Certified Medical Coding Reviewer

Job Summary

A company is looking for a PI Medical Coding Reviewer III, responsible for generating reports and analyzing performance related to medical coding processes.

Key Responsibilities

• Generate comprehensive reports and coordinate with management to enhance team performance
• Mentor and train staff on coding practices and identify workflow inefficiencies
• Analyze complex provider claims submissions using coding guidelines and make claim payment decisions

Required Qualifications, Training, and Education

• Associate's degree or equivalent relevant work experience is required
• Minimum of five years of medical billing and coding experience, including three years in SIU/FWA
• Prior experience with claim pre-payment and medical claim auditing is required
• Medicaid/Medicare experience is required
• Certification as a Medical Coder (CPC, RHIT, or RHIA) is required at the time of hire