Claims Coder & Authorization Specialist Wexford Health Sources, Inc. 184 reviews - Pittsburgh, PA 15220 Wexford Health Sources , (located in Green Tree) one of the nation's leading innovative correctional health care companies, provides clients with experienced management and technologically advanced services, combined with programs that control costs while ensuring quality. For nearly two decades, Wexford Health has consistently delivered proven staffing expertise and a full range of medical, behavioral health, pharmacy, utilization management, provider contracting, claims processing, and quality management services. At Wexford Health our philosophy is that health care should not be considered a luxury for anyone. We simply care for those in need and the corrections environment is our venue.

Wexford Health has an exceptional opportunity for a Claims, Coding, and Authorization Specialist to join our team of healthcare professionals in Pittsburgh Corporate Office located in Green Tree, PA

Were proud to offer a competitive benefits package including: Annual review with performance increase Generous paid-time off program that combines vacation and sick leave Paid holidays Comprehensive health insurance through Blue Cross Blue Shield Dental and Vision insurance 401(k) retirement savings plan Company-paid short-term disability Healthcare and dependent care spending account POSITION SUMMARY Responsibilities include but are not limited to reviewing and updating eligibility, authorization and provider claims information as required to meet client contract requirements. DUTIES AND RESPONSIBILITIES Review suspended medical claims (CMS 1500/UB04/invoices) for accurate identification of issues. Review relevant authorizations for correctness and update system appropriately to expedite claims processing. Review suspended claims to determine the appropriateness of the claim status and take necessary action based on status. Examine system information to include eligibility, authorizations, payments, denials, and resolve outstanding issues to meet client expectations. Report daily production Resolve simple and complex issues through established work processes. Identify and communicate opportunities for process improvement to management and co-workers. Deal professionally with confidential information. Assumes other duties as assigned and directed. REQUIRED EDUCATION AND SKILLS Minimum Qualifications: High school diploma or equivalent. Three years medical coding experience in a medical office and/or hospital/health system setting. Claims processing experience including CMS 1500 and UB04. Recent Medicare and Medicaid experience. Preferred Qualifications: Excellent PC skills including proficiency with all Microsoft Office applications and Internet. Excellent trouble shooting, problem solving, and claims processing skills. Thorough knowledge of ICD-10-CM and CPT coding principles and rules. Experience with encoder technology and familiarity with electronic health records (EHR). CCS/CCS-P or CPC/CPC-P certification preferred. Other: Highly self-motivated. Ability to work independently as well as with the team. Excellent written and verbal communication skills. Excellent organizational aptitude and prioritization skills for effective workload and time management. Adaptable and flexible in response to ever-changing client expectations. Strong attention to detail. Quality focused with strong analytical and problem-solving skills. Strong listening and interpersonal skills; skilled at developing and maintaining effective working relationships. Ability to follow general directions and efficiently make adjustments to fit specific situations as needed. Demonstrates responsiveness and a sense of urgency when dealing with internal and external customers. Initiative: takes appropriate action in the pursuit of individual, group, and organizational objectives and goals, before being asked by others or forced by circumstances. Superior service orientation: ability and willingness to calmly and effectively assist customers and represent Wexford Health in a professional manner at all times. 4 hours ago - save job - original job Apply On Company Site * Claim Coder Authorization Specialist jobs in Pittsburgh, PA * Jobs at Wexford Health Sources in Pittsburgh, PA * Claim Coder Authorization Specialist salaries in Pittsburgh, PA Wexford Health Sources, Inc. Wexford Health Sources, Inc. 184 reviews Wexford Health Sources, one of the nations leading providers of innovative correctional health care services, offers fulfilling... Let employers find you Thousands of employers search for candidates on Indeed Upload Your Resume