Job Summary
A healthcare company is seeking a Remote Retrospective Clinical Investigator.
Candidates will be responsible for the following:
- Initiating phone calls to members, providers, and other insurance companies
- Processing recovery on claims
- Ensuring adherence to state and federal compliance policies, reimbursement policies
Qualifications for this position include:
- High school diploma or GED (or higher)
- Certified Coder AHIMA or AAPC Certified coder (CPC, CCS, CCA, RHIT, CPMA, RHIA, CDIP) or Nurse (RN, LPN) with unrestricted license
- 2+ years of practical specialty coding (Neurology, Cardiology, Orthopaedics, etc.)
- 2+ years of practical experience interpreting reimbursement policies and provisions for Medicare, Community and State, Employer and Individual
- 2+ years of experience as AHIMA or AAPC Certified coder (CPT/HCPCS/ICD – 10/CM/PCS coding experience) or
- Licensed nurse with 2+ years of CPT/HCPCS/ICD – 10/CM/PCS coding experience (Professional)
