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Certified Coding Specialist - Cincinnati Area #4038

Absolute Opportunities
Cincinnati, Ohio, United States
February 14, 2018

Position Title Certified Coding Specialist - Cincinnati Area #4038

Relocation No

Location Cincinnati Area

Primarily responsible for thorough review of managed care contracts and comparison of such contracts against healthcare claims to identify underpayments for the assigned client.

Essential Duties and Responsibilities:

Research, communicate and educate others on coding changes that impact reimbursement

Identify areas of opportunity that occur as a result of a coding or billing error

Review insurance contracts to gain thorough understanding of payment methodologies

Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation

Contact insurance company to obtain missing information, explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client

Prepare and submit correspondence such as letters, emails, faxes, online inquiries, appeals, adjustments, reports and presentations

Maintain regular contact with necessary parties regarding claims status including payors, clients, managers and other personnel

Support and direct claims to all departments and client onsite analysts

Build strong, lasting relationships with clients, payors and personnel

Attend client, department and company meetings

Comply with federal and state laws, company and department policies and procedures

Essential Skills and Experience:

Minimum 2-years of experience working with hospital claims in some capacity

Familiarity with hospital billing guidelines and requirements

Knowledge of healthcare codes including CPT, HCPCS, ICD-9, ICD-10, DRG and ability to correctly use and apply codes in an operational setting

Ability to read and interpret an extensive variety of documents such as contracts, claims, medical records, EOB's, policies and procedures in written (English) and diagram form

Familiarity with CDM and its impact on reimbursement

High School diploma or equivalent

Ability to define problems, collect data, establish facts and draw valid conclusions

Strong organization and time management skills

Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook

Mathematical skills: ability to calculate rates using addition, subtraction, multiplication and division

Strong customer service orientation

Excellent interpersonal and communication skills

Strong team player

Commitment to company values

Non-Essential Skills and Experience:

Related Professional License/Certification(s)

Associate or Bachelor's Degree(s)

Bottom line requirements we need notes on with candidate submittal:

1. Certified Coding Specialist (CCS), Registered Health Information Analyst (RHIA), Registered Health Information Technician (RHIT).

2. 2+ years of experience working with hospital claims.

3. Experience with healthcare codes including CPT, HCPCS, ICD-9, ICD-10, DRG.

4. Local or close enough for a short easy move.