Job Summary
A well-known healthcare company is in need of a Telecommute Recovery and Resolution Consultant.
Core Responsibilities Include:
- Researching and interpreting healthcare claims payment policy to identify potential overpayment
- identifying overpayments related to fraud, waste, abuse, billing / coding errors and more
- Ensuring adherence to state and federal compliance policies, reimbursement policies and contract compliance
Applicants must meet the following qualifications:
- Bachelor's degree or higher
- Current and unrestricted RN license in the state of residency
- 5+ years of experience as a RN, including experience in an inpatient / acute setting
- 1+ years of medical claims coding / processing / billing experience
- Demonstrated solid knowledge of medical billings including CPT, HCPC and ICD - 10
- Demonstrated proficiency with Microsoft Word and Excel
