Outpatient Patient Denials Coder

Fulltime | Remote | Permanent

Managed Resources is a leading consulting group assisting healthcare organizations nationwide in optimizing its revenue cycle management through review, recovery and educational programs.
Please read the below description and apply if you meet the requirements and would like to hear more about this opportunity with Managed Resources!

The Outpatient Denials Coder is responsible for reviewing denied claims related to outpatient services, and identifying coding discrepancies. This position requires a thorough understanding of outpatient coding guidelines, healthcare regulations, and payer requirements.

Description:

• Conduct detailed analysis of medical records, coding documentation, and payer guidelines to determine the accuracy of code assignment.
• Review clinical documentation and diagnostic results as appropriate to extract data and apply appropriate ICD-10 Diagnosis codes, along with CPT/HCPCS codes as defined for the service type; for coding, billing, internal, and external reporting.
• Monitor changes in outpatient coding guidelines, payer policies, and regulatory requirements to ensure compliance and optimize appeal success rates.
• Maintain accurate records of denial trends, appeal activity, and reimbursement outcomes for reporting and analysis purposes.
• Review coding related denials from payers and recommending the appropriate action to resolve the claim based on payer guidelines.

Requirements:

• Experience creating appeal letters as appropriate and communication with billing teams within Guide house or within a client organization.
• Ability to analyze coding denial reason codes, review documentation and respond appropriately regarding what is needed to resolve the denial issue.
• Proficient in working denials for multispecialty coding, along with E&M coding for all places of services.

Certifications:

• Holds current CPC Credential.

Qualifications:

• 3-5 years ICD-10 and CPT coding experience.
• A minimum of (3-5) years previous physician coding experience with experience working claim edits and denials.
• Ability to analyze coding denial reason codes, review documentation, and respond appropriately regarding what is needed to resolve the denial issue.
• Strong understanding of outpatient coding guidelines, including CPT, HCPCS, and ICD-10-CM coding systems.
• Must have experience working in systems such as EPIC, Cerner, Next Gen, Allscripts or other EHR.
• Ability to interact with management personnel.
• Possess strong organizational skills and attention to detail.
• Adaptive and flexible to new ideas and change.

Check Out Our Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Referral program
• Vision insurance
• Pet Insurance
• Monthly Internet Stipend

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Managed Resources is an Equal Opportunity Employer (EOE) M/F/D/V/SO

Job Types: Full-time, Part-time

Pay: $26.00 - $28.00 per hour

Work setting:

• Remote

Experience:

• ICD-10 and CPT coding: 3 years (Preferred)
• Outpatient coding guidelines: 3 years (Preferred)

Work Location: Remote