Job Description

Are you a skilled medical coder or bill reviewer with a passion for accuracy and efficiency? We are looking for motivated candidates to join our team. Enjoy a dynamic work environment, competitive compensation, and ample opportunities for professional growth.

Job Summary:

As a part of our expanding group health program, you will leverage your clinical knowledge to review reports alongside medical records, ensuring accuracy in medical billing information and coding. Collaboration with fellow reviewers and office teams will be key to ensuring clarity and completeness of information within client deadlines.

Core Responsibilities:

Evaluate the appropriateness of medical codes and ensure adherence to program standards.
Verify accurate matching of medical records with assigned codes, obtaining additional records as needed.
Apply policy guidelines and healthcare terminology to determine compliance.
Assess claims for conflicts of interest and criteria appropriateness.
Adhere to program timelines and deliverables.
Provide exceptional customer service, collaborating closely with clients to ensure accurate and timely case resolution.
Offer clinical oversight for complex cases requiring additional review before client submission.
Serve as an additional layer of quality assurance and clinical expertise for cases with identified issues.
Requirements:

Education & Experience:

Certification as a CPC, APCC, or DRG coder required.
Prior experience in payment integrity or professional bill review strongly preferred.
Experience with out-of-network bill review is advantageous.
Remote work experience preferred.
Background in medical office or healthcare settings beneficial.
Skills:

Strong sense of urgency and commitment to meeting deadlines.
Self-motivated with a dedication to performance excellence.
Excellent written and verbal communication skills.
Proficiency in various computer programs; experience with Google Suite (Chrome, Gmail, Docs, Sheets) a plus.
Exceptional attention to detail required.
Benefits:

We offer generous Paid Time Off, a comprehensive benefits package, and competitive salary. Join us if you excel in a fast-paced environment and are driven by the opportunity to make a meaningful impact on others' lives.

About Us:

High-performance company ranked in the Inc. 500 list. We process over 200,000 insurance claims annually for leading national and regional carriers and organizations. Our services include Independent Medical Exams and Peer Review programs aimed at facilitating appropriate medical determinations in claims management.
Employment Type: Full-Time
Salary: $ 18.00 24.00 Per Hour

Job Tags

Hourly pay, Full time, Work experience placement,

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