Job Description

Are you a passionate coder, bill reviewer, or payment integrity reviewer? We are seeking highly motivated individuals to join our dynamic team! Enjoy a rewarding work environment with competitive compensation and excellent growth opportunities.

Job Summary:

We are excited to introduce a new program on the group health side of our business. This role allows you to leverage your clinical knowledge by reviewing reports accompanying medical records to ensure accurate medical billing and coding. You will collaborate with other reviewers and office teams to clarify information, address any questions, and meet client deadlines.

Core Duties & Responsibilities:

Evaluate the appropriateness of codes and ensure compliance with established program standards.
Ensure medical records align with codes; obtain necessary records when discrepancies arise.
Read and apply policy guidelines and healthcare terminology, determining when criteria are or are not met.
Assess claims for potential conflicts of interest and appropriateness of criteria.
Work within established timeframes according to program parameters.
Provide exceptional customer service, collaborating closely with clients to deliver complete, timely, and error-free quality assurance for cases.
Offer clinical oversight for complex cases that require additional review before returning to the client.
Serve as an additional level of quality assurance and clinical expertise for cases with quality issues.
Requirements:

Education & Experience:

Certified Professional Coder (CPC), AAPC, or DRG certification is required.
Strongly preferred: experience in payment integrity or professional bill review.
Experience with out-of-network bill review is a plus.
Familiarity with remote work environments is preferred.
A background in a medical office or healthcare setting is advantageous.
Skills:

Demonstrated ability to work with a sense of urgency and meet deadlines.
Self-motivated with a strong drive for performance excellence.
Excellent written and verbal communication skills.
Proficiency in various computer programs; experience with Google Chrome, Gmail, Docs, and Sheets is a plus.
Keen attention to detail is essential.
Important Note:

For the security of all parties involved, please be aware that we will never conduct interviews via text or request any payments from candidates for purchasing equipment.

Benefits:

We offer generous paid time off, a comprehensive benefits package, and a competitive salary. If you are a standout candidate who thrives in a fast-paced environment and is eager to make a meaningful impact, we encourage you to apply!
Employment Type: Full-Time
Salary: $ 18.00 24.00 Per Hour

Job Tags

Hourly pay, Full time,

Similar Jobs