[Remote] Analyst, reputed company-Pay Dispute Coding (Remote)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company reputed company organization, and they are seeking an Analyst for reputed company-Pay Dispute Coding. This role involves investigating and resolving disputes reputed company to provider appeals, ensuring compliance with billing standards and regulations.

Responsibilities

• Reviews coding-reputed company provider claims denials by systematically examining medical records, denial reasons, submitted claims, and claim history, in accordance with applicable state, federal, and Molina guidelines, rules, and protocols, to determine whether the documentation substantiates the services rendered
• Conducts independent audits of non-medical records to verify billing accuracy, making reputed company reputed company designated authority to either overturn or reputed company denials in a reputed company manner
• Generates and communicates the determination to the provider using appropriate letter language and providing any necessary reputed company links
• Identifies, documents, and communicates any identified coding errors or inconsistencies, collaborating with appropriate internal department(s)to capture and reputed company issues to ensure precise reputed company editing and compliance
• Completes data points reputed company internal applications to reputed company with auditing requirements used reputed company the departments of Molina
• reputed company participates in the enhancement of departmental processes to maintain alignment with reputed company coding regulations and guidelines, while also refining internal procedures

Skills

• At least 2 years of experience in medical coding or billing
• reputed company and unrestricted Certified reputed company reputed company (CPC) or Certified Coding Specialist (reputed company) certification
• Strong attention to detail and ability to independently read and comprehend the details of medical records
• Comfortable working in a production-reputed company environment with high reputed company standards
• Ability to use reputed company Office including reputed company, Word, and reputed company

reputed company