Medical Coding Specialist

Join our Culture of Caring

Mission:
With every action we take,
Advanced Radiology Consultants
is committed to building and maintaining the trust of our referring physicians and providing our patients with exceptional care.

Advanced Radiology is one of the largest independent radiology practices in the tri-state area with the most experienced radiologists. We look for team members who want to grow and be professionally challenged, while enjoying a rewarding, caring, and friendly environment. We are looking for a Revenue Cycle Coding Specialist 
to join our team. The pay range for this role will depend on experience and qualifications.

Position Summary:

Under the direction of the Senior Revenue Cycle Manager, provide assistance with practice education on insurance and billing criteria with CPT and ICD-10.  Chart review for proper coding and/or denial follow up or for clinical information and/or study confirmation as requested through Lyra RAI to expedite radiology claim submission and denial follow up.  Assist Revenue Cycle Specialists with various A/R follow-up functions, patient dispute resolution Review AR reports for patterns/issues.   Insurance carrier contract maintenance.

Essential Job Duties and Responsibilities:

• Review/resolve billing company's 'request for additional information' (RAI's) 

• CPT/ICD-10 review and/or confirmation prior to billing

• Coding denials; review for resolution/resubmission and/or adjustment

• Authorization denials: review/work, forward to appropriate dept. for correction, if needed

• Patient disputes: investigate coding accuracy, clinical information, claim transactions and patient's dispute. Resolve as applicable.

• Assist Revenue Cycle Manager with practice education on complying with CPT, ICD-10, and carrier guidelines. Educate staff as requested on insurance guidelines and billing criteria on examinations performed

• Interventional Radiology procedure audits to ensure billing company is correctly coding/billing

• Handle escalated billing calls and/or web inquiries as received. Professionally handle/resolve issues with exceptional customer service and/or assist ADRAD staff and/or patients with escalated coding/insurance questions

• Review of AR Denial's, categorize & work with billing company towards claim resolution

• Monthly review of current outstanding A/R report;

• Provide assistance in identifying denial patterns/coding issues

• Identify claims mishandled with Sr. Manager for educational review and improvement and improvement with internal ADRAD staff and/or billing company

• Review insurance carrier, State and Federal resources (publications/websites) for administrative and/or medical policy changes and updates.  Summarize monthly and review with manager for ADRAD staff education when applicable

• Monthly charge reconciliation in EMR, when needed

• Assistance with other Revenue Cycle Departments, as needed

Knowledge, Skills and Abilities:

• Attention to detail, meticulously reviewing reports, charts and assigning codes with a high degree of accuracy is critical to assign accurate CPT, ICD-10, HCPCS & modifiers

• Knowledge of medical terminology

• Understanding of insurance carrier claim processing, rules and regulations to include