State Licensed Payment Integrity Associate

Job Summary

A company is looking for a Payment Integrity Associate - Itemized Bill Review.

Key Responsibilities

• Perform line-by-line review of high-dollar facility itemized bills and corresponding claim forms
• Identify and document potential billing errors, including duplicate billing and improper unbundling of services
• Review claims eligible under specific reimbursement scenarios and prepare documentation of findings

Required Qualifications

• A bachelor's degree or 4+ years of commensurate experience
• 2+ years of bill/coding audit experience focused on hospital or facility billing (UB-04)
• 4+ years of experience in medical coding
• Medical coding certification through AAPC or AHIMA
• Experience with reimbursement methodologies and common claims processing practices