Tech Stack

Description

You will conduct professional and facility coding reviews to ensure accurate code assignment, DRG/reimbursement, and maximize overpayment identification. Join a dynamic Payment Integrity team to support accurate reimbursement solutions in a high-growth environment.

Requirements

• 3-5 years of experience
• Expert knowledge of ICD-10-CM/PCS, CPT, HCPCS coding guidelines
• CCS or CPC credential
• Knowledge of US healthcare payment methodologies for Commercial, Marketplace, Medicare, Medicaid
• Bachelor's degree

Responsibilities

• Conduct comprehensive professional and facility coding reviews
• Ensure accuracy of code assignment, DRG/reimbursement
• Maximize overpayment identification
• Audit outpatient and inpatient claims including ambulatory surgery and hospital observation
• Audit high-cost drug and durable medical equipment claims