Employer Industry: Healthcare Services

Why Consider this Job Opportunity:
- Competitive pay up to $128,100 per year
- Opportunity for career advancement and growth within the organization
- Comprehensive benefits package including medical, dental, vision, and life insurance
- Chance to work in a supportive and collaborative environment
- Extensive training and certifications provided
- Opportunity to make a positive impact on claims payment integrity and compliance

What to Expect (Job Responsibilities):
- Provide coding and billing expertise to ensure compliance with industry standards and regulations
- Conduct audits and analysis of high-risk claims to validate coding accuracy and appropriateness of service
- Collaborate with internal and external partners to obtain and share information for decision-making
- Review escalated issues and recommend changes to improve processes and reduce potential overpayments
- Synthesize data and collaborate with data team to resolve data concerns

What is Required (Qualifications):
- Minimum of 5 years of related work experience in medical records review
- Bachelor's degree in a related field or equivalent work experience
- Minimum of 3-5 AAPC Medical Coding Certifications
- Strong familiarity with IC9/10 and CPT/HCPCS coding
- Proficiency in medical terminology and claims processing procedures
- Excellent analytical and communication skills

How to Stand Out (Preferred Qualifications):
- Master's degree in a related field
- Experience with multiple provider reimbursement and pricing methodologies
- Working knowledge of COB/OPL, Subrogation, and Workers' Comp
- Proficiency with various healthcare tools and applications

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