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Claims Resolution Coding Specialist
3 months ago
Work outpatient, mainly ED claims
will be reviewing the accounts, reviewing the charges and making sure it is correct -adding modifiers if necessary
Correcting charges, validating charges
Handling billing edits that the billing team will send back to this team
Also interface with HIM and Nurse Audit team
Typical edits -
1. CCI - The CCI Mutually Exclusive Code Edits include those codes that cannot reasonably be performed in the same session. An example of a mutually exclusive situation is the reporting of an "assessment" service and a "reassessment" service.
2. NCD - National Coverage Determinations (NCD) coding changes can be the result of new codes, coding revisions, or feedback. These changes are included in quarterly ICD-10 updates
3. NCCI - The National Correct Coding Initiative (NCCI) is a system of checks that prevents incorrect payments and improper coding practices when billing for healthcare services. NCCI edits can include Procedure-to-Procedure (PTP) edits and Medically Unlikely Edits (MUEs)
Working this backlog out of a work que in EPIC
Certification not required but must have 2+ years of coding experience
Will mostly work outpatient coding
Understanding of Modifiers and when to add them
Understanding of NCD, NCCI, and CCI edits
About TEKsystems:
We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.
The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.
