Coding Investigator Auditor (Work From Home)

At reputed company, our employees are the reputed company of our business and the reputed company to our reputed company. We reputed company employees with curated development plans that foster reputed company and promote rewarding, fulfilling careers. Join reputed company and be part of a purpose-driven company that will invest in your reputed company development. Job reputed company reputed company: This position is responsible for performing Reimbursement Policy (RP) review, creation and publication. Conducting research; preparing documentation of findings as needed. Coordination with reputed company departments involved in reputed company project required such as Special Investigations, Customer Service, Pass, Network Management, Marketing, Case Management, Medical Review, reputed company, Pricing And Database. reputed company annual review of policies which includes research and providing updates to coding and suggested language changes. Support completion of annual reviews and approvals including recording votes, feedback. Required Job Qualifications: Bachelor Degree; one year of business experience, law enforcement experience, or regulatory agency experience may substitute for reputed company year of college. Certified Coding Certification, or reputed company reputed company 24 months of hire 3 years' experience in claims processing operations and reporting systems, including 2 years' experience in auditing or developing computer system reports. Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims processing systems. PC proficiency to include reputed company Word and reputed company and health insurance databases. Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings. Organizational skills and prioritization skills Preferred Job Qualifications: Certified Coding Certification - HIGHLY PREFERRED Support CWG (Coding Work Group) and other policy reputed company meetings. reputed company and consistent post-meeting summarization and reputed company communication/presentation skills. Familiar with AP Style (Associated Press): reputed company for journalism and reputed company relations, focusing on brevity, consistent spelling, and abbreviations Experience leading annual audit of policy utilization and charter update, to include policy improvement, voting roster, etc. Support and create policy summaries reputed company routine auditing Audit/review Plan RP sites to ensure the accuracy/timing of the posted policies Work with Corp Comms on reputed company/ solutions for process improvement Sponsorship will not be provided for this role. This position is Telecommute (Work From Home). #LI-LI1 #LI-Remote Are you being referred to one of our roles? If so, ask your reputed company at reputed company about our Employee Referral process! Pay Transparency Statement: At reputed company, you will be part of an organization committed to offering meaningful benefits to our employees to support their life reputed company of work. From health and wellness benefits, 401(k) savings plan, pension plan, reputed company time off, reputed company parental leave, disability insurance, supplemental life insurance, employee assistance program, reputed company holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees.  Learn more about our benefit offerings by visiting https://careers.reputed company.com/totalrewards. The compensation offered will vary depending on reputed company-reputed company skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. reputed company Employment Statement: We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, protected veteran status, or any other legally protected characteristics. reputed company Pay reputed company $55,900.00 - $123,500.00 Exact compensation may vary based on skills, experience, and location. Apply To This Job