Certified Coder Payment Recovery Specialist
The posted compensation range of $22.95 - $33.28 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.
Hello humankindness Dignity Health Medical Group is the employed physician group of Dignity Health Arizona. Dignity Health Medical Group (DHMG) employs approximately 200 providers and 500 support staff that cover a wide variety of specialties. The medical group has had tremendous success over the past few years and now provides more than 73 subspecialty services. The physicians provide clinical services in their areas of specialty and many serve in pivotal academic research and leadership roles.DHMG is also heavily involved in preparing tomorrows healthcare providers. DHMG has 84 medical school students and approximately 200 residents and fellows throughout the 25 academic programs. Clinical services are complemented with translational and bench research to augment medical education for residents and students. The mission of Dignity Health Medical Group is consistent with Dignity Healths mission and St. Josephs guiding principles with a focus on innovative clinical care and the pursuit of excellence through scholarly activities. As part of the Dignity Health hospital system DHMG has full access to the staff and all facilities on our hospital campuses. This unique relationship with our hospital allows Dignity Health Medical Group to provide its patients with state-of-the-art patient services including care of the poor and disenfranchised.Look for us on Facebook and follow us on Twitter.For the health of our community ... we are proud to announce that we are a tobacco-free campus
Responsibilities
Accurately reviews record for coding errors and corrects diagnostic and procedural codes in billing system for the purpose of reimbursement utilizing ICD-10-CM, CPT, HCPCS, and proper modifiers. Must be able to identify and communicate payer and/or system trends to Management. Maintains thorough knowledge of payer contracts, regulations and guidelines, as well as state and federal laws relating to billing and collection procedures to ensure accurate and compliant billing processes. Communicate with courtesy and tact to fellow employees and external customers to promote better quality and more efficient customer service.
- Utilizes Centricity and/or related modules to obtain, analyze and interpret coding denials and other reimbursement data to support compliance and billing concepts and procedures.
- Manages and corrects denied claims for coding issues, i.e., unbundling, medical necessity, coding errors, etc as determined by management to facilitate payment and resolution.
- Ensures all coding error corrects accurately reflect the services provided, dates of service(s), identity of person providing services, and diagnosis is accurate and carried to highest level of specificity, etc.
- Analyzes, investigates and follows-up on denied claims. Manages all assigned denial work files, understands and addresses denials independently in a timely manner.
- Reviews and adheres to all Dignity Health coding policies and procedures.
**You MUST be a Certified Professional Coder CPC or CBCS to be considered for this position
Qualifications
MINIMUM
HS Diploma
Three (3) years prior experience in medical coding and/or billing for physician office services
Proficiency assigning ICD-10-CM , CPT, HCPCS, and modifiers.
Ability to read and comprehend an EOB.
Proficient in guidelines, CCI, LMRP, coding, use of modifiers.
Ability to research CPT/ICD10 codes to bill appropriately.
Proficient in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules).
Adept in physician and insurance reimbursement and billing concepts and procedures, as well as laws and regulations affecting payment compliance, denials and appeals recovery.
Proficient understanding of medical coding systems effecting the adjudication of claims payment.
Proficiently utilizes MS Office applications, including MS Excel and MS Access.
Certified Professional Coder CPC or CBCS
PREFERRED
Associate's degree
Five (5) years work experience in medical billing and coding for physician office services.
Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.
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Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.
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CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].
CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.