Professional Fee Edits Specialist

Position Description

The ProFee Edits Specialist will review front-end edits and rejection/denials and/or code physician records to determine appropriate designation of diagnosis, procedure and wRVUs while maintaining compliance with coding guidelines and client guidelines.

Position Responsibilities

  • Analyze, evaluate and review client medical records to ensure accuracy of code assignment.
  • Identify issues and remediate denials received by clients. Work and fix edits as requested by the client.
  • Code professional fee charts as needed by the client.
  • Prepare daily edits/denials logs.
  • Demonstrates proficiency in coding including both ICD-10 and CPT while maintaining a 95% accuracy.
  • Follow and adhere to AHIMA’s Standards of Ethical Coding, all applicable regulations and guidelines, and all client-specific policies.
  • Maintain productivity based on national standards and/or client-specific standards
  • Work as a team player in a dynamic environment
  • Basic knowledge and experience in Microsoft Office applications (Excel, Office, Word, Sharepoint, etc…)
  • Other duties as assigned based on company needs and client projects.

Certification/Experience

  • RHIT, CCS, or CCS-P – active and in good standing with AHIMA or
  • CPC – active and in good standing with AAPC
  • Minimum of 5 years of physician/ProFee or payer Rejection/Denials Remediation experience

 

“YES encourages a team-oriented culture and really exemplifies keeping everyone in touch throughout the day so we don’t get lost in our remote positions. They help you feel like a person instead of just a number.”

Lizzi – RHIT, CPC

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