Licensed Medical Coding Reviewer

Job Summary

A company is looking for a Medical Coding Reviewer I.

Key Responsibilities

• Perform clinical and coding medical claim reviews to ensure compliance with coding practices
• Analyze provider billing practices and review medical records for consistency with billing
• Identify potential billing errors, fraud, and opportunities for prepayment reviews

Required Qualifications, Training, and Education

• Associate's degree in a related field or equivalent experience
• Coding certification and 2+ years of experience in medical billing & coding or related fields
• Experience in provider communication and education preferred
• Licensure or certification as LPN, RN, CPC, or equivalent
• 2+ years of related clinical experience