Remote Risk Adjustment Coder Jobs in Orem, UT (NOW HIRING)

Job Description:

The Oncology Financial Coordinator is responsible for obtaining accurate financial approvals for patients at Intermountain Health. The Oncology Financial Coordinator is responsible for analyzing and validating the information needed to obtain financial approval for services. This position mitigates the financial risk to Intermountain Health by performing an accurate financial review along with a comprehensive analysis of patient payer specific benefits and patient liability and provides a platform for counseling patients on financial considerations throughout their care experience. This position works with a multidisciplinary team consisting of patients, revenue cycle, physicians, nurses, and pharmacists.

Essential Functions

• Verify the prescriber is currently credentialed with the facility or through Select Health, or verifies the prescriber has an active license in good standing.
• Ensure clinically appropriate documentation is received timely from medical providers/facilities, and ensures medical necessity is appropriate for type of services being provided.
• Evaluate the need for, and if appropriate, confirms Letter of Medical Necessity has been received to ensure third party payment.
• Ensure orders include an appropriate ICD-10 code.
• Collaborate with clinicians and intake managers to minimize risk associated with medical necessity or financial sponsorship changes that affect the reimbursement.
• Make appropriate corrections in the patient's record to ensure accuracy in order to prevent denials and/or problems with billing and reimbursement.
• Obtain insurance eligibility and benefit information, ensures authorization requirements are completed within the required timeframe, and maintains appropriate authorizations throughout patient treatment at the specified clinic. Ensure ongoing eligibility based on clinical documentation for medical necessity and ensure reauthorization functions are completed in a timely manner, based on individual payer requirements.
• Estimate cost of service using ICD-10 or CPT codes. Performs calculations using insurance benefit information to accurately estimate patient responsibility. Analyzes patient/guarantor's previous account history to guide financial conversation.
• Educate patient regarding Medicare ABN and potential costs associated with non-coverage, as well as ramifications of not signing the form. Sends the Medicare ABN to the patient if necessary. Communicates the ABN status to the specific Infusion Clinic.

Skills

• Healthcare Common Procedure Coding System (HCPCS)
• ICD Coding
• Medical Billing and Coding
• Medical Insurance Coding
• Medical Billing
• Medical Records Management
• Coding Education
• Coding Practices
• Clinical Documentation
• Health Administration

Minimum Qualifications

• Experience as a Financial/Eligibility Counselor, Health insurance related experience (billing, authorizations, etc.), or Certificate in healthcare coding.
• Demonstratedcustomer service experience in a healthcare, insurance, or financial field.
  Demonstrated outstanding public relations and interpersonal skills.
• Demonstrated organizational skills. Multi-tasker with demonstrated ability to complete work timely and accurately.
• Demonstrated self-starter and team oriented, flexibility to adapt to change, ability to work with minimal supervision.

Preferred Qualifications

• Bachelor's degree in a health care field or business
• Bi-lingual
• Communication skills, both written and verbal

Location:

Intermountain Health Riverton Hospital

Work City:

Riverton

Work State:

Utah

Scheduled Weekly Hours:

40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$20.35 - $30.97

We care about your well-being - mind, body, and spirit - which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we usethe artificial intelligence ("AI") platform, HiredScore to improve your job application experience.HiredScore helps match your skills and experiences to the best jobs for you. WhileHiredScore assists in reviewing applications, all final decisions are made byIntermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.