Job Family :

General Coding Travel Required :

None Clearance Required :

None What You Will Do :

Review multi-specialty inpatient and outpatient and clinical Charge Correction requests for ICD-10, CPT and HCPCS coding for accuracy and make necessary corrections. Review LCD and NCD criteria and insurance billing guidelines. Report any changes as necessary to collections teams. Electronically file replacement claims and some payment posting as needed. M-F onsite training for approx. 3-6 months. After training hybrid with 90% being remote/working from home.

What You Will Need :

High School Diploma/GED (relevant experience may be substituted for formal education) 1+ years of medical coding experience

AAPC CPC-A

coding certification Experience in ICD-10, CPT and HCPCS Level II Coding Ability to determine medical necessity of services provided and charged based on provider/clinical documentation Knowledge, understanding and proper application of Medicare, Medicaid, and third-party payer

HCFA-1500

billing and reporting requirements including resolution of CCI, MUE and Medical Necessity edits applied to claims Ability to determine accurate medical codes for diagnoses, procedures and services performed in the emergency department, inpatient and outpatient settings.

For example:

emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology, imaging, and laboratory), and outpatient therapies (physical therapy, occupational therapy, speech therapy, and chemotherapy.) Knowledge of current code bundling rules and regulations along with ability on issues of compliance, and reimbursement under outpatient grouping systems such as Medicare OPPS and Medicaid or Commercial Insurance EAPG's Ability to use

MS Excel What Would Be Nice To Have :

5 years' experience in Revenue Integrity Coding and Billing Knowledge and understanding of physician charge description master coding systems and structures. Physician medical billing and auditing experience #LI-DNI The annual salary range for this position is $38,000.00-$64,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer :

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

Medical, Rx, Dental & Vision Insurance Personal and Family Sick Time & Company Paid Holidays Position may be eligible for a discretionary variable incentive bonus Parental Leave 401(k) Retirement Plan Basic Life & Supplemental Life Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts Short-Term & Long-Term Disability Tuition Reimbursement, Personal Development & Learning Opportunities Skills Development & Certifications Employee Referral Program Corporate Sponsored Events & Community Outreach Emergency Back-Up Childcare Program About Guidehouse Guidehouse is an Equal Opportunity Employer-Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. 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