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Profee Medical Coding Denial Specialist at Guidehouse. Location Information: USA. Job Family. :. General Coding. Travel Required. :. None. Clearance Required. :. None. What You Will Do. :. TheCoding Denial Specialist. will reviewassigned coding denialsacrossmultiple specialties, determine root cause and followingestablished clientworkflowresolveand/or appeal denialsbased onclinical documentation and diagnostic resultsin alignment withFederal & State Coding regulations;including the National Correct Coding Initiative, CPT, HCPC’s and ICD10 CM Guidelines. This position is full time and is 100% remote.. Triage incoming coding denial inventory, validating appeal criteria is met in compliance with departmental policies and procedures . Compose technical denial arguments for reconsideration and appeal . Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective appeal argument . Identify problem accounts/processes/trends and escalate as appropriate . Utilize effective documentation standards that support a strong historical record of actions taken on the account . Resolve claims impacted by payor recoupments, refunds, and posting errors . Assist team members with coding questions and provide resolution guidance . Meet and maintain established performance metrics for production and quality  . Maintains a working knowledge of ICD-10 and CPT coding principles, governmental regulations, official coding guidelines, and third-party requirements regarding documentation and billing . Assures that all services documented in the patient’s chart are coded with appropriate ICD-10 and CPT codes. When services/diagnoses are not documented appropriately, seeks to attain proper documentation in a timely manner according to facility standards. . Charts that require re-bills are corrected and communicated to the facility daily for the re-bill process. See re-bill policy in facility guidelines. . Coder downtime must be reported immediately to the administrative staff to ensure turnaround is met. . Responsible for working directly with the IQC staff to ensure quality standards are being met for each facility. . Provides accurate answers to physician’s/hospitals coding and/or billing questions within eight hours of request. . Responsible for coding or pending every chart placed in their queue within 24 hours. . It is the responsibility of the coder to notify administrative staff in the event they cannot meet the twenty-four hour turn around standard. . Coders are responsible for checking the Guidehouse email system at least every two hours during coding session. . Coders must maintain their current professional credentials while working for Guidehouse. . Coders are responsible for becoming familiar with the Guidehouse coding website and using the information contained in the website as a daily tool to correctly code and abstract for each facility. . Coders are responsible for maintaining HIPAA compliant workstations (reference HIPAA workstation policy) . It is the responsibility of each coder to review and adhere to the coding division policy and procedure manual content. . Works well with other members of the facilities coding and billing team to insure maximum efficiency and reimbursement for properly documented services. . What You Will Need. :. High School Diploma or equivalent. 1+ years Physician Coding experience . 1+ years Physician Coding Denial Management experience . CPC certification from AAPC . Must maintain credential throughout employment . High level of accuracy and attention to detail . Strong Working Knowledge of Federal & State Coding regulations; including the National Correct Coding Initiative . Strong working knowledge of CPT, HCPC’s and ICD10 CM Guidelines . Good working knowledge of HIPAA regulations, hospital operations, and working with electronic health record (EHR) systems such as EPIC or Cerner . What Would Be Nice To Have. :. AAPC specialty credential(s)  . Proficient in the interpretation of Claim Adjustment and Remittance Advice Reason Codes . Excellent verbal, written and interpersonal communication skills . Basic knowledge of Excel, Word and PowerPoint . Strong critical thinking, analytical, and communication skills, with an attention to detail and the ability to work in a fast-paced environment independently or collaboratively . The annual salary range for this position is $38,000.00-$64,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.. What We Offer. :. Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.. Benefits include:. Medical, Rx, Dental & Vision Insurance. Personal and Family Sick Time & Company Paid Holidays. Position may be eligible for a discretionary variable incentive bonus. Parental Leave. 401(k) Retirement Plan. Basic Life & Supplemental Life. Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts. Short-Term & Long-Term Disability. Tuition Reimbursement, Personal Development & Learning Opportunities. Skills Development & Certifications. Employee Referral Program. Corporate Sponsored Events & Community Outreach. Emergency Back-Up Childcare Program. About Guidehouse. Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at . [email protected]. . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or . [email protected]. .  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.. If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact . [email protected]. . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.