Job Description

Job Description

Job Description

Salary:

About Plutus Health Inc.  
Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services with SOC2 Certification. We are dedicated to helping healthcare providers improve their financial performance. Our expertise spans across various specialties. We are committed to delivering exceptional service and innovative solutions to our clients. As a result, Plutus Health Inc. has been recognized on the 5000 list of the fastest-growing private companies in America and ranked 100 in the Dallas area. Additionally, the company has been a 2024 finalist in the EY Entrepreneur Of The Year.

Job Overview

We are seeking an experienced Hospital Medical Coder & AR Specialist with a strong background in hospital Revenue Cycle Management (RCM). The ideal candidate will ensure accurate coding of diagnoses and procedures, manage AR processes, and help maximize reimbursement for hospital services.

Key Responsibilities

• Medical Coding : Review medical records and assign appropriate ICD-10, CPT, and HCPCS codes for hospital-based services.
• Charge Capture : Ensure that all services rendered are properly coded and captured for billing.
• Denial Management : Work on resolving coding-related denials by correcting and resubmitting claims.
• Compliance : Stay updated on payer guidelines, coding standards, and healthcare regulations to ensure compliance (e.g., HIPAA, CMS).
• Accounts Receivable : Assist in AR management by working closely with the billing team to resolve unpaid claims.
• Audits : Conduct coding audits to ensure accuracy and compliance in claims submission.
• Reporting : Generate reports on coding accuracy, AR performance, and outstanding claims.

Qualifications

• Experience : Minimum of 3-5 years of experience in hospital medical coding and AR management.
• Certifications : CPC, CCS, or equivalent coding certification is required.
• Knowledge : Strong understanding of hospital billing, ICD-10, CPT, and HCPCS codes, as well as Medicare, Medicaid, and private payer requirements.
• Skills : Proficiency in coding software and medical billing platforms (e.g., Epic, Cerner), strong analytical skills, and attention to detail.

Preferred Qualifications

• Experience in coding for large hospitals or multi-specialty healthcare facilities.
• Strong understanding of coding guidelines for inpatient and outpatient hospital services.
• Familiarity with denial management and AR collections processes.

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