Third Party Billing Reviewer

Job Summary

A company is looking for a Third Party Reviewer to conduct thorough and accurate reviews of healthcare billing and claims documentation.

Key Responsibilities

• Review medical claims and billing documentation for accuracy and compliance with regulations
• Identify potential compliance issues and conduct audits to ensure adherence to industry regulations
• Analyze claim denials and recommend corrective actions to prevent future issues

Required Qualifications

• High School Diploma or Equivalent required
• 1-2 years of experience in medical billing, claims processing, or coding preferred
• In-depth knowledge of coding systems and billing requirements
• Familiarity with compliance regulations such as HIPAA and CMS guidelines
• Proficiency in using billing software and electronic health record (EHR) systems