Employer Industry: Medical Billing and Coding

Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Engage in a variety of tasks beyond traditional roles, enhancing skill development
- Collaborative work environment with healthcare providers, insurance companies, and legal entities
- Maintain relevant certifications and pursue additional qualifications as necessary
- Chance to become an expert witness in legal proceedings, showcasing your expertise

What to Expect (Job Responsibilities):
- Conduct comprehensive forensic examinations of medical records, bills, and associated documents to identify inaccuracies or fraud
- Serve as an expert witness in legal proceedings, providing clear and authoritative testimony on medical coding and billing
- Document findings clearly and concisely, generating reports detailing discrepancies and suspected fraud
- Advise medical and administrative teams on compliance requirements and potential areas of risk
- Work closely with healthcare providers and legal entities to offer guidance on medical billing and coding matters

What is Required (Qualifications):
- 5 or more years of experience in medical billing and coding, focusing on forensic analysis and insurance claims
- 5 or more years' experience with the End-To-End Revenue Cycle Management process
- 5 or more years' experience in medical record documentation review
- Certification in Medical Coding, such as CPC, CCS, BCSC, or CMRS
- In-depth understanding of healthcare billing processes, insurance claims, and regulatory guidelines

How to Stand Out (Preferred Qualifications):
- History of expert testifying experience
- Bachelor's degree or higher in business or a similar field
- Familiarity with legal processes and protocols related to healthcare fraud
- Strong written and verbal communication skills for conveying complex information
- Additional Medical Certifications such as FMC, RHIA, or CPMA

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