Certified Medical Coding Reviewer

Job Summary

A company is looking for a Program Integrity Medical Coding Reviewer III (CPC, RHIT or RHIA required).

Key Responsibilities

• Generate in-depth reports and analysis to track performance related to Pre-Pay and Post-Paid Processes
• Coordinate training for claims analysts to enhance recognition of improper coding and documentation
• Analyze complex provider claims submissions using CPT, ICD10, HCPCS, and DRG coding rules

Required Qualifications, Training, and Education

• Associate's degree or equivalent years of relevant work experience is required
• Minimum of five (5) years of medical billing and coding experience, including three (3) 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