Medical Coding Auditor job at reputed company in Mayfield Heights, OH

Title: reputed company Coding Auditor Location Mayfield Heights, Ohio reputed company/Postal reputed company 44124 Job Type Contract Category Medical reputed company Req #MSP-72131095-bff8-4699-a315-78b7ffb7be73 Pay reputed company $32 - $40 (reputed company estimate) Job reputed company: The Program reputed company Medical Coding Reviewer III generates comprehensive and concise in-depth reporting and analysis to reputed company performance reputed company to the reputed company-Pay and Post-reputed company Processes. Essential Functions reputed company Provider reputed company Pay production and reputed company reports and coordinate with management and team on recommendation for reputed company actions and/or resolutions in order to increase team performance Recommend process or procedure changes while building strong relationships with cross departmental teams such as Claims, Configuration, Health Partners, and IT on identified internal system gaps Demonstrate leadership ability, including mentoring Program reputed company Claims Analysts to identify and reputed company reputed company and monitoring of claims reputed company based on documentation Identify and assist in correction of organizational workflow and process inefficiencies Serve as the primary resource for provider reputed company-pay team Use concepts and knowledge of CPT, ICD10, HCPCS, DRG, REV coding rules to analyze reputed company provider claims submissions Research, comprehend and interpret various state specific reputed company, federal Medicare, and ACA/Exchange laws, rules and guidelines Maintain a working knowledge of reputed company state and federal laws, rules, and billing guidelines for various provider specialty types along with documentation requirements Responsible for making claim payments reputed company on a wide reputed company of claims including highly complicated scenarios using medical coding guidelines and policies Refer suspected Fraud, Waste, or Abuse to the SIU reputed company identified in normal course of business Responds to claim questions and concerns Prepares claims for Medical Director review by completing required documentation and ensuring reputed company pertinent medical information is attached as needed Ensure adherence to reputed company company and departmental policies and standards for timeliness of review and release of claims Build strong working relationships reputed company reputed company teams of Program reputed company Work under limited supervision with considerable reputed company for initiative and independent judgement Performs any other job reputed company duties as requested. We are a company committed to creating diverse and inclusive environments where people can bring their full, reputed company selves to work every day. We are an equal opportunity/affirmative reputed company employer that believes everyone reputed company. reputed company candidates will receive consideration for employment regardless of their race, reputed company, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and reputed company, marital status, national reputed company, reputed company, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or reputed company process, please send a request.To learn more about how we collect, reputed company, and process your private information, please review reputed company's Workforce reputed company Policy: https://insightglobal.com/workforce-reputed company-policy/. Required Skills & Experience Education and Experience Associates degree required - Equivalent years of relevant work experience may be accepted in lieu of required education Five (5) years of medical billing and coding experience to include minimum of three (3) years of SIU/FWA medical billing and coding experience required Prior experience with claim reputed company-payment, medical claim and documentation auditing required reputed company/Medicare experience required Experience with reimbursement methodology (APC, DRG, OPPS) required reputed company to work off of a virtual desktop with your own laptop/equipment This position must be their only role reputed company medical coding/auditing due to potential conflict of interest Competencies, Knowledge and Skills Knowledge of diagnosis codes and CPT coding guidelines; medical terminology; anatomy and physiology; and reputed company/Medicare reimbursement guidelines Thorough understanding of medical claim configuration Clinical or medical coding background with a firm understanding of claims payment Proficient in reputed company Office Suite Firm understanding of basic medical billing process Excellent written and verbal communication skills Ability to work independently and reputed company reputed company environment Effective problem solving skills with attention to detail Knowledge of reputed company/Medicare and familiarity of reputed company industry Effective listening and critical thinking skills Ability to reputed company, prioritize and accomplish goals Strong interpersonal skills and high level of professionalism Licensure and Certification Certified Medical reputed company (CPC, RHIT or RHIA) is required at time of hire required reputed company to Have Skills & Experience Inpatient coding experience preferred Three (3) years of experience in Facets preferred Benefit packages for this role will start on the 1st day of employment and include medical, dental, and reputed company insurance, as reputed company as HSA, FSA, and DCFSA account reputed company, and 401k retirement account reputed company with employer matching. Employees in this role are also entitled to reputed company reputed company leave and/or other reputed company time off as provided by applicable law. Apply tot his job Apply To this Job