Claims Coding Analyst
2 weeks ago
Position Overview:
As a vital member of the United Surgical Partners team, the Claims Coding Analyst will report directly to the Coding Manager. This role is essential for leveraging expertise in reimbursement and coding to address unresolved medical claims that have been either pended or denied due to various coding issues related to both government and commercial payers.
Key Responsibilities:
• Oversee daily coding email queues, ensuring timely responses within a 3-business day timeframe.
• Investigate and rectify coding-related denials from payers, facilitating claim reimbursement.
• Identify and apply documentation and coding guidelines or regulations to substantiate claims as billed or to support necessary corrections in response to payer denials.
• Analyze patient medical records comprehensively to find documentation that supports medical necessity.
• Perform additional duties as assigned.
Required Skills:
Qualifications:
• RHIA, RHIT, CPC, or CCS certification is mandatory.
• Proficient understanding of AMA, CMS, and CPT coding guidelines is essential.
• Familiarity with ICD-10-CM, medical terminology, and anatomy & physiology is required.
• A minimum of 2 years of experience in ASC revenue cycle or coding is expected.
• High School diploma or equivalent is necessary.
• Proven ability to maintain productivity and accuracy standards.
• Exceptional verbal and written communication skills are crucial.
• Strong ability to prioritize tasks, manage competing priorities, and consistently meet or exceed deadlines.
Additional Requirements:
• RHIA, RHIT, CPC, COC, or CCS certification is required.
• An Associate's degree in a relevant field is preferred, or a combination of education and experience equivalent to this requirement.
• Must possess knowledge of AMA, CMS, and CPT coding guidelines.
• Understanding of ICD-10-CM, medical terminology, and anatomy & physiology is necessary.
• At least 2 years of experience in ASC revenue cycle or coding is required.
• Proficiency in Microsoft Word and Excel is essential.
• Ability to maintain required productivity and accuracy standards is expected.
• Excellent verbal and written communication skills are vital.
• Ability to prioritize workload, manage competing priorities, and consistently meet or exceed deadlines.
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