Reimbursement Analyst

Reimbursement Analyst Our client a leading academic medical center in NYC has an opening for a Reimbursement Analyst. Responsibilities Review documentation associated with accounts reside in Epic work queues to determine the appropriate charge/s, procedure and/or diagnosis codes. Liaison with front end, as needed, to ensure that visits are registered correctly. Ensure that documentation supports charges on claim to prevent denials/underpayments and are in adherence with compliance standards and credible coding sources. Assist PFS with analyzing coding denials and writing appeals, as needed. Review and distribute coding-related articles to clinical staff, including medical necessity policies and coding/billing information for various procedures. Research and identify missing device &/or drug related charges that are required to support procedure on claim & bring to manager's attention for needed follow‑up. Identify and assists with documentation gaps in retrospect of CMS, AHA or AMA guidelines for revenue enhancement opportunities. Identify patterns, trends, and opportunities for charge capture and revenue enhancement. Update charges in Eagle as required by posting and deleting and ensure that the correct info is entered to avoid negative charges or incorrect DOS. Assists / performs special projects related to re‑billing or charge master activities. Participate in education programs to maintain up to date coding skills. Qualifications Proficient in Epic Billing and have thorough working knowledge of ICD-10 diagnosis coding guidelines, CPT/HCPCS code assignments. Knowledge of the Outpatient Prospective Payment System (OPPS). Detailed knowledge and understanding of hospital vs. professional charging and coding. Ability to concentrate and accomplish tasks with explicit accuracy and established/maintained effective working relationships as required by the duties of the position. Functional knowledge of facility EMR, encoder, and other support software. Education and Experience 3-5 years of multispecialty coding experience in AmSurg and/or clinic settings. Bachelor’s degree or equivalent work experience required. Certificates, Licenses, and Registrations Required: AHIMA (CCS) or AAPC (CPC) approved credential Work arrangement Can be hybrid. Salary Salary: $78,000-$82,000. #J-18808-Ljbffr