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Company Contact Info
- Remote - work from home
- Julia Jasko
- Phone: 513-301-0353
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Onebridge • Remote - work from home
Posted 13 days ago
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Onebridge is actively seeking a Medical Coding Specialist for a remote (work from home opportunity).
Job Title: Medical Coding Specialist
Address City: Dayton - remote (work from home)
Address State: OH
Address Country: US
Employment Type: Full Time
Specific Skills and Responsibilities:
Reduce backlog of Regulatory compliance appeals.
Knowledge of Medicare/Medicaid Regulations
Major Job Duties and Responsibilities:
Responsible for reviewing and evaluating as a secondary-level review and decision maker on medical record documentation for claims and/or appeals to ensure diagnostic and procedural codes accurately reflect and support the visit as it relates to correct coding guidelines and medical necessity
Maintain incoming pended claims, electronic inquiries and medical records work queue as a secondary-level review and decision maker
Prepare claims for medical director review by completing worksheets and attaching all pertinent medical information
Read and interpret medical procedures and terminology by reviewing medical notes
Analyze and make a determination of appropriate reimbursement for unlisted and by report codes submitted on claims
Leverage an automated workflow system to track/monitor/report on progress and issues/blockers
Collaborate with leadership to communicate opportunities based on industry standard coding practices
Assist in the analysis and development of claims test case scenarios and test plans to ensure industry standard coding practices are implemented
Conducts on-going review monitoring and communications to promote and ensure adherence to established protocols and best practices
Maintain an understanding of Federal and State Regulatory requirements, i.e. CMS, ODJFS& MDCH
Responsible for meeting company and associated department standards for timeliness of review claims while maintaining accuracy of medical decisions
Timeliness of reviews must be consistent with regulatory standards for production and turnaround
Perform all job functions with a high degree of discretion and confidentiality in compliance with federal, state and departmental confidentiality guidelines
Perform any other job related instructions, as requested
Associates or Bachelor’s degree in Health Information Management is required OR a high school diploma or GED and a minimum of two (2) years of medical billing coding experience is required
Medicaid experience is preferred
A clinical background with a firm understanding of claims payment is preferred
Experience with a Clinical Editing Toolset is preferred
Knowledge of diagnosis codes, and CPT coding guidelines; medical terminology; anatomy and physiology; and Medicare/Medicaid/Commercial reimbursement guidelines
Intermediate level of Facets, Microsoft Word, Excel, PowerPoint and Access
Firm understanding of basic medical billing process
Reimbursement Methodology (APC, DRG, OPPS) preferred
Advanced communication skills
Data analysis and quality assurance skills
Ability to work independently and within a team environment
Ability to generate reports & identify trends in coding
Attention to detail
Familiarity of the healthcare field
Knowledge of Medicaid/Medicare/Commercial
Critical listening and thinking skills
Claims processing skills
Technical writing skills
Time management skills
Decision making/problem solving skills
Proper phone etiquette
Broad understanding of business considerations and functionality
Certified Medical Coder (CPC, RHIT or RHIA) is required
Onebridge offers competitive compensation and access to a comprehensive program which includes: Medical, Dental, Vision, Flexible PTO, Holiday Pay, and 401K.