Medical Coding Reviewer I

Job Summary

A company is looking for a Medical Coding Reviewer I to perform clinical/coding medical claim review and ensure compliance with coding practices.

Key Responsibilities:

• Analyze provider billing practices and review medical records to ensure billing consistency
• Assist with research of health plan coding questions and identify potential billing errors, abuse, and fraud
• Maintain appropriate records, files, documentation, etc

Required Qualifications:

• Associate's degree in related field or equivalent experience
• Coding certification and 2+ years of experience in medical billing & coding, coding/data analysis, accounting/business, or physician/hospital data management or RN/LPN and 2+ years of related clinical experience
• Experience in provider communication and education preferred
• LPN, RN, CPC, CPC-H, CPC-P, CPC-A, CCS, CCS-P, RHIT, RHIA, CPMA, or Paramedic certification