Overview
Remote
Depends on Experience
Contract - W2
Job Details
Clinical Editing Coding Analyst | Remote | Contract
Walker Healthforce is seeking a Clinical Editing Coding Analyst with 1-5+ years of experience.. This is a 6-month contract opportunity.
CORE REQUIREMENTS:
WE CONSIDER IT A BONUS IF YOU ALSO HAVE:
JOB RESPONSIBILITIES:
This position is primarily responsible for the coordination of activities within the clinical editing unit. This area is responsible for the development, implementation and decision-making related to the clinical editing software utilized by the health plan to determine the appropriateness of billing and reimbursement within said parameters. These parameters include clinical edits, multi-line surgery claims and daily limit processing (dlp), as well as related provider appeals. There is an emphasis on report analysis to determine appropriate payment levels based on standard billing practices and medical coding standards
WHAT WE OFFER:
WHY WORK WITH WALKER?
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US:
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
Walker Healthforce is seeking a Clinical Editing Coding Analyst with 1-5+ years of experience.. This is a 6-month contract opportunity.
CORE REQUIREMENTS:
- Certified Professional Coder certification (e.g., CPC, CCS, CCS-P, or RHIT)
- 1-5 years experience - in billing/coding (preferably in a comprehensive surgical center or facility) or Claims resolution (including adjudication, coding, thorough analysis and problem-solving)
- Ability to analyze, investigate and edit codes - Working knowledge of medical coding standards, and reviewing/editing codes including HCPCS, CPT, ICD-10, etc.
- Knowledge and understanding of provider coding and billing practices and systems logic for reimbursement
- Knowledge of NCQA, CMS, State, and Federal regulations
- Associate’s degree or two years of college, with a preferred area of concentration in business, information systems, or a health care related field
WE CONSIDER IT A BONUS IF YOU ALSO HAVE:
- Experience in spreadsheet development, word processing, and database software; Windows environment and ACCESS
- Experience/knowledge working with benefits and/or claims, claim process flow, systems, and/or reimbursement guidelines
- ICD 10-CM and CPT courses preferred; may consider two years experience with these manuals in lieu of classes
- Bachelor’s degree
JOB RESPONSIBILITIES:
This position is primarily responsible for the coordination of activities within the clinical editing unit. This area is responsible for the development, implementation and decision-making related to the clinical editing software utilized by the health plan to determine the appropriateness of billing and reimbursement within said parameters. These parameters include clinical edits, multi-line surgery claims and daily limit processing (dlp), as well as related provider appeals. There is an emphasis on report analysis to determine appropriate payment levels based on standard billing practices and medical coding standards
WHAT WE OFFER:
- Competitive compensation package
- Weekly pay via Direct Deposit
- Medical, Dental & Vision available
- 401k options
WHY WORK WITH WALKER?
- Access to our top ranked team of recruiting and placement specialists
- Continuous, one-on-one support from a dedicated engagement manager
- Professional resume development and interview preparation
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US:
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.