Sr. Billing & Coding Representative
Remote
Posted on 1/19/2024
INACTIVE
Aledade

1,001-5,000 employees

Empowers primary care practices with value-based solutions
Company Overview
Aledade, Inc. stands out as a leading network of independent primary care, offering robust support to practices through its unique model that combines advanced data analytics, user-friendly workflows, and health care policy expertise. The company's commitment to the success of independent practices is demonstrated through its strong payer relationships and integrated care solutions, which enable physicians to thrive financially while focusing on patient health. With over 1,500 practices across 45 states and the District of Columbia, Aledade's shared risk and reward model, managing over 2 million patient lives, showcases its industry leadership and its significant role in the evolving healthcare landscape.
AI & Machine Learning
Data & Analytics

Company Stage

Series F

Total Funding

$657.6M

Founded

2014

Headquarters

Bethesda, Maryland

Growth & Insights
Headcount

6 month growth

1%

1 year growth

17%

2 year growth

96%
Locations
Charlotte, NC, USA
Experience Level
Entry
Junior
Mid
Senior
Expert
CategoriesNew
Medical, Clinical & Veterinary
Requirements
  • High School Diploma or GED
  • Bachelor's degree in health-related services preferred
  • Minimum 10 years’ experience of billing and coding experience in an outpatient physician practice, ambulatory care setting, or other health-related enterprise
  • Certified Professional Coder (CPC) required
  • Certified Risk Adjustment (CRC) nice to have
Responsibilities
  • Conduct coding related pre-visit planning, post visit chart audits prior to claim submission, and query providers for identified discrepancies between claim documentation, ICD-10, and CPT Category I and II codes
  • Timely follow-up on claim denials, submission of corrected claims and written appeals, ongoing follow-up of appeal submissions
  • Utilize the accounts receivable aging report to resolve outstanding AR
  • Electronic claims submission according to payer contracts, governmental and/or third-party guidelines
  • Identify and alert management of denial trends and make recommendations for front-end edits to minimize reimbursement delays
  • Report data inconsistencies to management
  • Participate in regular team meetings, peer review activities, and departmental and organizational work groups as applicable
  • Adhere to productivity standards using key performance indicators (KPIs) and established healthcare billing metrics
  • Performs all job functions in compliance with applicable federal, state, and local laws and organizational policies and procedures
  • Other duties as assigned
Desired Qualifications
  • Certified Risk Adjustment (CRC)