Coding Analyst

The Coding Analyst is responsible for insurance follow up, coding, charge entry and billing under general supervision of the Revenue Cycle manager.
This position will analyze denied claims and report billing, coding and registration errors from a denial management function.
The Coding Analyst will work directly with staff and management to produce reports and compile key performance indicator (KPI) reports to manage the operation and its functions.
Other items include: Daily Operations • Managing, directing and monitoring CPT & ICD coding methodology.
• Responsible for ongoing coding & billing training of staff and physicians • Secures, maintains and distributes the most current coding/billing information and changes.
• Responsible for implementing the coding/billing changes with staff and physicians • Maintains a current charge description master (CDM) ensuring accurate CPT and ICD reimbursement codes.
• Responsible billing and account management of denied/rejected claims related to coding • Conduct comprehensive insurance follow-up in accordance with policy/procedure to ensure operational effectiveness.
• Provide and or manage effectively communicate with all payers for resolving claim disputes.
• Prepare appeal letters and track case until resolved.
• Analyze denied claims related to coding issues • Collaborates with in-house and outsourced coding work to ensure backlogs do not occur in the coding process.
• Monitors productivity to assure targets are being met.
• Randomly conducts audits to ensure accuracy • Provides ongoing training and education to on third party billing requirements and coding rules • Monitors and ensures that billing and appeals are filed timely.
• Monitors denied/rejected claims for trends and provides feedback to appropriate personnel to reduce the denied claims volume.
• Maintains payor communications file; responds to inquiries from payors and patients regarding insurance claims status.
• Interacts with Coding Personnel to resolve billing issues related to CPT, HCPCS and ICD-10 coding issues.
• Performs other related duties as assigned.
Required Skills • Knowledge of third party fee profiles and reimbursement mechanisms • Knowledge of Federal and State billing and documentation requirements • Knowledge of ICD and CPT coding procedures and protocol • Ability to maintain a positive attitude as demonstrated by communicating with others to include those in authority in a courteous and professional manner.
• Knowledge and experience with automated billing systems.
• Clerical and analytical ability to be self-sufficient in performing duties and maintaining confidential records.
• Excellent oral and communication skills with ability to communicate clearly by phone or in person.
Required Education and Experience Bachelor Degree with two (2) to five (5) experience in central business office (CBO) healthcare clinical setting, hospital or physician practice group, with emphasis in coding, billing and collections required.
Coding Certification required (CPC,CCS) This position will be eligible for a hybrid work schedule after 60 days.