Full Time Remote Risk Adjustment Coder Jobs in Nashville, TN

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Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. To learn more about AMSURG, visit www.amsurg.com.

POSITION SUMMARY:

The Representative Accounts Receivable III is responsible for follow up on intermediate outstanding accounts receivable.

Work Schedule: Remote

ESSENTIAL RESPONSIBILITIES:

• Follow-up on outstanding claims and appeals
• Work escalation views
• Review Vendor Clarification logs
• Provide employee and vendor training
• Acts as a knowledge resource for team members
• Not limited to working Claim Ack Rejections, Claim Edits & Charge Corrections
• Phone patients for payment or payment arrangements
• Print and re-file claims as needed.
• Work correspondence daily.
• Maintain continuing education, training in industry career development
• Exceed productivity standards as outlined by business line
• Answer incoming patient insurance company and physician office telephone calls.
• Research/audit patient accounts for further payment or adjustments.
• Work KAM reports as assigned.
• Work accounts receivable collector queue with proficiency within 30-60 days of employment.
• Work 40-50 accounts daily with > or =90% accuracy rating; meet department productivity standards.
• Calculate billing unties and reimbursement amounts.
• Maintain strictest confidentiality and adhere to all company policies and procedures.
• Other duties as assigned
• Reads and abides by the company’s code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs
• Reports any real or suspected violation of the corporate compliance program, company policies and procedures, harassment or other prohibited activities in accordance with the reporting policies of the company
• Obtains clarification of policy whenever necessary and may use the resources available through the Compliance, Human Resources or Legal Department to do so
• Support and abide by the values of the company
  • Excellence – Going above and beyond to deliver the highest quality care and experience to our patients and teammates
  • Collaboration – Being inclusive and supportive of one another to deliver improved outcomes to our patients and teammates
  • Ethical Responsibility – Acting with the utmost integrity and doing the right thing, even when nobody is watching
  • Engagement – Promote an environment where clinicians and teammates thrive, feel passion and joy for what they do, take care of each other, and are proud of who we are and what we do.

QUALIFICATIONS: 

To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily.  The requirements listed below are representative of the knowledge, skills and/or abilities required.

• Working knowledge of CPT, ICD-9 and ASA codes
• Strong mathematical, research, analysis, decision making and problem-solving skills.
• Strong data gathering and reporting skills.
• Working knowledge of medical terminology, insurance processing guidelines and laws.
• Demonstrates advanced understanding of commercial, Medicare and Medicaid payers
• Working knowledge of TWCC guidelines and laws, commercial managed care insurance, Medicare and Medicaid guidelines.
• Strong interpersonal skills and comfortable working with physicians, external customers, hospital staff, co-workers and senior leadership.
• Strong verbal and written communication skills
• Team oriented, must have a pleasant disposition and high tolerance level for diverse personalities.
• Ability to work independently with limited supervision.
• Demonstrates advanced understanding of claim needs and ability to accurately perform needed billing activities (Evaluation/Correction of billing edits, claim transmission, rejections, and other claim functions)

Education/Experience:

• High School graduate or equivalent.
• 3 to 5 years’ experience in a healthcare insurance receivables environment
• Associate or bachelor’s degree in business administration or related field preferred
• Two - three years collection experience required.
• Two years posting, coding or accounts receivable collection experience in health care organization is preferred.

Computer Skills:

To perform this job successfully, an individual should have knowledge of:

• Microsoft Office Suite
• Working knowledge of PC applications (MS Office, Word and Excel).

Employment at AMSURG: Living Our Values Every Day
At AMSURG, our values define who we are and how we serve our patients, partners, and each other. As a national leader in ambulatory surgery, we are committed to a culture of excellence, integrity, teamwork and caring deeply. Our values guide every decision, ensuring we continue to elevate healthcare and provide the highest quality care.
These guiding principles are the foundation of our culture and a guide to how we collaborate, innovate, and make a difference every day.

• Care Deeply for those around us.
• Cultivate Integrity to build trust.
• Champion Excellence for continuous improvement
• Celebrate Teamwork every step to the way.

Benefits:

To ensure we retain and invest in great people, AMSURG provides its employees with the benefits, recognition, training, and opportunities needed for professional growth. Our wide range of health and welfare benefits allow you to choose the right coverage for you and your family. AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.

Paid Time Off:

AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

EOE Statement:

AMSURG is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age (40 or older), race, color, religion, gender, sex, national origin, pregnancy, sexual orientation, disability, genetic information or any other status protected under applicable federal, state, or local laws. We strive to also provide a disability inclusive application and interview process. If you are a candidate with a disability and require reasonable accommodation in order to submit an application, please contact us at: careers@amsurg.com. Please include your full name, the role you’re applying for and the accommodation necessary to assist you with the recruiting process. 

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