Pro fee Neurosurgery Denials
Denials Coder for Neuro Surgery for 6 months
Certified Professional Coder (CPC) JOB SUMMARY The purpose of this position is to ensure accurate coding to maximize reimbursement for the organization. Reviews claims for submission, refiles denied claims, reviews all supporting documentation and ensures that information is handled accurately and confidentially. Follows all AAPHC financial policies and procedures.
DUTIES AND RESPONSIBILITIES 1. Maintain working knowledge of regulations, guidelines, policies for all insurance companies that pertain to the billing physician and non physician CPT codes. 2. Maintain working knowledge of proper filing and refiling denied claims based on insurance company guidelines. 3. Ability to apply, interpret and code Physician History and Physicals, Consults and Operative notes using CPT and ICD coding books. 4. Ability to interpret EOBs and follow up on denied claims with all insurance companies. 5. Working knowledge of hospital systems in order to gather patient information. 6. Responsible for random chart audits, as assigned. 7. Assist billing/insurance staff with claim denials 8. Responsible for reviewing claims entered into current EHR system to ensure correct diagnosis, modifiers, etc are applied before releasing claim for submission. 9. Ensure 'clean' claims are submitted to 3rd party payers 10. Abides by all state and federal guidelines for coding. 11. Research and resolve coding related issues. 12. Maintains open communication to notify appropriate staff
KNOWLEDGE, SKILLS, AND ABILITIES CPC - Knowledge of medical business office procedures. Knowledge of coding and insurance reimbursement practices. Knowledge of patient accounting systems and computer data entry. Ability to prioritize and use independent judgment/decision making. Knowledge of organization's policies specific to patient accounting principles.
EDUCATION AND EXPERIENCE High school graduate; Associate degree preferred. Minimum of one year experience in coding Must be CPC or equivalent coding certified Strong working knowledge of ICD and CPT Coding Knowledge of medical and insurance terminology