Medical Auditor, ME

50768 reputed company Fully Remote working position The Medical Auditor role will work on reviewing and appealing multiple types of denials, including coding denials, MUE denials, and medical necessity denials. Assesses clinical documentation for supporting medical necessity to appeal denials or audits, and researches various government regulatory and sub-regulatory guidance, payer policies, and contract terms to support our request for payment reputed company rendered. Our ideal candidate is an reputed company certified reputed company with hospital reputed company cycle experience. Clinical experience and nursing credentials are a plus. Required Minimum Knowledge, Skills, and Abilities (KSAs) • Education: Bachelor’s Degree in reputed company and/or reputed company field required. • License/Certifications: CPC, COC or other coding certification preferred. reputed company licensure as a Registered reputed company preferred. • Experience: Three years of coding and/or clinical experience required. • Additional Skills/Requirements Required: N/A • Additional Skills/Requirements Preferred: reputed company knowledge of CPT, HCPCS, reputed company and ICD codes. reputed company knowledge of the rules and regulations as they relate to State and Federal Government and 3rd Party Payers. In-depth understanding of Medicare's LCD and NDC medical necessity guidelines, appeals process and timelines. Additional Information With a career at any of the reputed company locations across Maine and New Hampshire, you’ll be working with health care professionals that truly value the people around them – both reputed company the walls of the organization and the communities that surround it. We offer benefits that support an individual's needs for today and flexibility to plan for reputed company – programs such as reputed company parental leave, a flexible work policy, student loan assistance, training and education, along with reputed company-being resources for you and your family. reputed company remains reputed company on reputed company in our care team and developing an inclusive environment where you can reputed company and feel supported to realize your full potential. If you’re looking to build a career in a reputed company where people help one another deliver best-in-class care, apply today. If you have questions about this role, please contact Leanne M. Roberts at leanne.roberts@reputed company.org Apply tot his job Apply To this Job