We are looking for Emergency Department Appeals Review Consultants with strong proficiency and experience in emergency department coding • AAPC or AHIMA coding credentials are preferred • Education or experience in coding emergency department records utilizing ICD-10-CM, CPT, HCPCS, and E/M Levels is required • Candidate should possess strong knowledge of reimbursement methodology, federal, state and payor coding, documentation and billing requirements • Attention to detail • Ability to clearly communicate verbally and in writing.

Flexibility to work with advance notice is required for this position.Consultants will be paid a flat rate per review. Reviews will be assigned on an as-needed basis, according to volume and availability. Completion of reviews will be on a strict turn-around time. Compensation is per review completed, reviews generally take approximately 15 minutes.

Job Description:

The ER Appeals Review Consultant applies Emergency Department Evaluation and Management (ED E/M) knowledge to review hospital appeals for payor down-coded ER claims. The outcome of the review is communicated via a completed form that is sent to the payor.

Essential Functions:

·Review appeals of reimbursed CPT levels for Emergency Room encounters.

·Complete ER Review form with details of the outcome of the review.

·Communicate with internal administrative team to prioritize and complete reviews within designated turn-around time.

• Professional verbal and written communications skills
• Ability to prioritize effectively and manage to a high pressure deadline driven culture
• Proficient in Microsoft Office, including Outlook and Word
• Ability to work independently to meet objectives
• Maintains a high standard of confidentiality and ethics