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Advanced Coding Reimbursement Analyst III

2 months ago

Charlotte, North Carolina, United States Atrium Health Full time

Overview

Position Summary

This role involves performing tasks of moderate to high complexity, analyzing denial data, and utilizing reports and work queues to identify trends and propose solutions.

Key Responsibilities

  • Act as a subject matter expert in at least one specialty area, such as oncology, gynecology, surgical coding (excluding primary care procedures), and infusion coding, including chemotherapy and multi-drug infusions.
  • Assign CPT and ICD codes for cases of moderate to high complexity.
  • Interpret and assign CPT codes based on provider documentation, including infusion records and operative reports.
  • Conduct ICD and CPT coding for professional services and ensure all necessary charge information is accurately entered.
  • Apply all relevant modifiers.
  • Prioritize CPT codes when multiple codes are applicable.
  • Assign Evaluation and Management (E/M) codes.
  • Execute reconciliation processes to ensure comprehensive charge capture.
  • Process charges promptly, whether through automated systems or manual entry, within the applicable billing system.
  • Investigate and analyze coding and payer-specific issues.
  • Timely process charges and maintain ongoing communication with team members and practice management.
  • Engage with providers regarding coding issues of moderate to high complexity, including face-to-face interactions, explaining coding rationales, and providing education.
Physical Requirements
This position operates in a dynamic office/hospital environment, requiring consistent sitting, along with some walking, standing, stretching, and bending.

Qualifications

A High School Diploma or GED is required. A minimum of 2 years of coding experience is necessary. A CPC or equivalent coding credential is mandatory. Maintenance of coding certification (CPC, CCS, RHIT, RHIA) is essential. Extensive knowledge of coding, medical terminology, anatomy, and physiology is required, along with the ability to apply payer-specific rules related to coding, bundling, and appropriate modifier usage.