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Remote After Training Medical Coder in Phoenix, AZ in Aston Carter ID-11096

Job description: A/R Denials & Appeals Coder (On-Site -Remote After Training):

  • Utilizes Centricity and/or related modules to obtain, analyze and interpret coding denials and other reimbursement data to support compliance and billing concepts and procedures.
  • Manages and corrects denied claims for coding issues, i.e., unbundling, medical necessity, coding errors, etc as determined by management to facilitate payment and resolution.
  • Ensures all coding error corrects accurately reflect the services provided, dates of service(s), identity of person providing services, and diagnosis is accurate and carried to highest level of specificity, etc.
  • Analyzes, investigates and follows-up on denied claims.
  • Ensures that internal audits and quality controls are in place in accordance with departmental policies, procedures, generally accepted accounting practices and all applicable laws and regulations.
  • Interprets and resolves written and phone correspondence utilizing Physician Management system, with patients, physicians, specialists and insurance companies regarding outstanding document request to support the fulfillment of the prior authorization process.
  • Verifies patient’s benefits and ensures proper prior authorization before alerting laboratory that testing can be performed. Notifies provider’s office of approved prior authorization and/or denial.
  • Maintains comprehensive data base of insurance payors and CPT codes requiring prior authorizations. Documents all information from the authorization forms and ensures that providers are following standard guidelines to support medical necessity.
  • Performs prior authorization on patient claims in accordance with pre-screened work lists, and verifies daily addons and health plan responses to ensure a significant backlog doesn’t occur potentially jeopardizing specimen integrity.
  • Monitors claims and takes necessary steps with insurance companies, clients or patients to resolve open aging.
  • Reviews incoming payer correspondence related to information requests, denials, etc. and resolve issues to bring about claim resolution.
  • Collaborates with internal areas of billing and external payers to help actively research and resolve billing issues.
  • Researches and communicates payer specific medical policies for specialized testing as appropriate to help support the continued expansion of the prior authorization workflow process.
  • Communicates gaps in the fee schedules and contractual agreements with management staff with the objective of attaining successful reimbursement outcomes.

Skills & Minimum Qualifications:

  • High School diploma.
  • Three (2-3) years of related experience in Medical A/R Denials & Appeals Claims with the strength being Accounts Receivable!
  • Six Months (6 months) of Coding Experience minimum
  • Comprehensive knowledge of ICD-10 coding, CPT coding, HCPCS coding, modifiers, and government and commercial payer guidelines.
  • Ability to clearly and efficiently communicate complex issues using strong verbal and written aptitude.
  • Extensive knowledge of billing, insurance, computer systems, and medical billing processes.
  • Intermediate computer knowledge with various programs/software.
  • Ability to work independently and accurately with high volumes of data and minimal supervision.
  • Ability to effectively interface with patients, health plans, senior management staff and/or clients.

Additional Details:

  • Schedule: 8a-4p or 7a – 3pm M-F
  • Location: Central Ave and Thomas Rd
  • Training: 2-3 Months in Office more depending on how fast the info is picked up. Training could last 2-4 weeks and then Remote if the hire is skilled!
  • Vaccination: Required
  • Medical Immunizations are Required
  • Duration: CTH 6-10 Months before eligible to be converted. Performance and Attendance Based and when the HR dept open the FTE req.

About Aston Carter:

Please Note: Scammers are posing as Aston Carter. We’ll never contact you via Gmail, Telegram, or WhatsApp and we’ll never solicit money from you.

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At Aston Carter, we’re dedicated to expanding career opportunities for the skilled professionals who power our business. Our success is driven by the talented, motivated people who join our team across a range of positions – from recruiting, sales and delivery to corporate roles. As part of our team, employees have the opportunity for long-term career success, where hard work is rewarded and the potential for growth is limitless.

Established in 1997, Aston Carter is a leading staffing and consulting firm, providing high-caliber talent and premium services to more than 7,000 companies across North America. Spanning four continents and more than 200 offices, we extend our clients’ capabilities by seeking solvers and delivering solutions to address today’s workforce challenges. For organizations looking for innovative solutions shaped by critical-thinking professionals, visit . Aston Carter is a company within Allegis Group, a global leader in talent solutions.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please call or email for other accommodation options. However, if you have questions about this position, please contact the Recruiter located at the bottom of the job posting. The Recruiter is the sole point of contact for questions about this position.

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