61st Street Service Corporation
AR Follow-Up Specialist III - Coding and Complex Denials #Full Time #Remote
61st Street Service Corporation, Trenton, New Jersey, United States
AR Follow-Up Specialist III - Coding and Complex Denials - Full Time - Remote
Career Opportunities with 61st Street Service Corp Current job opportunities are posted here as they become available. Overview
The 61st Street Service Corporation provides administrative and clinical support staff for
ColumbiaDoctors . This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties. This position is primarily remote, candidates must reside in the Tri-State area. Note:
There may be occasional requirements to visit the office for training, meetings, and other business needs. Opportunity to grow as part of the Revenue Cycle Career Ladder! Job Responsibilities
Work closely with Certified Professional Coders (CPCs) to gather documentation, support appeals, and overturn coding-related denials effectively. Elevate cases requiring advanced coding review to appropriate CPCs or supervisors as needed. Prepare and submit appeals for denied claims, including Letters of Medical Necessity and other supporting documentation, in collaboration with coding professionals. Address incoming correspondence related to coding denials and respond timely to ensure prompt resolution. Identify patterns in coding-related denials and escalate trends to supervisors to improve processes and reduce future denials. Provide input on process improvements and best practices to enhance the efficiency of denial management. Assist Assistant Director/Supervisor with monitoring work queues and other assigned duties related to coding and denial follow-up. Support the training of new hires, particularly on coding and complex denial workflows. Contact insurance companies, patients, or account guarantors via phone, correspondence, and online portals to obtain the status of outstanding claims and submitted appeals. Perform demographic and insurance coverage updates on accounts as appropriate, ensuring all corrections are properly documented and billed. Address issues related to third-party sponsorship and follow up as needed. Job Qualifications
High school graduate or GED certificate is required. A minimum of 2 years’ experience in a physician billing or third party payer environment. Candidate must demonstrate the ability to understand and navigate contracts, insurance benefits, exclusions, and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations. Candidate must demonstrate strong customer service and patient-focused orientation and the ability to understand and communicate insurance benefits explanations, exclusions, denials, and the payer adjudication process. Must demonstrate effective communication skills both verbally and written. Intermediate proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.) Experience in Epic and or other electronic billing systems is preferred. Knowledge of medical terminology, diagnosis, and procedure coding is preferred. Previous experience in an academic healthcare setting is preferred. Compensation
Hourly Rate Ranges: $27.88 - $36.06 Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education. About 61st Street Service Corporation
61st Street Service Corporation is committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a comprehensive Benefits package to eligible employees, including Healthcare and Paid Time Off to promote a healthy lifestyle. We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.
#J-18808-Ljbffr
Career Opportunities with 61st Street Service Corp Current job opportunities are posted here as they become available. Overview
The 61st Street Service Corporation provides administrative and clinical support staff for
ColumbiaDoctors . This position will support ColumbiaDoctors, one of the largest multi-specialty practices in the Northeast. ColumbiaDoctors’ practices comprise an experienced group of more than 2,800 physicians, surgeons, dentists, and nurses, offering more than 240 specialties and subspecialties. This position is primarily remote, candidates must reside in the Tri-State area. Note:
There may be occasional requirements to visit the office for training, meetings, and other business needs. Opportunity to grow as part of the Revenue Cycle Career Ladder! Job Responsibilities
Work closely with Certified Professional Coders (CPCs) to gather documentation, support appeals, and overturn coding-related denials effectively. Elevate cases requiring advanced coding review to appropriate CPCs or supervisors as needed. Prepare and submit appeals for denied claims, including Letters of Medical Necessity and other supporting documentation, in collaboration with coding professionals. Address incoming correspondence related to coding denials and respond timely to ensure prompt resolution. Identify patterns in coding-related denials and escalate trends to supervisors to improve processes and reduce future denials. Provide input on process improvements and best practices to enhance the efficiency of denial management. Assist Assistant Director/Supervisor with monitoring work queues and other assigned duties related to coding and denial follow-up. Support the training of new hires, particularly on coding and complex denial workflows. Contact insurance companies, patients, or account guarantors via phone, correspondence, and online portals to obtain the status of outstanding claims and submitted appeals. Perform demographic and insurance coverage updates on accounts as appropriate, ensuring all corrections are properly documented and billed. Address issues related to third-party sponsorship and follow up as needed. Job Qualifications
High school graduate or GED certificate is required. A minimum of 2 years’ experience in a physician billing or third party payer environment. Candidate must demonstrate the ability to understand and navigate contracts, insurance benefits, exclusions, and other billing requirements as well as claim forms, HMOs, PPOs, Medicare, Medicaid and compliance program regulations. Candidate must demonstrate strong customer service and patient-focused orientation and the ability to understand and communicate insurance benefits explanations, exclusions, denials, and the payer adjudication process. Must demonstrate effective communication skills both verbally and written. Intermediate proficiency in computer software skills (e.g. Microsoft Word, Excel and Outlook, E-mail, etc.) Experience in Epic and or other electronic billing systems is preferred. Knowledge of medical terminology, diagnosis, and procedure coding is preferred. Previous experience in an academic healthcare setting is preferred. Compensation
Hourly Rate Ranges: $27.88 - $36.06 Note: Our salary offers will fall within these ranges based on a variety of factors, including but not limited to experience, skill set, training and education. About 61st Street Service Corporation
61st Street Service Corporation is committed to providing our client with excellent customer service while maintaining a productive environment for all employees. The Service Corporation offers a comprehensive Benefits package to eligible employees, including Healthcare and Paid Time Off to promote a healthy lifestyle. We are an equal employment opportunity employer and we adhere to all requirements of all applicable federal, state, and local civil rights laws.
#J-18808-Ljbffr