Reimbursement Analyst

Our client a leading academic medical center in NYC has an opening for a Reimbursement Analyst.

The Reimbursement Analyst will be responsible for resolving coding related errors and/or denials identified by CDM edits or by the Billing Dept.

· Review documentation associated with accounts reside in Epic work queues to determine the appropriate charge/s, procedure and/or diagnosis codes.

· Liaison with front end, as needed, to ensure that visits are registered correctly

· Ensure that documentation supports charges on claim to prevent denials/underpayments and are in adherence with compliance standards and credible coding sources

· Assist PFS with analyzing coding denials and writing appeals, as needed.

· Review and distribute coding-related articles to clinical staff, including medical necessity policies and coding/billing information for various procedures

· Research and identify missing device &/or drug related charges that's required to support procedure on claim & bring to manger's attention for needed follow-up

· Identify and assists with documentation gaps in retrospect of CMS, AHA or AMA guidelines for revenue enhancement opportunities

· Identify patterns, trends, and opportunities for charge capture and revenue enhancement.

· Update charges in Eagle as required by posting and deleting and ensure that the correct info is entered to avoid negative charges or incorrect DOS.

· Assists /perform special projects related to re-billing or charge master activities.

· Participate in education programs to maintain up to date coding skills.

Qualifications:

§ Proficient in Epic Billing and have thorough working knowledge of ICD-10 diagnosis coding guidelines, CPT/HCPCS code assignments.

§ Knowledge of the Outpatient Prospective Payment System (OPPS)

• Detailed knowledge and understanding of hospital vs. professional charging and coding.

§ Ability to concentrate and accomplish tasks with explicit accuracy and established/maintained effective working relationships as required by the duties of the position.

§ Functional knowledge of facility EMR, encoder, and other support software

EDUCATION / EXPERIENCE:

3-5 years of multispecialty coding experience in AmSurg and/or clinic settings

Bachelor’s degree or equivalent work experience required.

CERTIFICATES, LICENSES, REGISTRATIONS
Required: AHIMA (CCS) or AAPC (CPC) approved credential

Can be hybrid

Salary: $78, 000-$82,000. This salary range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.

View all jobs online at: https://jobs.talhealthcare.com/

There is no such thing as a perfect candidate, so do not let that hold you back from applying. You do not need 100% of the qualifications to add incredible value to the team. If you are passionate about what you could accomplish in this role, we would love to hear from you!