LogoFresh Jobs Ahead
EnableComp
EnableComp
501 – 1.000 Angajați
AsigurăriConsultanțăLogistică
EnableComp oferă servicii de gestionare a ciclului veniturilor din domeniul sănătății pentru furnizori și sisteme de sănătate din întreaga SUA. Activitatea sa se concentrează pe cereri complexe care implică Administrația pentru Veterani, despăgubirea lucrătorilor, accidentele auto și Medicaid din alte state, precum și pe gestionarea refuzurilor în cazul diferitelor categorii de plătitori. Prin automatizare inteligentă și platforma proprietară E360 RCM™, EnableComp sprijină o facturare mai eficientă, rambursări exacte și colectări mai consistente. Pentru persoanele aflate în căutarea unui loc de muncă, profilul companiei este relevant în special pentru roluri legate de operațiunile din domeniul sănătății, cereri, gestionarea ciclului veniturilor, tehnologia de facturare și serviciile pentru clienți.
LinkedIn
Locurile de muncă ale companiei

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.

USStatele Unite ale AmericiiTNTennesseeRemoteNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăAuditor

Descriere

  • 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.

Cerințe

  • 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.

Beneficii

  • 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.

Locuri de muncă similare