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The Multispecialty Denials Coding Specialist reviews documentation and coding guidelines to research payer denials and submit customized appeals. They are responsible for identifying root causes of claim issues and ensuring appropriate revenue capture while maintaining compliance with medical guidelines.
Job Details: Position Type: Full Time, Salary Range: $25.00 - $27.00, 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 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.
Apply today to get your career started with Ensource!
Qualifications:
“I was the first applicant for a remote marketing position that got listed on the company website the same day I applied. Had an interview within 48 hours!”