PI Medical Coding Reviewer III, CPC, RHIT, RHIA required
Job Description:
- Supports most complex medical record audit programs
- Provides Provider Pre Pay production and progress reports
- Recommends process or procedure changes while building strong relationships with cross departmental teams
- Demonstrates leadership ability, including mentoring Program Integrity Audit Analysts
- Identifies knowledge gaps and provides training opportunities to team members
- Coordinates the training of new and existing claims analyst staff
- Analyzes complex provider claims submissions using knowledge of CPT, ICD10, HCPCS, DRG, REV coding rules
- Maintains a working knowledge of all state and federal laws, rules, and billing guidelines
Requirements:
- Associates degree required
- Five (5) years of medical billing and coding experience
- Minimum of three (3) years of SIU/FWA medical billing and coding experience required
- Medicaid/Medicare experience required
- Prior experience with claim pre-payment, medical claim and documentation auditing required
- Three (3) years of experience in Facets preferred
- Experience with reimbursement methodology (APC, DRG, OPPS) required
- Inpatient coding experience preferred
- Leadership experience preferred
- Certified Medical Coder (CPC, RHIT or RHIA) is required at time of hire required
Benefits:
- Comprehensive total rewards package
- Health insurance
- Bonuses tied to company and individual performance