Invasive Coding Analyst - Ortho

The Invasive Coding Analyst identifies and analyzes denials, determines solutions, and implements corrections to result in accurate claim processing and payment. The role investigates denial and coding issues related to services provided and associated charges, works with multiple payers and payer-specific policies, and helps resolve billing and reimbursement issues for patient accounts.

Additional responsibilities include:

• Reviewing denial reports and providing recommendations based on findings
• Identifying coding-related revenue and reimbursement improvement opportunities for Orthopaedic Services
• Consulting with physicians on clinical documentation as it relates to coding requirements
• Analyzing complex accounts and completing action steps to resolve them
• Serving as a subject matter expert and providing guidance to RCM Specialists
• Collaborating with Orthopaedic leadership on insurance issues, departmental procedures, and operations
• Reporting erroneous processing trends by payer to management