Certified Medical Coding Reviewer

A company is looking for a Program Integrity Medical Coding Reviewer II, requiring CPC, RHIT, or RHIA certification.

Key Responsibilities

Review vendor audit activities and make claim payment decisions based on medical coding guidelines

Identify and implement process improvements and collaborate with internal departments for claim resolution

Support provider pre-pay and post-pay teams with coding reviews and prepare claims for Medical Director review

Required Qualifications, Training, and Education

Associate's degree or equivalent relevant work experience is required

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

Medicaid / Medicare experience is preferred

Clinical background with an understanding of claims payment is preferred

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