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Code Based Reimb Analyst

Revenue Management

 

Address   Franciscan Alliance
    421 North Emerson Avenue
    Greenwood, IN 46143

Hours  Days

Calendar  Full-Time

Education Bacherlor's or Associate's Degree, High school diploma or equivalent required

WHAT WE NEED

Accurate coding extraordinaire

WHO WE ARE LOOKING FOR

High quality health care is both a calling and a business. And the business side dictates preparing letters, providing information to payors, and evaluating coding issues. Bottom line: this job is important for back-end operations.

Are you accurate and detail-oriented? Do you have experience working in health care? We’ve got a place where your skills are needed and ultimately help provide the best health care to our patients.

WHAT YOU WILL DO
  • Reviews medical record documentation to appropriately assign and correct ICD10 and CPT codes in order to meet medical necessity criteria.
  • Identifies and resolves coding/billing issues developing them into process improvement projects and provides data to support departmental education as needed.
  • Distributes and maintains local coverage determination (LCD) database. Provides local coverage determination status reports to director as needed.
  • Reviews Revenue Guardian workqueue and provides feedback to Hospital Billing team on possible new edits to identify charging errors.
  • Serve as liaison to facility clinical site areas.
  • Prepare appeal letters and provide information to payors, in response to clinical denials.
  • Review and understand CMS, Medicare, Medicaid, and coding clinics. 
WHAT IT TAKES TO SUCCEED
  • Excellent communication skills, including strong presentation skills.
  • Prior coding experience.
  • Knowledge of billing and collection systems.
  • Understanding of payor relationships, requirements and compliant billing practices.
  • Knowledge of types of health information and the rules and regulations surrounding their use.
  • Proficient in Microsoft Office Applications.
  • Process Improvement.
  • Understanding of managed care requirements under Medicare/Medicaid and other third party payor programs.
  • Quality control analysis.
  • Conduct research and present findings.
  • Critical and Analytical Thinking.
  • Organizational Skills.
  • Training and facilitation.


WHAT WE'RE LOOKING FOR

 

Minimum 1 year of coding experience strongly preferred. General understanding of billing, claims, EOBs, and Medicare guidelines strongly preferred. Knowledge of medical necessity and LCD preferred. 

 

Certification(s): Registered Health Information Administration (RHIA) preferred. At minimum, must have one of the following: Certified Professional Coder (CPC), Certified Coding Specialist (CCS), Registered Health Information Technology (RHIT). Candidates will also be considered if they have taken the necessary coursework and are on track to sit for the RHIT/RHIA exam within 6 months.  

 

Travel: Never or Rarely

 

EQUAL OPPORTUNITY EMPLOYER

It is the policy of Franciscan Alliance to provide equal employment to its employees and qualified applicants for employment as otherwise required by an applicable local, state or Federal law.

Franciscan Alliance reserves a Right of Conscience objection in the event local, state or Federal ordinances that violate its values and the free exercise of its religious rights.

Franciscan Alliance is committed to equal employment opportunity.

BILLING & HEALTH INFORMATION ​​​​


Nearest Major Market: Indianapolis