Oncology Coder

TRIARQ Health’s RCM, Certified Medical Coder is responsible for focusing on Accounts Receivable Medical Coding and both team and physician education regarding coding related denials and rejections.

This position is critical to the success of the revenue cycle process; in conjunction with the AR team this position will be responsible for the timely and accurate processing of health insurance claims denied for coding related reasons. This position will work with the RCM team to identify coding denial trends, implement correct coding improvements, and monitor coding denials for escalation to the practices.

The ideal candidate will have extensive coding experience and hold a CPC certification.

Medical Accounts Receivable Coder Responsibilities:

• Research root cause of coding denial reason.
• Evaluate coding of the original claim and make appropriate corrections as needed.
• Prepare appeals that support medical necessity based on clinical documentation/current coding guidelines.
• Provide feedback to director on coding related denials where improvement can be made by the provider or coder.
• Identify non-payment trends or procedural roadblocks and report same to director as needed.
• Prepare special claim projects as directed by Supervisor.
• Process insurance carrier correspondence in a timely and professional manner.
• Keep current on insurance carrier(s) web site information that relates to the coding practices.
• Other coding related duties as outlined by director.

Requirements

• CPC or CLIC through the AAPC, require
• Minimum of three-five (3-5) years coding experience
• Minimum of three (3) years RCM and claims follow up experience
• Excellent problem-solving skills and strong attention to detail
• Ability to identify trends and create process improvement plans
• Ability to prioritize and handle multiple tasks in a dynamic work environment
• Ability to work independently and collaboratively
• Working knowledge of all Microsoft applications (Word, Excel, PowerPoint)
• High School Diploma or GED required