Public - Responsibilities
Partner with Clinical, Claims, and Payment Integrity peers to review claims for DRG related issues on a prospective and retrospective basis that drive inaccurate payments to providers.
Proactively identify overpayments to ensure accurate claims payments on inpatient services.
Participate in collaborative discussions with MDs to verify the clinical rationale behind billed procedures.
Communicate effectively while building trust and lasting partnerships both laterally and vertically across multi-discipline teams.
Communicate effectively both internally and externally to ensure accurate claims adjudication and proper provider notification.
Public - Required Skills
You hold a CCS or CIC certification; required.
Knowledge of DRG pricing methodology; required.
You have 1-2 years of experience in inpatient clinical coding; preferred
Medicare or Medicare Advantage payment integrity or claims operations experience; preferred
You are technologically savvy with strong computer skills in Excel and PowerPoint.
Public - Preferred Skills
You hold a CCS or CIC certification; required.
Knowledge of DRG pricing methodology; required.
You have 1-2 years of experience in inpatient clinical coding; preferred
Medicare or Medicare Advantage payment integrity or claims operations experience; preferred
You are technologically savvy with strong computer skills in Excel and PowerPoint.
Public - Schedule/Shift
EST Hours 8-5
Compensation: $38.00 - $48.00 per hour
Benefits:
401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance
Application Question(s):
Do you have an active CCS or CIC certification
Do you have any experience with inpatient auditing and coding for payer side or insurance companies
Work Location: Remote
Apply To this Job
Company : Healthcare
Salary : 3848 an hour
