Lawrence General Hospital Claims Editor in Lawrence, Massachusetts
The Claims Editor enhances the Hospital's revenue by reducing claim edit denials resulting from charge entry and/or coding errors and omissions. The Claims Editor works closely with the Claims Edit Coordinator to ensure that these edits are corrected in a timely fashion while also determining root causes. The position requires working with ancillary departments to resolve and prevent future claim rejections related to coding, medical necessity and missed charges and makes corrections to claim rejection in McKesson and ePREMIS billing systems prior to submission to payer. The Claims Editor must demonstrate extensive knowledge of medical terminology, anatomy and physiology, human disease process, ICD-10, CPT and HCPCS coding. High school diploma required as well as advanced training in medical coding. Excellent communication skills both written and oral a must. Minimum one year experience as a staff coder in an HIM Departments or in a physician practice preferred. Medical billing experience preferred. Certification as a CPC, CCS, CCS-P, CPC or CPC-H preferred. This position reports to the Revenue Integrity Manager.