Job Description

Who We Are:

At SolutionHealth our Revenue Integrity team takes great pride it the work that we do. We encourage everyone to work as a team and provide support where needed. If you have great attention to detail, and meet the requirements below, our team encourages you to apply! Join a team, where you can thrive and grow together!

About the Job:

The Claims Editor will support all activities related to federal, state funded and commercial code-based reimbursement to ensure that the hospital follows federal regulations, and that reimbursement is both timely and accurate. The incumbent will review and monitor all charges entered by departments into the electronic medical record for quality and appropriateness; and will function as a liaison between departments, coders, and billers for all charge issues.

What You’ll Do:

• Responsible for monitoring all government related coding and billing practices
  • Including NCD, LCD/LMRP, OCE and CCI edit management
• Serve as a liaison to clinical departments to ensure that all edits are appropriately resolved
• Review claims to ensure coding is accurate and in compliance with clean claim edits, within the designated timeframe
• Apply compliant coding/billing practices to resolve claim edits
• Perform dual maintenance (making corrections in EPIC to coding and charging), as well as in FinThrive to resolve all claim edits
• Develop and maintain reports which summarize and trend information
• And more

Who You Are:

• High school diploma or GED
• Certified coding credentials - CPC, CPC - H, CCS, CCS-P, RHIT, or RHIA, Required.
• At least three (3) years of acute care coding experience, Required
• Thorough knowledge of ICD[1]10-CM, CPT-4, DRG methodologies and all regulatory requirements associated with coding and DRG assignment, Required
• Epic Experience, Preferred

Why You’ll Love Us:

• Health, dental, prescription, and vision coverage for full-time & part-time employees  
• Short term, long term disability, Accident insurance, & life insurance
• Tuition Reimbursement
• Referral bonuses
• Accrued earned time for full-time & part-time employees
• 403b Retirement plans, with generous employer contributions
• And more!

#CRM

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