Job Description

Job Summary:

An exciting opportunity in the group health sector awaits, where you can leverage your clinical expertise to review reports alongside medical records, ensuring accuracy in medical billing information and coding. Collaborate closely with fellow reviewers and office teams to clarify information, address queries comprehensively, and meet client deadlines promptly.

Core Duties & Responsibilities:

Assess the accuracy of codes against established standards.
Ensure proper alignment of medical records with codes; obtain additional records as necessary.
Apply policy guidelines and healthcare terminology adeptly, identifying adherence to criteria.
Evaluate claims for appropriateness and potential conflicts of interest.
Adhere to program timelines and parameters.
Deliver exceptional customer service, resolving cases on a case-by-case basis with precision and timeliness.
Provide clinical oversight for complex cases requiring additional review before client submission.
Offer additional quality assurance and clinical insights for cases with identified issues.
Requirements

Required Education & Experience:

Certification as a CPC, APCC, or DRG coder.
Preferred experience in payment integrity or professional bill review.
Advantageous to have out-of-network bill review experience.
Remote work experience preferred.
Background in medical office or healthcare settings beneficial.
Required Skills:

Ability to work with urgency and consistently meet deadlines.
Self-motivated with a commitment to excellence in performance.
Strong written and verbal communication skills.
Proficiency in navigating various computer programs; familiarity with Google Chrome, Gmail, Docs, Sheets is advantageous.
Meticulous attention to detail required.
Benefits:

We offer competitive compensation, a comprehensive benefits package, and generous Paid Time Off. If you are passionate about making a meaningful impact in a dynamic environment, we encourage you to apply.
Employment Type: Full-Time
Salary: $ 18.00 24.00 Per Hour

Job Tags

Hourly pay, Full time, Work experience placement, Remote job,

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