Medical Coding and Billing Quality Assurance Specialist

Join a Dynamic Team in Healthcare Coding and Payment Integrity

Are you looking to make a meaningful contribution in the healthcare industry? We welcome passionate individuals who are eager to leverage their coding, bill reviewing, or payment integrity skills in a vibrant work environment that fosters growth and rewards excellence...

Role Overview

This position offers the opportunity to utilize clinical knowledge by reviewing reports that accompany medical records, ensuring the accuracy of medical billing and coding. You will collaborate with various teams to address inquiries and ensure that client deadlines are met.

Key Responsibilities
? Code Evaluation: Assess the appropriateness of codes and ensure they comply with established program standards.
? Record Alignment: Verify that medical records correspond with assigned codes and procure necessary documentation when discrepancies are identified.
? Policy Application: Interpret healthcare policy guidelines and terminology to determine compliance criteria.
? Claims Assessment: Review claims for potential conflicts of interest and criteria appropriateness.
? Timely Delivery: Work within specified timeframes in accordance with program parameters.
? Customer Service: Provide exceptional service by working closely with clients to deliver complete, timely, and error-free quality assurance.
? Complex Case Oversight: Offer clinical insight for complex cases that require additional review before returning to clients.
? Quality Assurance: Serve as a quality assurance layer for cases with identified quality issues.

Requirements

Education & Experience
? Certification: Certified Professional Coder (CPC), AAPC, or DRG certification is required.
? Preferred Experience: Experience in payment integrity or professional bill review is strongly preferred; experience with out-of-network bill review is a plus.
? Work Environment: Familiarity with remote work setups is preferred, with a background in a medical office or healthcare setting being advantageous.

Skills
? Ability to work efficiently under tight deadlines and approach tasks with a sense of urgency.
? Self-motivation and a commitment to performance excellence.
? Excellent written and verbal communication skills.
? Proficiency in computer applications, including experience with Google Chrome, Gmail, Docs, and Sheets.
? Strong attention to detail.

Important Information

We prioritize the safety and security of our candidates. Please note that we will never conduct interviews via text or request any payments for equipment.

Benefits

We offer a generous paid time off policy, a comprehensive benefits package, and competitive salary options. If you thrive in a fast-paced environment and are eager to make a significant impact in the healthcare space, we encourage you to consider this opportunity!

Employment Type: Full-Time

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