Why Mayo Clinic
Mayo Clinic is top-ranked in more specialties than any other care provider according to U.S. News & World Report. As we work together to put the needs of the patient first, we are also dedicated to our employees, investing in competitive compensation and comprehensive benefit plans – to take care of you and your family, now and in the future. And with continuing education and advancement opportunities at every turn, you can build a long, successful career with Mayo Clinic. You’ll thrive in an environment that supports innovation, is committed to ending racism and supporting diversity, equity and inclusion, and provides the resources you need to succeed.
Responsibilities
The Denial Management Coding Analyst supports the denial management team by reviewing claims for coding accuracy and root causes for coding-related denials, as well as proposing process improvements to mitigate future denials. The Denial Management Coding Analyst liaises between the denial management team, coding operations, and providers, resolving queries for missing documentation and promoting departmental awareness of coding best practices. This position will serve as a resource for Denial Management Coders needing assistance resolving complex denials and may provide direction to those staff regarding priorities and productivity goals.
A Denial Management Coding Analyst will also research and resolve coding denials via Epic work queues, and process charge corrections based on medical record reviews, contracts, regulations, in accordance with Mayo Clinic’s policies. This position is also required to interpret and review physician-professional documentation in validating procedural, supplies, drugs and diagnosis coding for the professional claims. A Denial Management Coding Analyst is also responsible for reviewing hospital inpatient or hospital outpatient documentation in validating claim ICD-10-CM diagnosis codes, ICD-10-PCS codes, and CPT-4 procedural codes for UB-04 Outpatient or Inpatient claims. This position will defend the claim and seek payment from the payer by facilitating resolution of the denial through resubmission of supporting documentation, including discussion(s) with the payer or via the payer’s website.
Qualifications
-Associate’s Degree required; Bachelor’s Degree is preferred in a health care related area.
-Minimum of 4 years of physician/professional or hospital outpatient coding experience or minimum of 6 years of relevant hospital inpatient coding experience including DRG assignment.
Additional Qualifications:
1)Knowledge of professional/physician coding rules for inpatient, hospital outpatient, clinic, and/or emergency settings. Experience with National Correct Coding Initiative edits (NCCI), National Coverage Determinations (NCD), Local Coverage Determinations (LCD), and Outpatient coding guidelines for official coding and reporting.
2)In-depth knowledge of medical terminology, disease processes, patient health record content and the medical record coding process.
3)Knowledge of principles, methods, and techniques related to compliant healthcare billing/collections.
4)Familiarity with provider based billing (PBB) and critical access hospital (CAH) coding and billing requirements is a plus.
5)Demonstrated ability to partner with physicians and provide feedback on medical documentation best practices.
Licensure/Certifications:
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or coding credential of a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) required.
Exemption Status
Exempt
Compensation Detail
$65,978.00 – $89,107.00 / year. Education, experience and tenure may be considered along with internal equity when job offers are extended.
Benefits Eligible
Yes
Schedule
Full Time
Hours/Pay Period
80
Schedule Details
Monday – Friday
Weekend Schedule
N/A
International Assignment
No
Site Description
Just as our reputation has spread beyond our Minnesota roots, so have our locations. Today, our employees are located at our three major campuses in Phoenix/Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota, and at Mayo Clinic Health System campuses throughout Midwestern communities, and at our international locations. Each Mayo Clinic location is a special place where our employees thrive in both their work and personal lives. Learn more about what each unique Mayo Clinic campus has to offer, and where your best fit is.
Affirmative Action and Equal Opportunity Employer
As an Affirmative Action and Equal Opportunity Employer Mayo Clinic is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities and people with disabilities are strongly encouraged to apply to join our teams. Reasonable accommodations to access job openings or to apply for a job are available.
Recruiter
Ronnie Bartz
Department Title
Mayo Clinic Finance