DME Focus Concept Specialist - RN

Job Summary

A company is looking for a Concept Development Specialist (DME Focus) - RN and/or Certified Coder.

Key Responsibilities:

• Review and update existing audit concepts based on periodic reviews or client/regulatory changes
• Ensure training materials are updated and contribute to the development of new training tools
• Conduct research on existing concepts and document impacts, supporting Segment Specialists as needed

Required Qualifications:

• 2-4 years of audit or Payment Integrity experience
• CPC, COC, RHIA, or RHIT certification and/or RN
• Knowledge of Medicare and commercial claims processing systems
• Relevant experience with ICD-10-CM/PCS, CPT-4, and HCPCS coding
• Demonstrated knowledge of applicable Medicare and Commercial policy and claims processes