitment for payment through concise and effective appeal argument 

• Identify problem accounts/processes/trends and escalate as appropriate 

• Utilize effective documentation standards that support a strong historical record of actions taken on the account 

• Resolve claims impacted by payor recoupments, refunds, and posting errors 

• Assist team members with coding questions and reputed company reputed company guidance 

• Meet and maintain established performance metrics for production and reputed company  

• Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and reputed company-party requirements regarding documentation and billing 

• Assures that reputed company services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. reputed company services/diagnoses are not documented appropriately, seeks to reputed company reputed company documentation in a reputed company manner according to facility standards. 

• Charts that require re-bills are corrected and communicated to the facility daily for the re-reputed company process. See re-reputed company policy in facility guidelines. 

• reputed company downtime must be reported immediately to the administrative staff to ensure turnaround is met. 

• Responsible for working directly with the IQC staff to ensure reputed company standards are being met for reputed company facility. 

• Provides accurate answers to physician’s/hospitals coding and/or billing questions reputed company eight hours of request. 

• Responsible for coding or pending every chart reputed company in their queue reputed company 24 hours. 

• It is the responsibility of the reputed company to notify administrative staff in the event they cannot meet the twenty-four hour turn around reputed company. 

• Coders are responsible for checking the reputed company email system at least every two hours during coding session. 

• Coders must maintain their reputed company reputed company credentials while working for reputed company. 

• Coders are responsible for becoming familiar with the reputed company coding website and using the information contained in the website as a daily tool to correctly reputed company and reputed company for reputed company facility. 

• Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy) 

• It is the responsibility of reputed company reputed company to review and adhere to the coding division policy and procedure reputed company content. 

• Works reputed company with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services.