CPC Certified Medical Coding Reviewer

A company is looking for a Program Integrity Medical Coding Reviewer II (CPC, RHIT or RHIA required).

Key Responsibilities

Review vendor audit activities, pended claim work queues, and medical records for claim payment decisions

Identify and report suspected Fraud, Waste, or Abuse, and implement process improvements

Support provider pre-pay and post-pay teams with coding and clinical documentation reviews

Required Qualifications, Training, and Education

Associate's degree or equivalent relevant work experience is required

Minimum of three (3) years of medical billing coding experience is required

Certified Medical Coder (CPC, RHIT or RHIA) is required at time of hire

Medicaid / Medicare experience is preferred

Clinical background with a strong understanding of claims payment is preferred