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Billing and Coding Specialist

Billing and Coding Specialist

Location: Virtual – Work From Home

Job Id: 1437

# of Openings: 1

About Revecore

Revecore is an innovative, technology-driven company that is committed to helping our clients, our employees, our company, and our communities thrive. An award-winning services firm, partnering with hospitals and health systems, providing the momentum they need to maintain a strong revenue cycle amid today’s evolving healthcare environment.

With a 20+ year history, Revecore is the leading provider of revenue integrity and complex claims solutions for hospitals.

We offer a dynamic and flexible work environment, full of opportunity for motivated, hands-on team players. We strive each day to solve complex business problems and find new ways to enhance the efficiency, effectiveness, and quality of our services. If those attributes resonate with you, regardless of where you are locatedwe want you on our team!

Position Summary

Performs retrospective outpatient coding and both inpatient and outpatient billing reviews in coordination with internal staff in our mission to capture full, fair, and accurate reimbursement for our hospital clients

Duties and Responsibilities

  • Support internal and external customers by providing accurate and timely responses to coding and billing questions
  • Perform retrospective coding and billing reviews on inpatient and outpatient hospital claims
  • Provide correction recommendations to internal associates or clients, and support recommendations with rationale that may include coding guidelines, industry standard billing guidelines, or payer specific guidelines
  • Research and stay current on industry changes with regards to coding guidelines and payer specific billing guidelines for commercial and government payers
  • Ability to comprehend payment methodologies and how they apply to billing and coding scenarios
  • Build strong, lasting relationships with Revecore personnel
  • Attend department and company meetings as required
  • Comply with federal and state laws, company and department policies and procedures
  • Assist with other related responsibilities to meet the needs of the business

Skills and Experience

  • Coding certification required, with 1+ years hospital coding/ auditing experience i.e. CPC, COC, CIC, CCS-P, CCS
  • Entry level understanding of Managed Care, Medicare and Medicaid billing and reimbursement guidelines
  • Entry level understanding of inpatient and outpatient hospital reimbursement methodologies a plus
  • Moderate computer proficiency including working knowledge of MS Excel, Word and Outlook
  • Mathematical skills sufficient to apply the concepts of claim payment methodologies
  • Ability to read and interpret an extensive variety of documents such as claims, instructions, policies and procedures in written (in English) and diagram form
  • Ability to present ideas on complex, detailed issues with ease
  • Ability to define problems, collect data, establish facts and draw valid conclusions
  • Strong team player, with willingness to adapt to changing priorities

Physical Demands and Work Environment

The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Physical Demands: While performing the duties of this job, the employee is occasionally required to walk; sit; use hands to handle or feel objects, tools or controls; reach with hands and arms; balance; stoop; talk or hear. The employee must occasionally lift and/or move up to 15 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
  • Work Environment: While performing the duties of this job, the employee is exposed to weather conditions prevalent at the time. The noise level in the work environment is usually moderate.