Certified Medical Coding Reviewer

Job Summary

A company is looking for a Program Integrity Medical Coding Reviewer III.

Key Responsibilities

• Generate reports and analysis to track performance related to Pre-Pay and Post-Paid Processes
• Mentor and train claims analysts on coding and documentation standards
• Analyze complex provider claims submissions using medical coding guidelines

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
• Certified Medical Coder (CPC, RHIT or RHIA) is required at time of hire