Unified Women's Healthcare is seeking an experienced Certified Professional Coder for a fully remote position! The candidate must have a minimum of 3 years experience as a CPC. In this position, the candidate will comply with guidelines and standards of The American Medical Association (AMA), The Center for Medicare and Medicaid Services (CMS) and The American Academy of Professional Coding (AAPC) in the review of billing and coding issues. This position is responsible for ensuring accurate claim data is submitted for the payment of services provided.
Essential duties and responsibilities:
· Serves as a representative of Women's Health CT, a proud affiliate of Unified Women's Healthcare, displaying courtesy, tact, consideration, and discretion in all interactions with other members of the Women’s Health communities, and the public.
· Reviews all insurance claims stopped by scrubbing software based on rules to insure accuracy, compliance and conformity with AMA, CMS, AAPC and insurance specific guidelines; includes creation, utilization, and maintenance of rules within claims scrubber software or other tool.
· Reviews patient medical records in accordance with CMS standards
· Performs chart audits as needed to ensure that patient medical record documentation supports the code(s) billed to patients and health plans
· Reviews patient medical record to ensure that any coding change(s) are supported by medical record documentation.
· Reviews operative records, office notes and radiology and pathology reports and assures the correct diagnostic and procedural codes are assigned using the coding systems of ICD-10, CPT and HCPCS.
· Assists with coding and claims error resolution, understanding, reviewing, and correcting insurance denials related to coding and writing letters of appeal.
· Utilizes insurance websites or calls to payer to resolve unpaid claims for coding related denials.
· Previews internal reports, securing and correcting inaccurate data for claims submissions and/or appeals to appropriate insurance companies.
· Respond in a timely manner by either telephone and or written communication to all requests from divisions, insurance companies regarding and/or concerns associated with coding.
· Attend s and participate in insurance company provider representative meetings on an as needed basis.
· Trains providers on coding related items and correct documentation requirements.
· Verify, update, and communicate to communities all relevant coding modifications to various office and hospital encounter forms on an annual or as needed basis
· High School Diploma or GED
· Must be an experienced Certified Professional Coder through the American Academy of Professional Coding and maintain certification.
· Experience using CPT, HCPCS and ICD Codes
· Minimum of two years of prior medical coding experience.
· Ability to set priorities
· Ability to calmly manage stressful situations.
· Excellent verbal and written communication skills
· Demonstrate strong computer skills as evidenced by proficiency and/or training with applicable software.
Job Types: Full-time, Part-time
Pay: $21.54 - $25.94 per hour
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
- High school or equivalent (Required)
- CPC: 2 years (Required)
- CPT coding: 2 years (Preferred)
- Certified Professional Coder (Required)
Work Location: Remote