Full time
Day (United States of America)
2331 Franklin Rd - Roanoke
R159966 Invasive Coding Analyst - Ortho (Open)


The Invasive Coding Analyst identifies and analyzes denials, determines solutions and implements corrections to result in accurate processing/payment of claims. Investigates denial and coding issues as it relates to services provided and associated charges. May require a strong working knowledge of multiple payers knowing payer specific policies and procedures in order to serve as subject matter expert. Makes important decisions and determination by the payers for claims. Works in a fast-paced, office environment with high productivity and accuracy standards that requires focus and concentration on tedious details and research. Investigate and identify errors in billing, coding or procedures relating to patient accounts.
Collaboration with leadership in recommending solutions to management related to insurance issues, departmental procedures, and operations.
Retrieves and analyzes denial reports and provides recommendations based on findings.


The Invasive Coding Analyst
- May act as coding and billing expert and resource.
- Assists with denial reviews and creation of denial trending reports for management.
- Identifies coding-related revenue and reimbursement improvement opportunities for Orthopaedic Services and reports these findings to management.
- Consults with and provides education to physicians regarding clinical documentation as it relates to coding requirements.
- Investigate and identify errors in billing, coding or procedures relating to patient accounts.
- Conducts analysis of complex accounts. Determines actions and completes action steps to resolve accounts.
- Serving as a subject matter expert and provides guidance to RCM Specialists.
- Collaboration with Orthopaedic Leadership in recommending solutions to management related to insurance issues, departmental procedures, and operations.
- Reports any erroneous processing trends by payer to management.



Education: High School education required.
Experience: Minimum of 3 years of demonstrated proficiency in coding required.
Licensure/certification: RHIT, RHIA, CCA, CCS, CPC, or CPC-H required.
Other Minimum Qualifications: Effective oral and written communication skills. Must be a team player with intiative, organizational skills, analytical abilities, detail oriented and have the ability to work independently. Maintains working knowledge of computer systems used for healthcare operations. Must be proficient with Word, Excel and researching the web for coding and billing information. Must be able to provide own transportation for travel to other Carilion work sites.
This job description is only meant to be a representative summary of the major responsibilities and accountabilities performed by the incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.



Compensation Range:
$23.23 - $32.52
Employee pay is based on a variety of factors, including qualifications, credentials, education, and prior work experience. The compensation range does not include benefits or pension plan.



Recruiter:
EMILY ALLEN
Recruiter Email:
[email protected]
For more information, contact the HR Service Center at 1-800-599-2537.
Carilion Clinic is an Equal Opportunity Employer: We provide equal employment opportunities to all employees and applicants without regard to race, color, religion, sex, national origin, age (40 or older), disability, genetic information, or veterans status. Carilion is a Drug-Free Workplace. For more information or for individuals with disabilities needing special assistance with our online application process contact Carilion HR Service Center at 800-599-2537, 8:00 a.m. to 4:30 p.m., Monday through Friday.
For more information on E-Verify: https://www.carilionclinic.org/eoe-e-verify-and-right-work-policies



Carilion understands the importance of prioritizing your well-being to help you develop and thrive. That’s why we offer a well-rounded benefits package, and many perks and well-being resources to help you live a happy, healthy life – at work and when you’re away.
When you make your tomorrow with us, we’ll enhance your potential to realize the best in yourself. Below are benefits available to you when you join Carilion:
- Comprehensive Medical, Dental, & Vision Benefits
- Employer Funded Pension Plan, vested after five years (Voluntary 403B)
- Paid Time Off (accrued from day one)
- Onsite fitness studios and discounts to our Carilion Wellness centers
- Access to our health and wellness app, Personify Health
- Discounts on childcare
- Continued education and training
