MULTISPECIALTY DENIALS CODING SPECIALIST at Professional in Remote

Ensource RCM partners with hospitals, physician groups, health systems, and legal teams nationwide to deliver trusted revenue cycle management solutions.

We recognize and understand some of the challenges and feelings of isolation that can come with remote work, so we’ve dialed in on what makes working remotely successful for our valued employees.

What you'll do:

The Multispecialty Denials Coding Specialist will review documentation and coding guidelines for professional fee-based coding, evaluation and management services, procedures, and diagnoses. Researching claim denials, submitting appeals, following up on outstanding claims, and handling claims correspondence. This is a full-time remote employee opportunity.

Essential Job duties and Responsibilities:

• Research payer denials related to referral, pre-authorization, eligibility/registration, notifications, medical necessity, non-covered services, and billing resulting in denials and delays in payment.
• Submit detailed, customized appeals to payers based on review of medical records and in accordance with Medicare, Medicaid, and third-party guidelines as well as client’s policies and procedures.
• Submit retro-authorizations in accordance with payor requirements in response to authorization denials.
• Demonstrate knowledge and understanding of insurance billing procedures as evidenced by the identification of root-causes of claim issues and proposed resolutions to ensure timely and appropriate payment.
• Ensure appropriate revenue is captured; to prevent federal and payer audits, malpractice litigation, and health plan denials.

Requirements:

• Proficiency with MS Office Suite and Athena software
• Profee multispecialty, E/M coding: 2 years
• Physician based Denials: 5+ years
• (AAPC) CPC and/or (AHIMA) CCS, CCS-P, or RHIT certification
• Knowledge of medical terminology, insurance and appeals processes, and medical record management
• High level of accuracy and attention to detail
• Strong written and verbal communication skills

Reasons to Join Our Team:

• Flexible schedules to balance your work and personal goals
• Remote working environment with virtual team socials and collaboration opportunities
• Growth potential, both personally and professionally
• Great benefits (health, dental & vision Insurance)
• We offer a traditional 401k/Roth Plan with discretionary matching.
• Paid Time Off for Full-Time and Part-Time Employees
• Yearly Stipend for Educational CEU Resources
• Paid Volunteer and Community Outreach Program that allows you to ‘help others’ in the community
• This is a full-time remote job opportunity working 35-40 hours per week

Apply today to get your career started with Ensource RCM!