Remote Senior Medical Claims Investigator

Job Summary

A health information company has a current position open for a Remote Senior Medical Claims Investigator.

Candidates will be responsible for the following:

• Achieving measured production, quality, and growth results while ensuring compliance with HIPAA regulations and requirements
• Evaluating medical claims for coding and pricing errors using accurate HCPCS, ICD-10, and CPT codes
• Aiding in the training of others in the Payment Accuracy department for data mining and auditing best practices

Required Skills:

• Minimum high school diploma or GED along with four (4) years' direct experience in medical claims investigation, auditing or data mining
• Bachelors' degree in a relevant field and/or attainment of relevant medical billing and coding certification is highly preferred plus required licensures
• Extensive experience in applying principles of coding guidelines; federal/state regulations and policies pertaining to coding and billing