Physician Services - Lead Coding, Billing & Appeals

Job Description

Teleworking Available

SHERLOQ Revenue Solutions is looking to hire for the position of full-time Coding Lead, Insurance Revenue Cycle. Are you looking to work for a high-energy, fast-paced company that fosters a team environment? Do you want to work where you will be respected and valued for what you contribute? An organization with a long history in the community for over 100 years! Well, you found it. Sherloq Revenue Solutions is looking to enhance our team with top performers who are knowledgeable in the Healthcare Revenue Cycle. We are seeking candidates with experience from healthcare providers that are looking to maximize their skills in the industry.

This position earns competitive pay, depending on experience. We value our employees and offer amazing benefits, including medical Insurance, a 401(k) plan, generous vacation and paid-time-off (PTO), eight paid holidays, and tuition reimbursement as well as life, dental, accidental death & disability, and supplemental insurance. Our plans are designed to be both valuable and affordable.

JOB SUMMARY

We are seeking an experienced coder to help lead a small physician coding, billing, and follow-up team. The ideal candidate will have extensive knowledge of CPT-4 and ICD-10 coding, as well as a strong understanding of the professional medical billing, denials and appeals processes. The lead will be responsible for assisting in training staff and ensuring compliance with insurance guidelines. This position requires strong organizational, problem-solving, and communication skills, as well as the ability to multitask and work effectively in a team environment.

The ideal candidate will have experience with Michigan physician claims, insurance reimbursement and coding policies in the EPIC PB Resolute billing system.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Supervise a small team including assistance in completing performance reviews, coordinating employee disciplinary actions with management, monitoring employee adherence to company policies, creating training documents and reviewing time card related items. Daily respond to inquiries from the team regarding claim denials, escalated coding issues, insurance payer issues, and workflow.

Resolve physician claims through post-bill coding error resolution, billing, appeals, reviewing medical records, EOBs and applying payer reimbursement and coding policies. Present trends and concerns in an understandable way to the team and management with actionable steps for resolution.

SKILLS

Communication: Excellent verbal, written and presentation communication skills.

Leadership Skills: Ability to lead a small team effectively, with previous experience preferred.

Problem-solving: Strong analytical and problem-solving skills, identify trends in payer underpayments and claim denials.

Technical Skills: Proficiency in Microsoft Teams, Word, Excel, and Outlook. Including the ability to develop the skills needed to create basic pivot tables and analyze data. Navigate and utilize various healthcare provider software systems.

Time Management: Ability to manage daily tasks, meet production and quality metrics, and prioritize workload effectively.

CERTIFICATION REQUIREMENTS:

CPC, RHIA, RHIT, or CCS minimum certification required

Continue to maintain accreditation throughout employment with continuing educational units.

Obtain AAHAM Certified Revenue Cycle Specialist accreditation within two years of employment

EXPERIENCE REQUIREMENTS:

One (1) year of current verifiable coding experience in ICD-10 and CPT-4 required

One (1) year of current verifiable physician coding and abstracting experience required

One (1) year of verifiable EPIC PB Resolute billing system required

Three (3) years of healthcare industry experience preferred, with a solid understanding of the entire Revenue Cycle process.

Experience leading a team preferred.

Experience with Michigan healthcare payers preferred.

EDUCATIONAL REQUIREMENTS:

Associates degree preferred, high school diploma or equivalent required.

We are proud to be an EOE/AA Employer (Minority/Female/Disabled/Veteran) -

We maintain a drug-free workplace and perform pre-employment substance abuse testing.

ACCESSIBILITY NOTICE: If you need a reasonable accommodation for any part of the employment process due to a physical or mental disability, please notify Human Resources.

READY TO JOIN OUR TEAM?

We understand your time is valuable and that is why we have a very quick and easy application process. If you feel that you would be right for this position, please fill out our initial 3-minute, mobile-friendly application. We look forward to meeting you!

Job Posted by ApplicantPro