Carilion Clinic

InvasiveCodingAnalyst-Ortho

Roanoke, Virginia, United States FULL TIME
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Mid candidates.

The Brief

“Invasive Coding Analyst - Ortho at Carilion Clinic. Skills: Coding, Denial analysis, Claim processing. Identify and analyze denials. Determine solutions and implement corrections”

What You'll Achieve.

Accurate processing/payment of claims; Denial trending reports for management; Coding-related revenue and reimbursement improvement opportunities

Industry & Context.

Problems you'll solve

Analytical abilities

Eligibility Requirements

Must be able to provide own transportation for travel to other Carilion work sites

What They're Looking For.

Must Have

High School education required, Minimum of 3 years of demonstrated proficiency in coding required, RHIT, RHIA, CCA, CCS, CPC, or CPC-H required, Effective oral and written communication skills, Must be proficient with Word, Excel and researching the web for coding and billing information

What You'll Do.

Identify and analyze denials

Determine solutions and implement corrections

Investigate denial and coding issues

Investigate and identify errors in billing

Retrieve and analyze denial reports

Assist with denial reviews

Identify coding-related revenue opportunities

Consult with physicians regarding documentation

Conduct analysis of complex accounts

Determine actions and complete action steps

How You'll Work.

Team & Collaboration

Collaboration with leadership in recommending solutions; Collaboration with Orthopaedic Leadership in recommending solutions

Communication Scope

Effective oral and written communication skills

Full Job Description

## **Employment Status:** Full time ## **Shift:** Day (United States of America) ## **Facility:** 2331 Franklin Rd - Roanoke ## **Requisition Number:** R159966 Invasive Coding Analyst - Ortho (Open) # **How You’ll Help Transform Healthcare:** 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 manag

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