Description
We are seeking dedicated bill review professionals, CPC coders, AAPC, or DRG coders to join our dynamic team! This role offers a vibrant work environment, competitive compensation, and strong opportunities for growth.
As part of our new program in the group health sector, you will utilize your clinical expertise to review medical records and accompanying reports, ensuring the accuracy of medical billing and coding. Collaboration with fellow reviewers and office teams will be essential to clarify information, address inquiries, and meet client deadlines.
Core Duties & Responsibilities
- Evaluate coding appropriateness and ensure compliance with established program standards.
- Ensure medical records align with the correct codes and acquire any missing records as necessary.
- Read and apply policy guidelines and healthcare terminology, identifying when criteria are or are not met.
- Assess claims for potential conflicts of interest and appropriateness.
- Work within designated timeframes established by program guidelines.
- Deliver excellent customer service and collaborate closely with clients to ensure thorough, timely, and accurate quality assurance of cases.
- Provide clinical oversight for complex cases requiring additional review before returning to the client.
- Serve as an additional quality assurance resource, applying clinical knowledge to cases with identified quality issues.
Requirements
- Education & Experience:
- CPC, AAPC, or DRG coder certification is required.
- Previous experience in payment integrity or professional bill review is strongly preferred.
- Out-of-network bill review experience is a plus.
- Familiarity with remote work environments is preferred.
- A background in medical office or healthcare settings is advantageous.
- Skills:
- Ability to work with a sense of urgency and meet deadlines.
- Self-motivated with a strong drive for performance excellence.
- Excellent written and verbal communication skills.
- Proficiency in navigating various computer programs (experience with Google Chrome, Gmail, Docs, Sheets, etc. is a plus).
- Strong attention to detail is essential.
Important Note
For your safety, please be aware that we will never conduct interviews via text or request candidates to purchase equipment.
Benefits
We offer generous paid time off, an excellent benefits package, and a competitive salary. If you are an exceptional candidate who thrives in a fast-paced environment and is passionate about making a meaningful impact in the lives of others, we encourage you to apply!
Employment Type: Full-Time