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data analysis sql excel reimbursement medical coding📋 Description
- Lead Payment Integrity policy activities across edits and reimbursement policies.
- Analyze data to pinpoint payment issues and define remediation steps.
- Ensure payments align with industry standards, internal policies, and regulations.
- Respond to inquiries and disputes regarding policies and edits.
- Document coding rules and draft reimbursement policy language.
- Translate coding knowledge into business requirements for changes.
🎯 Requirements
- A bachelor’s degree or 4+ years of commensurate experience.
- 4+ years in claims processing, coding, auditing or health care operations.
- 4+ years experience in medical coding.
- Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA).
- Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices.
- 3+ year(s) ability to work independently to drive projects to completion.
🎁 Benefits
- Medical, dental, and vision benefits.
- Unlimited vacation program.
- Annual performance bonuses.
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