Urgently Hiring: Revenue Integrity Coding Billing Specialist
Let's build something amazing together. We're looking for a Revenue Integrity Coding Billing Specialist- Remote! Enjoy the freedom and flexibility of this Remote role. This position requires a strong and diverse skillset in relevant areas to drive success. A salary of a competitive salary is offered, reflecting your skills and experience.
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Job FamilyGeneral Coding...
Travel Required
None
Clearance Required
None
What You Will Do
Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialist provides revenue cycle support services through efficient review and prompt resolution of assigned Medicare and third-party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. This position is 100% remote.
 Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and/or specific Revenue Integrity Hold Codes in the hospital billing scrubber. Tasks associated with this work include resolving standard billing edits such as:
 Correct Coding Initiative (CCI)
 Medically Unlikely Edits (MUE)
 Medical Necessity edits
 Other claim level edits as assigned.
 As needed, review clinical documentation and diagnostic results as appropriate to confirm and apply applicable ICD-10, CPT, HCPCS codes and associated coding modifiers.
 Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX? system.
 Ensures coding and billing practices follow Federal/State guidelines by using diverse types of authoritative information.
 Maintains current knowledge of Medicare, Medicaid, and other third-party payer billing compliance guidelines and requirements.
 Other duties equal with skills and experience as determined by the Director of Revenue Integrity.
What You Will Need
 High school diploma and 3-5 years of prior relevant experience
 AAPC or AHIMA coding certification.
 Experience in ICD-10, CPT and HCPCS Level II Coding.
 Ability in determining medical necessity of services provided and charged based on provider/clinical documentation.
 Knowledge, understanding and proper application of Medicare, Medicaid, and third-party payer UB-04 billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims.
 Ability in determining accurate medical codes for diagnoses, procedures and services performed in the outpatient setting. For example: emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology, imaging, and laboratory), and outpatient therapies (physical therapy, occupational therapy, speech therapy, and chemotherapy)
 Knowledge of current code bundling rules and regulations along with ability on issues of compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPGÂs.
 Knowledge and understanding of hospital charge description master coding systems and structures.
 Ability to produce correct, assigned work product within specified periods.
What Would Be Nice To Have
 5 years experience in Revenue Integrity Coding and Billing
 Hospital medical billing and auditing experience
 Associate degree
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The annual salary range for this position is $49,400.00-$74,200.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.
What We Offer
Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.
Benefits Include
 Medical, Rx, Dental & Vision Insurance
 Personal and Family Sick Time & Company Paid Holidays
 Position may be eligible for a discretionary variable incentive bonus
 Parental Leave
 401(k) Retirement Plan
 Basic Life & Supplemental Life
 Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
 Short-Term & Long-Term Disability
 Tuition Reimbursement, Personal Development & Learning Opportunities
 Skills Development & Certifications
 Employee Referral Program
 Corporate Sponsored Events & Community Outreach
 Emergency Back-Up Childcare Program
About Guidehouse
Guidehouse is an Equal Employment Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, citizenship status, military status, protected veteran status, religion, creed, physical or mental disability, medical condition, marital status, sex, sexual orientation, gender, gender identity or expression, age, genetic information, or any other basis protected by law, ordinance, or regulation.
Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.
If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.
Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee Apply Job!
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