Revenue Integrity Coding and Billing Specialist- Remote

Job Family : General Coding

Travel Required : None

Clearance Required : None

What You Will Do :

Under the direction of the Director of Revenue Integrity, the Revenue Integrity Coding Billing Specialist provides revenue cycle support services through efficient review and prompt resolution of assigned Medicare and third-party payer accounts that are subject to pre-bill claim edits, hospital billing scrubber bill hold edits, and claim denials. This position is 100% remote .

Responsible for the daily resolution of assigned claims with applicable Revenue Integrity pre-bill edits and / or specific Revenue Integrity Hold Codes in the hospital billing scrubber. Tasks associated with this work include resolving standard billing edits such as :

• Correct Coding Initiative
• Medically Unlikely Edits (MUE)
• Medical Necessity edits
• Other claim level edits as assigned.
• As needed, review clinical documentation and diagnostic results as appropriate to confirm and apply applicable ICD-10, CPT, HCPCS codes and associated coding modifiers.
• Responsible for daily resolution of assigned claims with Revenue Integrity specific denials in the Guidehouse METRIX℠ system
• Ensures coding and billing practices follow Federal / State guidelines by using diverse types of authoritative information.
• Maintains current knowledge of Medicare, Medicaid, and other third-party payer billing compliance guidelines and requirements.
• Other duties equal with skills and experience as determined by the Director of Revenue Integrity

What You Will Need :

What Would be Nice to Have :

The annual salary range for this position is $49,000.00-$81,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer :

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include :

About Guidehouse

Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

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