Why Mayo Clinic
Position will sit in Rochester, MN with the opportunity to Telecommute a couple days each week
The Denial Management Coding Analyst supports the denial management team by reviewing claims for coding accuracy and root causes for coding-related denials, as well as proposing process improvements to mitigate future denials. Working closely alongside the Physician Advisor, the Denial Management Coding Analyst liaises between the denial management team, coding operations, and providers, resolving queries for missing documentation and promoting departmental awareness of coding best practices. This position will serve as a resource for Denial Management Coders needing assistance resolving complex denials and may provide direction to those staff regarding priorities and productivity goals.
A Denial Management Coding Analyst will also research and resolve coding denials via Epic work queues, and process charge corrections based on medical record reviews, contracts, regulations, in accordance with Mayo Clinic’s policies. This position is also required to interpret and review physician-professional documentation in validating procedural, supplies, drugs and diagnosis coding for the professional claims. A Denial Management Coding Analyst is also responsible for reviewing hospital inpatient or hospital outpatient documentation in validating claim ICD-10-CM diagnosis codes, ICD-10-PCS codes, and CPT-4 procedural codes for UB-04 Outpatient or Inpatient claims. This position will defend the claim and seek payment from the payer by facilitating resolution of the denial through resubmission of supporting documentation, including discussion(s) with the payer or via the payer’s website.
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) required.
Associate’s Degree required; Bachelor’s Degree is preferred in a health care related area.
Minimum of 4 years of physician/professional or hospital outpatient coding experience or minimum of 6 years of relevant hospital inpatient coding experience including DRG assignment.
1)Knowledge of professional/physician coding rules for inpatient, hospital outpatient, clinic, and/or emergency settings. Experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
2)In-depth knowledge of medical terminology, disease processes, patient health record content and the medical record coding process.
3)Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections.
4)Familiarity with provider based billing (PBB) and critical access hospital (CAH) coding and billing requirements is a plus.
5)Demonstrated ability to partner with physicians and provide feedback on medical documentation best practices.
Education, experience and tenure may be considered along with internal equity when job offers are extended. The minimum salary every 2 weeks is approx $2,171.20, based on a full-time position.
Mayo Clinic is located in the heart of downtown Rochester, Minnesota, a vibrant, friendly city that provides a highly livable environment for more than 34,000 Mayo staff and students. The city is consistently ranked among the best places to live in the United States because of its affordable cost of living, healthy lifestyle, excellent school systems and exceptionally high quality of life.
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Equal opportunity employer
Mayo Clinic is an equal opportunity educator and employer (including veterans and persons with disabilities).