Innovaccer Analytics

Healthcare

4242MedicalCodingSpecialist

$65–85k ~AI est. Jersey City, New Jersey, United States FULL TIME
The Brief

“4242-Medical Coding Specialist at Innovaccer Analytics. Skills: Medical coding, Claim resolution, HIPAA compliance. Review front-end claims. Analyze front-end claims”

What You'll Achieve.

Maintain 90% coding accuracy

Industry & Context.

Healthcare
Problems you'll solve

Resolve coding issues; Resolve documentation issues

What They're Looking For.

Must Have

AAPC or AHIMA Certification, 3+ years of professional coding experience, Working knowledge of CPT, Working knowledge of ICD-10-CM, Working knowledge of medical terminology, Working knowledge of anatomy and physiology, Working knowledge of Medicare reimbursement guidelines, Familiarity with English grammar, Familiarity with professional documentation standards, Ability to research and analyze data, Ability to read, interpret, and apply policies, Ability to read and interpret medical documentation, Demonstrated ability to exercise independent judgment, Commitment to maintaining confidentiality, Prior experience in medical billing, Strict adherence to HIPAA compliance

Nice to Have

Microsoft Office Suite proficiency

What You'll Do.

Review front-end claims

Analyze front-end claims

Resolve front-end claims

Ensure accurate claim submission

Ensure timely claim submission

Identify coding-related issues

Correct coding-related issues

Apply coding guidelines

Apply payer requirements

Apply organizational policies

Prevent claim rejections

Support clean claim rates

Promote efficient reimbursement

Assign ICD-10-CM codes

Assign appropriate modifiers

Review medical records

Review applicable documentation

Determine appropriate codes

Ensure diagnosis codes meet medical necessity

Utilize internal coding resources

Utilize payer guidelines

Utilize reference materials

Follow HIPAA regulations

Uphold privacy standards

Uphold confidentiality standards

Maintain current knowledge of laws

Maintain current knowledge of regulations

Maintain current knowledge of payer policies

Maintain current knowledge of industry guidance

Independently review claim holds

Independently resolve claim holds

Participate in department meetings

Participate in one-on-one meetings

Participate in mentorship meetings

Escalate identified client trends

Escalate coding-related questions

Maintain CEU requirements

Perform other duties as assigned

How You'll Work.

Team & Collaboration

Work with revenue cycle partners; Collaborative working relationships

Communication Scope

Written communication; Verbal communication

Free ATS check

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