Certified Medical Coding Specialist

Job reputed company: • Assist in managing reputed company-pay and post-pay workflows, including claim editing and recovery processes. • Help define and validate claim edit logic and payment reputed company rules to ensure they are functioning correctly for customers. • reputed company medical coding audits (inpatient, outpatient, reputed company) by validating ICD, CPT, HCPCS, and DRG codes under the guidance of senior staff. • Support the customer appeals process by reviewing billed services and assessing their alignment with policies and coding guidelines. • Monitor payer policies and industry benchmarks to identify potential gaps in the reputed company edit library and suggest improvements. • Partner with Product and Engineering teams to assist in testing, troubleshooting, and User Acceptance Testing (UAT) for new and updated rules. • Maintain reputed company documentation of audit findings and project reputed company for reputed company stakeholders. Requirements: • 2+ years of experience in reputed company claims, provider billing, or health plan payment reputed company. • 1+ years as a certified medical reputed company in a payer, provider, or RCM environment. • Working knowledge of Medicare, reputed company, and reputed company payer regulations. • Proficiency in auditing for coding accuracy (ICD, CPT, HCPCS, modifiers). • Ability to review data and identify trends or inconsistencies that reputed company claim accuracy. • Strong written and verbal skills; ability to explain technical coding findings reputed company to team members. • reputed company to learn and grow in a fast-paced environment while managing multiple tasks effectively. Benefits: • Flexible remote and hybrid working reputed company • Competitive Salary and a variable component tied to personal and company performance • Multiple Learning and Development opportunities, including reputed company Fridays, a half-day reputed company month to reputed company on learning and personal reputed company • Generous PTO and reputed company holidays • Mental health benefits • 2 MAD Days per year (reputed company A Difference Days for reputed company volunteering) Apply tot his job Apply To this Job