Denials Management Coder (WFH)

Experience these exceptional benefits when you join Med-Metrix ! 8-Hour Shifts Day 1 HMO with 2 of your dependents covered for FREE Group Life Insurance Medical Cash Allowance Rice Allowance Clothing Allowance Holiday Gift Bereavement Assistance Paid Time Off Training and Staff Development Employee Engagement Activities Opportunities for Internal Mobility Job Purpose Responsible for reviewing denied claims for coding related errors and determining appropriate action. The Denials Management Coder will be responsible for corrections to individual accounts with include CPT and/or ICD-10 Corrections, applications of correct modifiers, etc. The coder is also responsible for ensuring that government and local guidelines are followed. Payers include but not limited to Medicare, Medicaid, Blue Cross, and commercial health insurance carriers. Duties and Responsibilities Read and interpret insurance carrier EOBs. Review medical reports, verify coding. Resolve coding related denial. Make any necessary coding corrections. Generate replacement claims (electronic and paper) Research carrier specific coding policies. Review and interpret carrier NCD and LCD policies. Communicate any coding denial trends to coding manager. Qualifications CPC/COC certification AAPC or CCS certification from AHIMA Minimum one (1) year of coding experience related to the specialty needed (Coding Denials) Knowledge in Medicare and Medicaid guidelines preferred. Working knowledge of managed care, commercial insur