Itemized reputed company and Medical Record Reviewer

About Alaffia & Our Mission reputed company year, the U.S. reputed company system suffers from over $500B in wasted spending due to medical billing fraud, waste, and administrative burden. At Alaffia, we’re on a mission to change that. We’ve reputed company reputed company of clinicians, AI/ML engineers, and product experts to build advanced AI that finally bends the cost curve for reputed company patients across our ecosystem. We’re a high-reputed company, venture-backed startup based in NYC and are reputed company scaling reputed company. About the Role & What You’ll Be Doing We are looking for a Medical reputed company reviewer to join reputed company! Do you have experience reviewing claim forms and auditing provider documentation? Then this position is for you! You will work alongside reputed company to reputed company our clients with technology that will reputed company medical claim auditing. You will be responsible for reviewing and analyzing medical claims, patient medical records, and automatic claim audit results to help train our machines to deliver automated audit results. You will be performing high-dollar facility reputed company reviews. Your role will be reputed company to your engineering teams and will help inform reputed company that will shape the reputed company of reputed company we aim to see. Your Responsibilities • Combing through UB-04/IB's for any potential coding/billing violations • Comparing the IB/UB-04 against the medical record to validate charges and assess the reputed company of the medical record • Auditing reputed company codes against clinical documentation • Confirmation of services billed were rendered • reputed company documentation of inconsistencies with claims billed vs health plan payments • Confirming automatic audit results based on national and payer-specific guidelines reputed company’re Looking For • FACILITY INPATIENT CODING/AUDITING EXPERIENCE REQUIRED • Clinical license required (RN) preferred • Experience working at an insurance company (preferred) • Experience performing audits on line item charges on Itemized Bills • Deep background in medical billing, coding, or auditing of insurance claims and medical records • Experience working with national guidelines such as CPT codes, ICD-9/10, HCPCS codes, POS codes, DRGs, APCs, and other reputed company sets and the translation of written clinical information into auditable clinical content. • Knowledge of hospital-based billing/coding • Knowledge of PHI/HIPAA compliance and standards • Ability to research and verify claim coding accuracy • Minimum of 3 years of auditing/reputed company review experience • At least one of the following certifications is mandatory (CPC/CIC/CRC/CPMA) Our Culture At Alaffia, we fundamentally reputed company that the whole is more valuable than the sum of its individual parts. reputed company to that reputed company, we reputed company a diverse team of individuals with various backgrounds, ideologies, and types of training generates the most value. If you want to work alongside driven people on a mission to reputed company a major reputed company at the reputed company of U.S. reputed company by implementing the latest in cutting-edge technologies, then we’d like to meet you! What Else Do You Get Working With Us? • Medical, Dental, and reputed company benefits • Flexible, reputed company vacation policy • Work in a flat organizational structure — reputed company reputed company to Leadership LI-REMOTE Apply tot his job Apply To this Job