Are you seeking an exciting opportunity to join a passionate, growing, and dynamic team of professionals who support patients?

The Certified Professional Coder, II, consistently generates revenue through professional billing practices by reviewing claims that have been denied for a coding reason and offers suggestions and corrections to be made to the claim based on review of the medical records as well as LCD/NCD policies, individual payer medical policies and coding guidelines.

What’s Attractive to the Right Candidate?

• Knowtion Health is a growing firm in a growing industry. Our status as a leader in this industry means that we have the resources to invest in the business and to innovate.
• Our business is intensely competitive and is constantly evolving. We quickly identify new challenges and develop solutions, so you won’t simply be doing what was done last year. Our new employees are frequently pleased and surprised by how quickly we make decisions and adapt to market conditions.
• Knowtion Health culture is inviting and competitive, embracing challenge and celebrating accomplishment; dedicated colleagues striving to provide quality results that have lasting impact.

The Opportunity:

• Analyzes coding and the denial information for the claim to identify coding issues that caused the denial on unpaid claims and determines next steps for recovery
• Creates detailed appeal letters for denials from payer to support payment of patient claims.
• Makes recommendations to client for corrections or changes to the claim based on LCD/NCD policies (local coverage and national coverage), individual payer medical policies and coding guidelines.
• Reviews and verifies that diagnosis codes on bills adhere to the patients' medical records for purpose of reimbursement
• Notifies management of complex, complicated or challenging accounts to ensure accounts are progressing effectively
• Assist Knowtion Health team members by providing coding review feedback in gathering supporting documentation to submit appeals

What you bring:

• Certified Professional Coder certification (CPC and CIC)
• Minimum of 5 years’ experience working for a hospital or payer or in a customer service position with experience to specifically include:
• Inpatient coding experience with DRG knowledge
• Outpatient coding experience with ICD-10, HCPC, and CPT codes
• Preferred experience includes healthcare insurance billing and/or follow up for hospitals, medical coding, claim adjudication, patient accounting, payer adjuster, filing and/or settlement of accident claims (motor vehicle or worker’s compensation) and other experience as determined based on the program
• Preferred experience with TruCode and/or 3M

The above statements are intended to provide the general nature and level of work being performed by most people assigned to the position. They are not intended to be an exhaustive list of all responsibilities, duties and requirements.

This position is remote and requires a dedicated, distraction-free work space at home. We offer a competitive benefits package including medical, dental, vision, life insurance, short term disability, long term disability, paid holidays, 401k, and a generous PTO policy.

Knowtion Health gives priority to applicants located in the following states: AR, AL, AZ, FL, GA, IL, KS, KY, MD, MA, MN, NC, OH, OK, PA, SC, TN, TX, WV, VA