Coding Analyst

Responsibilities

The essential duties and responsibilities (including but not limited to)

Review requests for coding changes (including but not limited to CPT/HCPCS, diagnosis, modifiers, place of service, authorizations, UOM, MUE, NDC) based on payer denials to ensure accurate coding and billing. Abstract relevant clinical information from the medical record and provider documentation to assign ICD‑10 and CPT/HCPCS codes in accordance with coding and reimbursement guidelines. Review and correct coding errors post–claim processing/denial, ensuring accurate refiling of corrected claims to payers. Use LCD/NCD policies to ensure accurate coding for the CMS region. Utilize coding tools such as Optum Encoder and CMS guidelines. Code with an accuracy of 95% or higher based on QA internal reviews. Other duties as assigned by Business Office Director.

Qualifications

• The ideal candidate for the position will have the following background and experience: Level 1 High school diploma or equivalent required.
• Successful completion of AAPC Certified Professional Coder Exam required.
• Minimum three years medical coding experience required.
• Proficiency with computer systems and Microsoft (Office Outlook, Word, Power Point, and Excel) required.
• Prior oncology experience preferred.
• Prior medical billing experience preferred.
• Level Sr (in addition to level 1 requirements) Education/Training: 4-year degree in related field OR equivalent experience desired.
• Associate's Degree + Four (4) years of related work experience Eight (8) years of related work experience Five years experience in coding, medical records and reimbursement Must be available for travel up to but not limited to 25-30% of the time.
• Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear.
• Requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination.
• Requires standing and walking for extensive periods of time.
• Occasionally lifts and carries items weighing up to 40 lbs.
• Requires corrected vision and hearing to normal range.
• Work Environment: The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment.
• Work will involve in-person interaction with co-workers and management and/or clients.
• Work may require minimal travel by automobile to office sites.