Reimbursement Analyst

Our client. a leading academic medical center in NYC, is hiring a Reimbursement Analyst.

Responsibilities :

• The Reimbursement Analyst will be responsible for resolving coding related errors and / or denials identified by CDM edits or by the Billing Dept.
• Review documentation associated with accounts reside in Epic work queues to determine the appropriate charge / s, procedure and / or diagnosis codes.
• Liaison with front end, as needed, to ensure that visits are registered correctly
• Ensure that documentation supports charges on claim to prevent denials / underpayments and are in adherence with compliance standards and credible coding sources
• Assist PFS with analyzing coding denials and writing appeals, as needed.
• Review and distribute coding-related articles to clinical staff, including medical necessity policies and coding / billing information for various procedures
• Research and identify missing device & / or drug related charges that's required to support procedure on claim & bring to manger's attention for needed follow-up
• Identify and assists with documentation gaps in retrospect of CMS, AHA or AMA guidelines for revenue enhancement opportunities
• Identify patterns, trends, and opportunities for charge capture and revenue enhancement.
• Update charges in Eagle as required by posting and deleting and ensure that the correct info is entered to avoid negative charges or incorrect DOS.
• Assists / perform special projects related to re-billing or charge master activities.
• Participate in education programs to maintain up to date coding skills.
• Can be remote or hybrid Requirements :
• Proficient in Epic Billing and have thorough working knowledge of ICD-10 diagnosis coding guidelines, CPT / HCPCS code assignments.
• Knowledge of the Outpatient Prospective Payment System (OPPS)
• Detailed knowledge and understanding of hospital vs. professional charging and coding.
• Ability to concentrate and accomplish tasks with explicit accuracy and established / maintained effective working relationships as required by the duties of the position.
• Functional knowledge of facility EMR, encoder, and other support software
• 3-5 years of multispecialty coding experience in AmSurg and / or clinic settings
• Bachelor’s degree or equivalent work experience required.
• AHIMA (CCS) or AAPC (CPC) approved credential Salary : The posted salary range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range.

Contact us for more information.

If you are passionate about what you could accomplish in this role, we would love to hear from you!

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