Curana Health is a provider of value-based primary care services exclusively for the senior living industry, including in nursing homes, assisted/independent living facilities, CCRC/life plan communities and affordable senior housing communities. Curana Health serves more than 1,100 senior living community partners across 30 states and participates in both the MSSP ACO, ACO Reach and Medicare Advantage programs with CMS. Backed by more than $300M in venture capital funding, the organization is poised to disrupt care delivery in senior living on a meaningful scale through innovative care models and applied analytics.

Essential Functions

• Effectively review and resolve coding-related denials applying official coding guidelines, payer policies and established departmental policies and procedures
• Reviews medical record and coded information to determine if coding needs to be updated or if an appeal is needed for resolution
• Navigate and research insurance policies & benefits for policy exclusions
• Navigate and research payer medical reimbursement policies and exclusions
• Contact providers to obtain additional information as needed to resolve claim denials
• Understand and act on the timely filing guidelines associated with claims filing, reconsiderations, and appeals for assigned payers
• Review accounts for accuracy (payments and adjustments)
• Identify, monitor, and communicate denial/rejection trends to the RCM/CDI/Compliance teams to help identify education/feedback opportunities
• Maintain timeliness, as well as productivity and quality standards
• Performs other coding functions as appropriate
• Attends department meetings to discuss denial trends and prevention opportunities

Competencies

• High Ethical and Professional Standards
• Time Management
• Excellent Organizational Skills
• High attention to detail
• Ability to multi-task
• Ability to work collaboratively in a remote environment
• Ability to work independently and adapt to a fast-changing environment
• Problem solving skills

Qualifications

• High School Diploma or equivalent
• The ideal candidate will have multi-specialty coding experience
• Minimum of 2 years E/M coding experience preferred
• Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC) or equivalent education
• Knowledge of ICD-10 CM and CPT coding guidelines
• Knowledge of Microsoft Word and Excel
• Knowledge of 3M Coding Software

Curana Health is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances.

The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment.