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Overnight Remote Medical Billing & Coding Jobs in Tennessee

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DRG Auditor (REMOTE)

Franklin, TN · Remote

$27 - $30.50/hr

... medical record reviews post-bill to determine if submitted diagnosis and procedure codes are ... This role is primarily office-based or remote, depending on company policy, with extensive computer ...

Vertek Staffing

Revenue Integrity Analyst

Franklin, TN · Remote

Healthcare Revenue Integrity Analyst - Edits & Charge Capture | Remote | Contract Schedule: Monday ... resolving charging, coding, and billing discrepancies. * Understanding of NCCI edits, medical ...

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Overnight Remote Medical Billing Coding information

What is the difference between Overnight Remote Medical Billing & Coding vs Remote Medical Coding?

AspectOvernight Remote Medical Billing & CodingRemote Medical Coding
CertificationsCPB, CPC, CCS-PCPC, CCS
Work EnvironmentRemote, overnight shiftsRemote, flexible hours
Job FocusBilling and coding combined, includes claims submissionPrimarily coding, reviewing medical records
Employer UsageHospitals, clinics, billing companiesInsurance companies, healthcare providers

Overnight Remote Medical Billing & Coding involves handling both billing and coding tasks during overnight shifts, often requiring certifications like CPC or CCS-P. Remote Medical Coding focuses solely on reviewing and assigning codes to medical records, usually with flexible hours. Both roles are remote but differ in scope and shift timing, catering to different employer needs and job preferences.

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Overnight Remote Medical Billing Coding jobs near you

Coding and Medical Records Auditor- Remote

American Health Partners

Franklin, TN • Remote

Full-time

Posted 13 days ago

Job description

JOB SUMMARY:
TruHealth is the clinical arm of the health plan and supplies the model of care. The Coding and Medical Records Auditor will be
responsible for conducting coding audits prior to claims submission. This position will ensure appropriate and accurate coding is
applied for each member of the plan. Additionally, post-payment coding reviews may be performed with coding education
correspondence sent to providers
The Coding and Medical Records Auditor will be responsible for conducting coding audits prior to claims submission. This position will ensure appropriate and accurate coding is applied for each member of the plan. Additionally, post-payment coding reviews may be performed with coding education correspondence sent to providers.
ESSENTIAL JOB DUTIES:
To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.
  • Review claims prior to billing to provide a proactive level of accuracy.
  • Assess trends; communicate appropriate education both individually to staff and collectively as an organization.
  • Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries as needed to verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis codes based on services rendered.
  • Conduct pre-claim and post-claim coding audits to ensure accurate claims' denials.
  • Work closely with delegated claim processor to ensure errors are reviewed and corrected prior to final payment.
  • Assist with validation audits to evaluate medical record documentation to ensure coding accurately reflects and supports relevant coding based on the ICD-10 code submitted to CMS and interpretation of medical documentation to ensure capture of all relevant coding based on CMS Hierarchical Condition Categories (HCC) conditions applicable to Medicare Risk Adjustment reimbursement initiatives.
  • Work assigned coding projects to completion.
  • Provide a high level of customer service to internal and external customers by consistently meeting and/or exceeding expectations including but not limited to quality and productivity.
  • Escalate appropriate coding audit issues to management as required and follow departmental/organizational policies and procedures.
  • Maintain required levels of production and quality standards as established by management.
  • Work directly with provider representatives and executive directors on Letters of Agreement (LOAs) to ensure appropriate coding methodology and reimbursement.
  • Ensure regulatory compliance and overall quality and efficiency by utilizing strong working knowledge of coding standards.
  • Follow all appropriate Federal and State regulatory requirements and guidelines applicable to Health Plan operations or as documented in company policies and procedures.
  • Participate in and support ad-hoc coding audits as needed.
  • Other duties as assigned

EXPERIENCE:
  • 3 years HCC coding and/or coding and billing required
  • 5 years HCC coding and/or coding and billing preferred
  • 2+ years of complex claims processing and/or coding auditing experience in the health insurance industry or medical health care delivery system recommended.
  • 2 + years of experience in managed healthcare environment related to claims' and/or coding audits recommended.
  • 2 year(s): Knowledge of standard coding and reference materials used in a claim setting, such as CPT4, ICD10, HCPCS and others
  • 2 year(s): Knowledge of CMS requirements regarding claims processing and coding; especially Skilled Nursing Facility and other complex claim processing rules and regulations
  • 2 year(s): Coding/auditing claims for Medicare and Medicaid plans.
  • 2 year(s): Experience in managed healthcare environment related to coding audits
  • 2 year(s): Complex claims processing and/or coding experience in the health insurance industry or medical health care delivery system

LICENSE/CERTIFICATION: REQUIRED (any of the following):
  • Certified Professional Coder (CPC)
  • Certified Risk Coder (CRC) • Certified Coding Specialist (CCS)
  • Certified Documentation Integrity Practitioner (CDIP)
  • Certified Clinical Documentation Specialist ( CCDS)
  • Registered Health Information Technician (RHIT)

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights notice from the Department of Labor.
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About American Health Partners

Sourced by ZipRecruiter

American Health Partners is a family of six divisions staffed by outstanding employees who care deeply about others. Since our inception more than 45 years ago, we have been committed to bringing the highest quality healthcare available to our communities. That commitment continues to serve us, our patients, our customers and our partners well. Today, our diverse healthcare offerings serve nearly 12,000 individuals annually across multiple states. We operate in both urban and rural communities where people need healthcare close to home. By working closely with hospitals and other providers, we offer cost-effective options that give individuals greater control over their healthcare.

Industry

Health care and social assistance

Company size

1,001 - 5,000 Employees

Headquarters location

Franklin, TN, US

Year founded

1976

Social media

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