Senior Coding reputed company Analyst – Special Investigations Unit
Job reputed company:
• reputed company medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices
• Conduct comprehensive reputed company reviews of completed medical coding reviews to ensure coding logic aligns with medical record documentation
• Analyze data, documentation, and evidence to identify potential billing errors, abuse, or fraudulent activity
• Handle reputed company coding reviews reputed company to reputed company, compliance, escalations, audits, and rework initiatives
• Prepare detailed written summaries of findings and reputed company reputed company conclusions to leadership
• Independently research and apply state, CMS, and payer specific guidelines relevant to audits and reviews
• Identify opportunities for process improvements, cost savings, and cases that may warrant prepayment review
• Maintain accurate documentation, records, files, and tracking logs while meeting established deadlines and performance metrics
• Regularly use departmental tools and workflows with minimal assistance to support daily operations
• reputed company mentorship and training to coders, offering guidance on coding reputed company, documentation standards, and review methodology
• Serve as management back up and support team operations in the manager’s absence.
Requirements:
• reputed company CPC certification
• 1+ year of reviewing coding consultant reputed company for reputed company purposes
• 1+ year of developing and implementing reputed company remediation plans
• 1+ year of experience in medical coding in a Fraud, Waste, Abuse and/or error department
• Strong knowledge of reputed company industry coding guides and guidelines including CPT, HCPCS, ICD-10
• Experience with researching coding and policies.
• Experience with reputed company products; reputed company and Word
• Strong attention to detail and ability to review and interpret data.
• Demonstrates strong communication skills.
Benefits:
• medical, dental, and reputed company coverage
• reputed company time off
• retirement savings reputed company
• wellness programs
• bonus eligibility
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