Reporting to the Billing Manager, the Certified Coder / AR Specialist is responsible for reviewing provider documentation and coding and providing feedback / education. The Certified Coder / AR Specialist will also be responsible for managing insurance and/or patient A/R to include: edits, rejections, denials and refunds.  Facilitate accurate claim submission per payer guidelines and timely account follow-up.  Provide feedback to leadership team to ensure policies and processes are optimized and with a focus on patient service.

Geode Health is a rapidly growing, national provider of outpatient mental health services.  Our mission is:_  TO EMPOWER OUR PATIENTS TO LIVE HEALTHIER, MORE REWARDING LIVES THROUGH ACCESSIBLE, AFFORDABLE AND EFFECTIVE MENTAL HEALTHCARE TO EXCEPTIONAL CARE TAILORED TO THEIR NEEDS._

JOB RESPONSIBILITIES:

• Review provider documentation and coding for accuracy (cpt, dx, upcoding, down-coding, documentation improvement needs, etc)
• Provide feedback and education to providers, regarding their documentation and coding, in a professional, courteous, organized, and effective manner
• Provide annual coding updates that directly affect Geode providers / specialties
• Work with insurance companies, payers and other third parties to ensure timely submission and payment on claims
• Contact payers and/or patients to obtain required information to resolve claim issues and denials
• Manage work effectively and timely
• Review EOB’s and payments to ensure correct processing of claims and review insurance and patient refunds as needed
• Front end claim review for self-pay and insurance
• Other duties as assigned

IDEAL CANDIDATE PROFILE:

• Passionate about our mission and inspiring others
• Self-starter, for whom no task is too big or too small and takes ownership of their decisions
• Contribute to the collective effort both within own scope - and beyond - as needed
• Creative and strategic thinker
• A lifelong learner who believes in giving and receiving feedback to get better each day
• Organized & process-oriented
• Effective, professional, and courteous communication with patients and peers

SKILLS/QUALIFICATIONS:

• Certified Coder; required
• 3-5 years coding experience; mental health / behavioral health preferred
• 3-5 years of experience working with Revenue Cycle software with in-depth knowledge of CPT and ICD-10 codes, insurance EOB’s, payment posting methodologies and payment refunds
• Knowledge and understanding of different types of insurance plans (HMO, PPO, POS, Medicare & Medicare Replacements, Medicaid and Medicaid Replacements)
• Knowledge and understanding of payer portals and when/how to utilize them
• Knowledge of Revenue Cycle processes, payer requirements for billing, and HIPAA
• Ability to learn contract requirements and apply to claim resolution efforts
• High School diploma or GED required; Associates Degree preferred
• Athena experience preferred

AT GEODE HEALTH, WE OFFER:

• Competitive compensation
• Medical, dental and vision benefits
• Life insurance
• Short and long-term disability
• Paid vacation and holidays
• Matching 401k plan
• State of the art technology

WHY WORK FOR GEODE HEALTH?

At Geode Health, we take our commitment to patients and providers seriously. We focus every day on how to help patients across the United States get the best possible mental health care available.  To achieve this, we focus on ensuring our providers have unmatched support and resources so that they can focus on providing great care.  We are backed by KKR, a leading private equity firm with the experience and mission alignment to truly make an impact.  Joining Geode Health will put you on the front-end of a rapidly growing movement to increase access and improve outcomes for mental health patients and providers across the nation.

To learn more, visit us as www.geodehealth.com