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Medical Coder

Onebridge • Remote - work from home

Posted 13 days ago

Job Snapshot

Full-Time
Travel - None
Experience - At least 2 year(s)
Degree - High School
$16.50 - $22.00 /Hour
Healthcare - Health Services
Health Care, Customer Service, Admin - Clerical
Relocation - No
55

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Job Description

Onebridge is actively seeking a Medical Coding Specialist for a remote (work from home opportunity). 

 

Job Title: Medical Coding Specialist

Vertical: Healthcare

Address City: Dayton - remote (work from home)

Address State: OH

Country:  US

ZipCode: 45402

Address Country: US

Employment Type: Full Time

 

Specific Skills and Responsibilities:

Reduce backlog of Regulatory compliance appeals.

ICD-10 Knowledge

CPT/HCPCS Knowledge

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

Job Requirements

General Education/Experience/Skills: 

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

Facets training/knowledge

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.

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