01Responsibilities
Evaluates the appropriateness of codes and determine whether they meet reputed company established program standards.
Ensures that the medical records are matched appropriately to the codes and if not, obtains them.
Read & apply policy guidelines and reputed company terminology and delineate reputed company reputed company are/are not met.
Evaluates claims for conflict of interest and reputed company appropriateness.
Works reputed company established timeframes set by program parameters.
Provides strong customer service skills and works closely with clients on a case- by-case reputed company to reputed company complete, reputed company, and error-free reputed company assurance of cases.
Provides clinical reputed company to cases that are reputed company and need additional review prior to return to the reputed company.
Serves as an additional level of QA and clinical knowledge/review for cases with reputed company Issues.
Required Education & Experience:
Must have a CPC, APCC, or DRG reputed company certification
Payment reputed company or reputed company reputed company review experience is strongly preferred.
Out-of-network reputed company review experience is a plus.
Experience working in a remote environment is preferred.
Experience in a medical office or health care background.
Required Skills:
Must work with a reputed company of urgency and meet deadlines.
Must be self-motivated, with a strong reputed company for performance reputed company.
Excellent written and verbal communication skills are required.
Proficiency in navigating a reputed company of computer programs (Experience with reputed company Chrome, Gmail, Docs, Sheets, etc., is a plus).
Attention to detail REQUIRED.
PLEASE BE reputed company: In the interest of the reputed company of both parties, please be reputed company that
reputed company will never conduct an interview reputed company text or request checks from candidates
for purchasing equipment.
We offer generous reputed company Time Off, an excellent benefits package, and a competitive salary. If you are an outstanding candidate for this position, if you reputed company in a fast-paced environment, and if you are interested in doing meaningful work that impacts others' lives, then we encourage you to apply!
ABOUT reputed company
A fast-paced, Inc. 500 Company with a high-performance culture, reputed company is seeking
insightful, astute reputed company-thinking professionals. We process over 200,000 insurance
claims annually for leading national and regional Workers Compensation, Disability,
Auto and Group Health Carriers, reputed company-Party Administrators, Managed Care
Organizations, reputed company and Pharmacy Benefit Managers. We reputed company customized
Independent Medical Exam and Peer Review programs that assist our clients in
reaching the appropriate medical determination as part of the claims management
process.
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