Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Competitive base compensation ranging from $62,000 to $84,000
- Opportunity for career advancement and growth within the organization
- Work remotely from anywhere within the United States
- Access to high-speed internet and necessary equipment provided
- Comprehensive benefits package including medical, dental, vision, disability, and life insurance coverage, 401(k) savings plans, paid family leave, and generous Paid Time Off (PTO)
- Positive work environment with the ability to positively handle/manage stress

What to Expect (Job Responsibilities):
- Conduct audits of medical records and healthcare claims to assess accuracy of medical coding and compliance with policies and regulations
- Prepare and submit detailed reports on audit findings with recommendations for improvement
- Conduct medical policy and research to support review findings
- Utilize knowledge of healthcare coding conventions, reimbursement methodologies, and identification of suspicious patterns in medical record documentation
- Stay updated on federal, state, and payer policies and coding guidelines
- Participate in special projects as required

What is Required (Qualifications):
- Bachelor's Degree in a related discipline or equivalent combination of education, training, and experience
- Preferred licenses: Licensed Practical Nurse (LPN) or Registered Nurse (RN)
- Required credential: Certified Professional Coder (CPC, CCS, CCS-P)
- 2-5 years of experience in auditing medical records
- Proficiency in MS Office suite
- Excellent verbal and written communication skills
- Strong listening and observation skills
- Attention to detail and high level of accuracy
- Effective organizational and prioritization skills
- Ability to conduct research in support of medical review determinations
- Understanding of ICD, CPT, HCPCS, APC, DRG, Revenue Codes, NCDs, and federal and state guidelines
- Healthcare claims experience helpful
- Ability to work independently and collaborate with peers and customers
- No adverse actions pending or taken against candidate by any State or Federal licensing board or program

How to Stand Out (Preferred Qualifications):
- 0-2 years of experience as an Rx Technician or Customer Service Representative in a healthcare-related service

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