Job Description

Tandym Group has several immediate contract opportunities for PB Coders. These are fully remote roles that will be focused on helping a client clear their large backlog in Ophthalmology where they are billing globally. The ideal resource will be fluid in both coding and Epic. They will understand specialty professional coding, have the ability to code, and will have strong experience with Epic, Epic PB Charge Review WQs, NCCI edits, and bundling/unbundling.

Key Responsibilities:

• Review and resolve claims that have been flagged due to edits or modifier issues.
• Bundling/unbundling
• Maintain up-to-date knowledge of coding guidelines and CPT.
• Utilize Epic PB
• Actively working through a designated Epic work queue, reviewing flagged accounts for potential coding errors, and taking corrective action as needed.
• Handling the PB Charge Review WQ.
• Identifying and resolving coding edits within the Epic system, such as NCCI edits, modifier issues, or incorrect code assignments.
• Identify trends and make recommendations for process improvements to enhance coding and/or claim-resolution efficiency.

Required Experience

• Coding certification required (CPC or equivalent).
• Minimum of 4 years of medical coding and auditing experience.
• Understands specialty professional coding.
• Advanced knowledge of CPT/HCPCS/Revenue Code procedure coding and ICD-10 coding principles
• Ability to code from scratch as well as perform edits, audits.
• Experience in bundling/unbundling.
• Strong experience with CCI edits.
• Minimum of 4 years of recent, strong Epic PB experience
• Need to be able to work down Charge Review WQ's in Epic PB system.
• Working knowledge of CPT & HCPCs coding guidelines.
• In-depth knowledge of coding information systems

Preferred Experience

• Exposure to OB, Ophthalmology, General Surgery, Lab, Rad specialties.
• Any additional Revenue Cycle certifications

Job Tags

Similar Jobs