About this opportunity
Nationwide Children’s Hospital lists this Documentation and Reimbursement Specialist opportunity in columbus, Ohio. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Job TitleActively investigates claim denials, performs root cause analysis, and responds to inquiries regarding documentation, coding, and billing of professional services. Conducts claim reviews, assess charts, and collaborates to resolve issues and provide feedback.Essential FunctionsResearches and responds to coding, documentation, compliance, and reimbursement inquiries.Provides compliance and documentation education sessions to physicians and staff.Clarifies ambiguous clinical data and provide feedback for improved documentation.Resolves billing discrepancies and issues with insurance providers.Collaborates with healthcare providers to gather necessary documentation for claims.Updates billing software with relevant patient and insurance information.Education RequirementAs required by listed licensure and/or certification requirement.Bachelor's Degree, preferred.Licensure Requirement(not specified)CertificationsRequired to have one of the following certifications:Certified Coding Specialist Physician Based (CCS-P) Certification by the American Health Information Management Association (AHIMA).Certified Professional Coder (CPC) certification by the American Academy of Professional Coders.SkillsProficiency with third party billing and documentation standards, particularly Evaluation and Management is essential.Knowledge of medical terminology and proficiency with diagnosis and CPT4 coding required.Excellent verbal and written communication skills.Ability to maintain and establish strong working relationships with physicians, support staff, and external parties.Able to work both as a team player and independently.Strong analytical abilities.Demonstrated aptitude for quantitative analysis and attention to detail.Strong problem solving, collaboration, and interpersonal skills.Able to balance multiple priorities and deadlines.Proficiency with personal computers and related software.Attention to patient confidentiality.ExperienceFive years of experience in related field (physician billing experience), preferred.One year of education or teaching related experience, required.Physical RequirementsOCCASIONALLY: Driving motor vehicles (work required) *additional testing may be required, Lifting / Carrying: 0-10 lbs, Standing, WalkingFREQUENTLY: Decision Making, Interpreting Data, Problem solvingCONTINUOUSLY: Audible speech, Computer skills, Flexing/extending of neck, Hand use: grasping, gripping, turning, Hearing acuity, Repetitive hand/arm use, Seeing – Far/near, SittingAdditional Physical Requirements performed but not listed above:(not specified)"The above list of duties is intended to describe the general nature and level of work performed by individuals assigned to this classification. It is not to be construed as an exhaustive list of duties performed by the individuals so classified, nor is it intended to limit or modify the right of any supervisor to assign, direct, and control the work of employees under their supervision. EOE M/F/Disability/Vet"
Worksite address
columbus, OH, 43231, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.