• Review inpatient records for coding accuracy and DRG validation • Identify anomalies for audit targeting • Apply ICD-10-CM/PCS coding guidelines and DRG logic • Assess how coding impacts reimbursement and severity adjustment • Conduct retrospective audits and document findings • Recommend adjustments, recoveries, or provider education • Collaborate with clinical reviewers and data analysts

• Review and validate medical codes assigned to diagnoses, procedures, and services to ensure accuracy and compliance with ICD-10, CPT, HCPCS, and other coding systems. • Provide expert coding guidance and support to clinicians, and other departments, serving as a resource for complex coding questions. • Conduct coding audits and quality reviews to identify discrepancies and ensure adherence to regulatory guidelines. • Generate and analyze coding productivity reports. • Collaborate with IT and billing teams to resolve system issues impacting coding workflows. • Participate in organizational initiatives, training and continuous improvement to better support the coding process.

• Assign ICD-10, CPT, HCPCS and modifiers codes from documentation • Review and appropriately resolve pre-bill edits • Review and appropriately resolve coding denials • Meet or exceed productivity standards • Meet or exceed accuracy rate of 95.5% in monthly internal audits • Effectively present coding issues to internal team members, internal clients, or external clients • Deliver information in a one-on-one or small group format to peers • Meet deadlines and complete assignments before monthly closing dates • Locate and apply CCI, LCD, NCD and other applicable coding rules and client specific guidelines • Other duties as assigned

Role Description We are seeking a highly motivated Medical Billing Accounts Receivable Coordinator to join our Accounts Receivable Resolution team. This job can be performed 100% remotely and out of state candidates will be considered. - Follow up on unpaid or rejected insurance claims for assigned carriers and work with insurance companies, physicians, and/or staff to resolve account issues. - Respond to inquiries from insurance carriers via telephone, email, or fax, demonstrating a high level of customer service. - Pursue reimbursement from carriers by placing phone calls and recording all contact in an electronic tracking system to ensure progress on outstanding accounts. - Review the Explanation of Benefits (EOBs) received from assigned carriers and take appropriate action according to company guidelines. - Collect necessary information and prepare appeals to carriers when not in agreement with claim denials. - Advise the Team Lead of any trends regarding insurance denials to identify problems with particular payers. - Follow HIPAA guidelines in handling all patient information. - Maintain an understanding of the hierarchy of payers and successfully navigate within the medical claim billing and EMR software. - Verify patient benefit eligibility/coverage and research ICD-10 diagnosis and CPT treatment codes as needed. - Complete required reports and other projects as necessary utilizing Microsoft Excel. Qualifications - High school diploma. - Minimum of 1-2 years hands-on experience in a fast-paced medical billing environment. - Previous experience in a healthcare setting. - Familiarity with CPT and ICD-10 is highly preferred. - Strong communication skills and attention to detail. - Able to handle a very high volume of work with speed and accuracy. Requirements - All applications MUST be submitted via our website. - You may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation in your materials. - CU Medicine is an Equal Opportunity Employer and complies with all applicable federal, state, and local laws governing non-discrimination in employment. - Background investigations for all prospective employees prior to employment. - Drug and health screenings may be required for some positions. Benefits - Generous leave. - Health plans. - Retirement contributions which take your total compensation beyond the number on your paycheck.