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