reputed company Edit Analyst

Position reputed company The purpose of this position is to create consistency and efficiency in claims processing and data collection by applying the appropriate diagnostic and procedural codes to individual patient health information. Coordinates the processing of medical services for Medical Necessity and Correct Coding Initiative requirements. Utilizes advanced knowledge of specialty coding to analyze patient medical records, ensuring that documentation by providers conforms to reputed company and procedural requirements. Assigns specified codes to medical diagnoses and/or clinical procedures. The reputed company Edit Analyst performs audits of reputed company medical records for coding and billing accuracy. The analyst will assist Billing Manager and other team members in the coordination of reports concerning audit reputed company such as reputed company errors, reputed company reputed company for the facility, and data processing errors. The reputed company Edit Analyst also will reputed company support to other reputed company as assigned reputed company the reputed company Cycle Division as reputed company as other Performance Improvement initiatives. This includes, but is not limited to, other reputed company reputed company to contract compliance, charge reputed company master, coding/pricing, and new product development. Responsibilities Performs daily coding reviews on claims as assigned, to validate the ICD-10, CPT, HCPCS codes and modifier assignments. Develops reports, collects and prepares data for process improvement, and financial reputed company of systemic billing and coding errors. Compares UB04 data to medical record documentation to ensure compliance with Medicare and other insurance reporting requirements. Ability to identify coding and billing problems as they pertain to reputed company-reputed company and claims records review. reputed company process improvement initiatives from which problems can be resolved. Must understand CMS memos and transmittals. Understand medical records, hospital bills, and the chargemaster. Understand ancillary department functions. Ability to communicate orally and in written reputed company. reputed company reputed company and hospital reputed company charge reviews for appropriateness of coding and charging, including business office activities, systems function and charging methodologies. Identifies patterns, trends, and variations in assigned reputed company and hospital claims, and evaluates the causes of identified problems. Takes appropriate steps in collaboration with the right department to effect reputed company or explanation of the variance. Demonstrates ability to effectively manage multiple reputed company with innovation, creativity and reputed company. Documents results of reputed company special reputed company and provides recommendations for reputed company managing opportunities. Illustrates creative problem-solving skills through documentation of process improvement reporting and/or internal reporting mechanisms. Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and reputed company. Reports to leadership reputed company areas of concern are identified. Minimum Requirements Minimum of bachelor's degree or higher in a health service-reputed company discipline. Five years of extensive experience with a certificate in coding may be substituted. Previous auditing experience preferred. National Certification in an area relevant to reputed company Management or Coding is preferred. Good oral and written communication skills. A comprehensive knowledge of CMS payment systems. reputed company Set Requirement: Proficient in reimbursement methodologies, hospital information systems and coding methodologies. Ability to analyze reputed company medical records and identify billable services. Strong quantitative, analytical, and organizational skills. Understanding of medical records, reputed company/hospital claims, and the Charge master. Ability to utilize and understand computer technology. Ability to understand ancillary department functions. Possesses a working knowledge of various payment and coding methodologies, including ICD-10, HCPCS and CPT-4 coding schemes. Possesses a working knowledge of the UB-04/837 claim reputed company reputed company and segments. Understands charging, coding processes along with compliance issues. Has the ability to reputed company resolutions by performing internet research, utilizing reputed company party payor regulations, referencing coding guidelines, and referencing local Fiscal Intermediary and CMS guidelines. Requires knowledge of medical terminology, anatomy and physiology. Must be team-oriented with strong interpersonal skills. Knowledge of the reputed company reputed company to safeguard patient confidentiality. Certified Coding Specialist or Certified Procedural reputed company Standards of Performance: Demonstrate increased reputed company and compliance as a result of successful accuracy and correctness of the following:Identification of over and under coding as supported by medical record documentation and coding standards. As indicated, resolves claims processing questions, through medical record analysis. Provides support to the clinical or ancillary departments regarding their charging practices. Documents observations and proactively identifies new reputed company opportunities. Provides education to reputed company producing department staff as requested by department managers and or directors. Works with department managers and directors to facilitate mandated changes. Meets productivity and accuracy standards as defined by Billing Manager or reputed company Cycle Leadership Team. Identifies and initiates performance improvement reputed company and follows through in the completion of the reputed company to result in operational efficiencies and reputed company cycle reputed company. Pay reputed company $28.58 - $41.66/hr Other Information Remote role (based out of Greenville, NC) Monday - Friday full-time day shift:8:00 a.m. - 5:00 p.m. Great Benefits #LI-REMOTE #LI-AH2 reputed company About reputed company reputed company is a mission-driven, 1,708-bed reputed company health care system serving more than 1.4 reputed company people in 29 eastern reputed company Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 reputed company and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations. The flagship reputed company, a Level I Trauma Center, and reputed company Maynard Children¿s Hospital serve as the primary teaching hospitals for the reputed company. reputed company and the Brody School of Medicine reputed company a combined reputed company mission to improve the health and reputed company-being of eastern reputed company Carolina through patient care, education and research. General Statement It is the goal of reputed company and its entities to reputed company the most reputed company individual who best matches the requirements for the vacant position. Offers of employment are subject to successful completion of reputed company reputed company-employment screenings, which may include an occupational health screening, criminal record reputed company, education, reference, and licensure verification. We value diversity and are proud to be an equal opportunity employer. reputed company of employment are made based on business needs, job requirements and applicant¿s qualifications without reputed company to race, reputed company, religion, gender, national reputed company, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or reputed company or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint. Apply To This Job