Loading job…
Aurrera Health Group$33.05 – $49.60 per hourUnited States only
Opens the original posting on Himalayas.
Apply nowSource: HimalayasApply on the original site
Companies in this catalog do not charge applicants. Never send money to apply.
13246 Enterprise Revenue Cycle - Integrity Operations: Facility Coding Denials Status:
40 Schedule Details/Additional Information:
May work remote for this opportunity out of the following states: AL, AK, AR, AZ, DE, FL, GA, IA, IL, ID, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.
Analyze and resolve coding-related PB and HB denials using CPT, HCPCS, ICD-10-CM, and modifiers.
Identify root causes, patterns, and trends in denial and rejection codes.
Collaborate with billing, coding, and payer teams to correct, resubmit, and prevent denied claims.
Conduct chart reviews to validate documentation against billed services.
Prepare and support appeals by researching payer guidelines, coding standards, and coverage policies.
Ensure accurate, compliant coding and sequencing aligned with official guidelines and payer requirements.
Track, document, and report denial resolutions, appeal outcomes, and coding quality issues.
Support compliance, quality assurance, and revenue integrity initiatives through issue monitoring and escalation resolution.
Educate clinicians, coders, and staff by sharing findings and supporting targeted training based on denial trends.
Contribute to operational and strategic initiatives, including denial avoidance strategies, work queue optimization, CARC code mapping, and technology-driven improvements.
Minimum Job Requirements Education Associate degree or equivalent education and experience required.
Coding credential required. A Coding Certification from American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) with relevant experience.
Experience 4 years of experience in expert-level hospital-based coding and experience in revenue cycle processes, health information workflows, and medical record auditing experience
Advanced knowledge of third-party reimbursement programs, state and federal regulatory issues, national and local coverage decisions, research related restrictions, and ICD-10-PCS/CM, CPT, and HCPCS coding classification systems.
Strong organizational skills and ability to work independently with limited guidance or direction. Effective critical thinking, creativity, problem solving and decision-making skills.
Preferred Certification / Registration / License
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.
#REMOTE
Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:
Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.
Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
Originally posted on Himalayas
Opens the original posting on Himalayas.
Apply nowSource: Himalayas