Claims & Compliance Speciality Coder II

Billings Clinic Billings , MT 59101

Posted 5 months ago

Responsible for researching and analyzing coding related pre-bill scrubber edits , denials, and requests for review from Patient Financial services , and ensuring proper coding in compliance with government and third party payer regulations and CPT-4 , ICD, and HCPCs guidelines. Responsible to appeal denials and follow up with payers until the denied claims are paid.# Collaborates with multiple departments and participates in review of Recovery Audit Contractor and other government audits and appeals. Provides reports to Coding Resources Advisors for trending and research and clarification of coding (ICD, CPT-4/HCPCS) and abstracting of diseases and surgical procedures.# Provides education to the Coding Resources teams based on findings .Ensures adherence to all applicable Billings Clinic and regulatory compliance policies and procedures governing medical records coding, insurance billing and reimbursement methodologies. # MINIMUM QUALIFICATIONS ######### High school graduate or equivalent


Prior training in anatomy


, medical terminology and coding


Registered Health Information Technician


(RHIT) or Registered Health Information Administrator (RHIA), Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) or other AHIMA or AAPC recognized credentials required.


Minimum Two years experience in a multi


-specialty clinic and/or hospital working with ICD-CM, CPT-4/HCPCS coding


Previous demonstrated experience in a clinical setting performing technical responsibilities related to ICD


-CM, CPT-4/HCPCS coding, fees and reimbursement


Demonstrated ability to understand and develop information using databases and creating complex spreadsheets


.# Intermediate knowledge of Microsoft Office products, including Word, Excel and PowerPoint. #


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Claims & Compliance Speciality Coder II

Billings Clinic