We are looking for Emergency Department Appeals Review Consultants with strong proficiency and experience in emergency department coding • AAPC or AHIMA coding credentials are preferred • Education or experience in coding emergency department records utilizing ICD-10-CM, CPT, HCPCS, and E/M Levels is required • Candidate should possess strong knowledge of reimbursement methodology, federal, state and payor coding, documentation and billing requirements • Attention to detail • Ability to clearly communicate verbally and in writing.

Flexibility to work with advance notice is required for this position. Consultants will be paid a flat rate per review. Reviews will be assigned on an as-needed basis, according to volume and availability. Completion of reviews will be on a strict turn-around time. Compensation is per review completed, reviews generally take approximately 15 minutes.

Job Description:

The ER Appeals Review Consultant applies Emergency Department Evaluation and Management (ED E/M) knowledge to review hospital appeals for payor down-coded ER claims. The outcome of the review is communicated via a completed form that is sent to the payor.

Essential Functions:

· Review appeals of reimbursed CPT levels for Emergency Room encounters.

· Complete ER Review form with details of the outcome of the review.

· Communicate with internal administrative team to prioritize and complete reviews within designated turn-around time.

• Professional verbal and written communications skills
• Ability to prioritize effectively and manage to a high pressure deadline driven culture
• Proficient in Microsoft Office, including Outlook and Word
• Ability to work independently to meet objectives
• Maintains a high standard of confidentiality and ethics

Required Skills

Requirements:

· High School Diploma or equivalent (GED) required

· AAPC or AHIMA coding credentials are preferred

· Experience in coding emergency department records utilizing ICD-10-CM, CPT, HCPCS, and E/M Levels is required

· Strong knowledge of reimbursement methodology, federal, state and payor coding, documentation and billing requirements

· Flexibility to work on an “as needed” schedule with advance notice

Required Experience

Requirements:

· High School Diploma or equivalent (GED) required

· AAPC or AHIMA coding credentials are preferred

· Experience in coding emergency department records utilizing ICD-10-CM, CPT, HCPCS, and E/M Levels is required

· Strong knowledge of reimbursement methodology, federal, state and payor coding, documentation and billing requirements

· Flexibility to work on an “as needed” schedule with advance notice