Top 22 coding specialist Jobs in allentown pa

Coding Appeals Specialist
St. Luke's University Health Network —Allentown, PA
- Part-time
- Anatomy knowledge
- 5 years
- Mid-level
Accounts Receivable Specialist- Hospital Billing
St. Luke's University Health Network —Allentown, PA
- Full-time
- Medical office experience
- English
- Mid-level
Claims and Denial Coding Analyst
St. Luke's University Health Network —Allentown, PA
- Full-time
- Mid-level
- 2 years
Inpatient Coding Specialist (Remote – Full Time | PA & NJ Candidates)
St. Luke's University Health Network —Allentown, PA
- Weekends as needed
- Remote
- Anatomy knowledge
- Customer service
- Mid-level
1d
RN DRG Downgrades Appeals Review Specialist
St. Luke's University Health Network —Allentown, PA
- Part-time
- Nursing
- RN License
- 5 years
Risk Adjustment Clinical Documentation Specialist-1
St. Luke's University Health Network —Allentown, PA
- Full-time
- Nursing
- RN License
- 5 years
14h
Oncology Data Specialist, Certified (Cancer Data Registrar) - Full Time
St. Luke's University Health Network —Bethlehem, PA
- Full-time
- Anatomy knowledge
- Mid-level
- Medical terminology
Accounts Receivable Specialist I
St. Luke's University Health Network —Sellersville, PA
- Full-time
- Medical office experience
- English
- High school diploma or GED
Patient Access Coordinator
St. Luke's University Health Network —Easton, PA
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Management
7d
Records Management Specialist
Pennsburg Manor —Pennsburg, PA
- $18 - $22 an hour
- Full-time
- HIPAA
- Mid-level
- High school diploma or GED
- Disability insurance
- Dental insurance
Remote Medical Coder
OnPoint Healthcare Solutions —United States
- $28 - $45 an hour
- Full-time
- Remote
- 5 years
- Outpatient
- US work authorization
- Health insurance
- Dental insurance
Quick Apply
RN Inpatient Hospital Auditor | Remote | Contract
Walker Healthforce, LLC —United States
- Contract
- Remote
- Anatomy knowledge
- RN License
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Remote Coding Specialist, Interventional Radiology Coder
LexiCode —United States
- From $28 an hour
- Full-time
- Remote
- Anatomy knowledge
- HIPAA
- Bachelor's degree
- Health savings account
- Health insurance
Quick Apply

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Accounts Receivable Specialist- Hospital Billing
St. Luke's University Health Network —Allentown, PA
Analyze daily aging of insurance accounts via the billing system to determine appropriate follow up for non- payment and delayed payment accounts, as well as to…
Accounts Receivable Specialist I
St. Luke's University Health Network —Sellersville, PA
Analyze daily aging of insurance accounts via the billing system to determine appropriate follow up for non- payment and delayed payment accounts, as well as to…

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Post insurance and patient payments accurately and timely. Reconcile payment discrepancies and identify billing issues.
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Coding Appeals Specialist

St. Luke's University Health Network -
Allentown, PA

Apply Now

Job Details

Part-time

Qualifications

Teaching hospital experience
Anatomy knowledge
Inpatient
Medical coding in outpatient clinics
Acute care
Medical terminology
Academic medical center experience

Full Job Description

St. Luke's is proud of the skills, experience and compassion of its employees. The employees of St. Luke's are our most valuable asset! Individually and together, our employees are dedicated to satisfying the mission of our organization which is an unwavering commitment to excellence as we care for the sick and injured; educate physicians, nurses and other health care providers; and improve access to care in the communities we serve, regardless of a patient's ability to pay for health care.

The Coding Appeals Specialist analyzes patient medical records, claims data and coding on all diagnosis and procedure codes to assure properly assigned MS-DRG for the purposes of appealing proposed MS-DRG and coding changes by insurance providers or their auditors. Assures that the most accurate and descriptive codes from the AHA ICD-9-CM/ICD-10-CM/PCS diagnoses and/or procedures support the services/treatment rendered.

