You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a skilled CPC Coder to ensure accuracy and compliance in accounts receivable coding and charge review. This role involves the management of complex coding cases, collaboration with senior leadership, and the resolution of claim denials to achieve optimal reimbursement outcomes.

Key Responsibilities

• Research root causes of claim denials and apply knowledge of payer policies to determine the appropriate course of action, including appeals.
• Manages complex coding-related cases and recommends resolutions while escalating issues when necessary.
• Prepares and reviews correspondence with insurance companies, patients, or guarantors to address claim-related inquiries.
• Documents all actions and findings in the billing system to maintain accurate and comprehensive account records.
• Collaborates with the senior leadership to address unresolved or escalated issues.
• Reviews charges in work queues for compliance and accuracy, ensuring alignment with Current Procedural Terminology (CPT), ICD-10, and other coding standards.
• Performs reconciliation of charges against appointment reports or procedure logs to ensure all patient services are billed appropriately.
• Verifies the accuracy of charge header information, including service provider, billing area, CPT codes, modifiers, and diagnosis linkage.
• Communicates with providers to resolve discrepancies via Epic or a secure chat.
• Reviews charge correction requests and ensures accuracy prior to resubmission.
• Collaborates with Accounts Receivable staff to resolve denied or rejected claims related to coding issues.
• Provides expertise in payer-specific coding requirements to facilitate successful appeals and payment recovery.
• Tracks trends in denials and recommends process improvements to reduce future errors.
• Conducts thorough insurance verification to ensure accurate claim submission and timely reimbursement.
• Updates patient accounts with corrected demographic or insurance information as necessary.
• Ensures compliance with organizational and regulatory coding standards, including HIPAA and Medicare/Medicaid guidelines.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.