JOB DESCRIPTION
Triage Consulting Group is a San Francisco-based healthcare
consulting firm specializing in hospital reimbursement that has recently opened an office in Sacramento, CA. This role would report to Management in Sacramento, with the option to work remotely.
Through our claims pricing and payment
validation process, Triage works to identify and recover lost revenue which
often involves identifying incorrect clinical codes on claims, and recommending
necessary corrections. In addition,
Triage assists clients with correcting and resubmitting claims to payers,
including Medicare. Triage is seeking a hospital coder to perform outpatient
coding reviews of hospital claims. For many years, Triage Consulting Group has been ranked among the top companies to work for in the United States.
RESPONSIBILITIES
§ Working
experience with International Classification of Diseases-Current Version (ICD-10),
Ambulatory Payment Classifications (APCs), and Healthcare Common Procedure
Coding Systems, all levels (HCPCS Level I - III)
§ Outpatient
hospital claims – Review medical records to determine accurate assignment of
HCPCS/CPTs, diagnosis codes, and apply knowledge of code edits (NCCI, MUEs,
MAUs) and other published coding guidance
§ Prepare
written recommendations for proposed “recodes” based on clinical documentation
and referencing official coding protocol and published guidance (Coding Clinic,
CPT Assistant, etc)
§ Serve
as coding resource to Consultants and internal specialty areas
§ Provide
outstanding customer service to internal project teams; respond timely to
coding review requests/inquiries, provide project teams with organized, well
supported feedback on cases referred
QUALIFICATIONS
§ Minimum
of 3 years experience as an acute hospital coder, with an emphasis in complex
surgical cases (cardiac, orthopedic, vascular, spinal/joint)
§ AHIMA
(CCS or CCA) or AAPC (CPC or COC) certified
§ Working
understanding of hospital Rev Cycle processes including HIM, CDM maintenance,
& billing/claims generation
§ Proficient
knowledge of Microsoft Outlook, Word, and Excel
§ Excellent
written and verbal communication skills
§ Exceptional
organizational and work flow management skills
§ Ability
to multitask and work independently with minimal supervision
§ Working
experience with hospital patient account systems/billing software (EPIC,
Meditech, MedAssets, etc)
§ Working
experience with Ambulatory Procedure Grouping (APGs), Diagnosis Related
Grouping (DRGs), and ICD-10 Procedural coding a plus
§ Working
knowledge of Managed Care and Government payer environment a plus
COMPENSATION
This
job opportunity offers a competitive hourly rate (commensurate with
experience), work-life balance, and flexibility.