JOB DUTIES AND RESPONSIBILITIES:

Conduct retrospective medical record reviews for diagnosis and procedure code assignment and MS-DRG accuracy.
Identify and provide feedback, including identification of trends, to the Network Coding and CDMP Managers for education of the medical staff, clinical documentation professionals and the coding professionals on documentation issues that affect proper documentation and coding of documented medical care for appropriate reimbursement.
Work with the physician liaison in review of patient medical records identified by RAC/MIC/CGI/QIO and other outside auditors in retrospective reviews for DRG and coding-related issues. May participate in review of other medical necessity issues as needed.
Develop and apply appeal arguments to defend the coding of and by the coding professionals and be able to refute the coding determination made by the outside payor including but not limited to CMS, Aetna, IBC, Omniclaim, QIP, Gateway Health, etc.
Draft appeal letters, including the coding argument, to support network coding.
Identify clinical documentation improvement issues and through excellent communication with physicians, nurses, coding and other members of the health care team and work independently to resolve such issues.
Participate as needed in Administrative Law Judge (ALJ) hearings.
Spends approximately 20% of their time weekly coding/abstracting patient medical records according to ICD-10-CM/PCS, UHDDS and CMS guidelines. Utilizes the 3M Encoder to verify and assign ICD-10-CM/PCS diagnosis and procedure codes, and MS-DRG assignment.
Performs data entry of coded patient medical records into EPIC, maintaining a 95% coding accuracy rate as measured through quality reviews.
Queries physicians when code assignments are not clear and consistent, or when documentation in the record is inadequate, ambiguous, or unclear for coding assignment.

PHYSICAL/SENSORY DEMANDS:

Sitting, standing and light lifting. Repetitive arm/finger use retrieving/viewing computerized patient medical record and abstracting of patient information. Corrected vision and hearing to within normal range. Hearing as it relates to normal conversation. Works inside with adequate lighting, comfortable temperature and ventilation.

EDUCATION:

RHIA, RHIT and/or CCS with knowledge of ICD-9-CM and ICD-10-CM/PCS diagnosis/procedure coding and MS-DRG assignment. Minimum of 5 years coding experience in an acute care, teaching hospital, inpatient setting required.

TRAINING, KNOWLEDGE AND EXPERIENCE:

Minimum 5 years demonstrated inpatient and/or outpatient coding experience in acute care, teaching setting. Knowledge of anatomy and physiology, pathophysiology, and medical terminology required. Working knowledge of ICD-10-CM/PCS and ability to understand complex disease processes strongly preferred. Possesses extensive knowledge of reimbursement systems; extensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation, coding and, as needed, medical necessity. Previous experience with electronic patient medical record/EPIC and 3M encoding system preferred.

Please complete your application using your full legal name and current home address. Be sure to include employment history for the past seven (7) years, including your present employer. Additionally, you are encouraged to upload a current resume, including all work history, education, and/or certifications and licenses, if applicable. It is highly recommended that you create a profile at the conclusion of submitting your first application. Thank you for your interest in St. Luke's!!

St. Luke's University Health Network is an Equal Opportunity Employer.

Apply Now

Refine Your Search

coding specialist jobs in allentown pa

Coding Appeals Specialist

Accounts Receivable Specialist- Hospital Billing

Claims and Denial Coding Analyst

Inpatient Coding Specialist (Remote – Full Time | PA & NJ Candidates)

RN DRG Downgrades Appeals Review Specialist

Risk Adjustment Clinical Documentation Specialist-1

Oncology Data Specialist, Certified (Cancer Data Registrar) - Full Time

Accounts Receivable Specialist I

Patient Access Coordinator

Records Management Specialist

Remote Medical Coder

RN Inpatient Hospital Auditor | Remote | Contract

Remote Coding Specialist, Interventional Radiology Coder

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St. Luke's University Health Network is an Equal Opportunity Employer.

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