Sr. Coding Analyst- CPC - Appeals PHX
THIS JOB HAS EXPIRED Description
PHX was honored as one of the 2013 Best Places to Work in NJ and also recognized this past year by NJBiz and Inc.5000 for our continued growth and excellence in our field.
PHX has developed a comprehensive claims editing process which yields fast, accurate and customized editing of in-network and out-of-network claims. Our advanced software combines payment policy and medical management edits in a single application. We also use an integrated approach combining state-of-the-art technology with Certified Professional Coders and Nurse Auditors to help us deliver proven recovery returns.
As a Sr. Coding Analyst, you will be responsible for reviewing claims and/or medical records for appropriate billing as well as responding to appeals or inquiries related to determinations with providers. The Senior Analyst will also partner with the Director for training and mentoring of junior Analysts, handling complex appeals and assisting with process improvement in the Claims Editing Department.
The Senior Analyst will have the opportunity to:
Research manuals/guidelines (including but not limited to AMA, CMS, and PHX Clinical Manual) once an appeal is received by PHX
Utilize the most up to date documentation/guidelines in responding to appeals
Customize and/or create appeal letters
Handle appeals and/or telephone/email inquiries related to determination of appeal
Validate edits for non-editing client claims
5+ years healthcare and medical claims processing experience within a provider/facility?s office or payer
CPC or equivalent credentialing
Appeals experience required
Excellent customer service and verbal communication skills
Exceptional written communication skills; demonstrated ability to draft professional correspondence
Diligent research and organizational skills
Ability to multi-task and be detail-oriented required
Knowledge of Microsoft Word & Excel a must
||Bedminster, NJ |
THIS JOB HAS EXPIRED