EnableComp
EnableComp
EnableComp पूरे संयुक्त राज्य अमेरिका में स्वास्थ्य सेवा प्रदाताओं और स्वास्थ्य प्रणालियों के लिए हेल्थकेयर रेवेन्यू साइकिल मैनेजमेंट सेवाएँ प्रदान करता है। इसका कार्य वेटरन्स एडमिनिस्ट्रेशन, श्रमिक मुआवज़े, मोटर वाहन दुर्घटनाओं और राज्य से बाहर के मेडिकेड से जुड़े जटिल दावों के साथ-साथ विभिन्न भुगतानकर्ता वर्गों में अस्वीकृतियों के प्रबंधन पर केंद्रित है। इंटेलिजेंट ऑटोमेशन और अपने स्वामित्व वाले E360 RCM™ प्लेटफ़ॉर्म के माध्यम से, EnableComp अधिक कुशल बिलिंग, सटीक प्रतिपूर्ति और बेहतर वसूली में सहायता करता है। नौकरी तलाशने वालों के लिए, कंपनी की प्रोफ़ाइल हेल्थकेयर संचालन, दावों, रेवेन्यू साइकिल मैनेजमेंट, बिलिंग तकनीक और ग्राहक सेवाओं से जुड़ी भूमिकाओं के लिए सबसे प्रासंगिक है।

Coding Denials Auditor — Tennessee Remote

Audit outpatient facility and professional claims for coding accuracy, billing compliance, and denial resolution at EnableComp. Prepare payer appeals and analyze medical records using established coding guidelines.

विवरण

  • Audit submitted outpatient facility and professional claims for coding accuracy.
  • Evaluate billing accuracy and compliance with third-party carrier coding and billing procedures.
  • Work with revenue cycle teams to investigate rejected and denied claims.
  • Support claim corrections and appeals through cross-functional collaboration.
  • Use Microsoft Office to prepare correspondence, charts, spreadsheets, and related materials.
  • Keep current with medical coding practices and changes across the healthcare market.
  • Analyze claims and medical records to evaluate documentation findings and outcomes.
  • Prepare payer appeals based on nationally recognized coding guidelines.
  • Share coding expertise and audit findings with internal and external stakeholders.
  • Complete additional duties as assigned.

आवश्यकताएँ

  • Associate or bachelor's degree.
  • Current CPC, AAPC-related, CCA, CCS, or RHIT certification.
  • Strong experience with orthopedic and surgical billing and coding.
  • Five or more years of orthopedic surgery billing experience preferred.
  • Experience in coding and medical billing, including accounts receivable, EOBs, account management, and coding denials.
  • Ability to collect and analyze claims and medical-record information.
  • Strong written communication skills.
  • Ability to write grammatically accurate appeals using CPT Assistant, specialty-society guidance, state fee schedules, and AAPC or AHIMA articles.
  • Effective time management and the ability to manage work independently.
  • Strong analytical, problem-solving, research, and creative-thinking abilities.
  • Comfort conducting CAC or Encoder audits and determining appropriate code selection.
  • Equivalent combinations of education and experience will be considered.
  • Ability to work remotely.
  • Proficiency with Microsoft Word, Excel, and Outlook.
  • Regular and dependable attendance.
  • Familiarity with healthcare documentation systems.
  • Knowledge of DRGs, APCs, and NCCI fee schedule concepts.
  • Strong verbal, written, interpersonal, and customer service communication skills.
  • Ability to explain audit findings and testing results to clinical and nonclinical staff.
  • Ability to interpret policies and procedures and explain complex topics clearly.
  • Critical-thinking skills and sound decision-making within assigned responsibilities.
  • Complex Claims medical billing and coding experience strongly preferred.

लाभ

  • Opportunities for professional growth and development.
  • Career-development tools, resources, and support.
  • Flexible, family-oriented workplace culture.
  • Support for maintaining work-life balance.
  • Remote work option.

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