Related skills
cms sql excel cpt medicare📋 Description
- Research CMS, CPT/AMA policies per payer requirements.
- Identify error areas to convert into automated logics to prevent overpayments.
- Take edits from concept to specification, then review, testing and data validation.
- Develop claims editing logics for Medicaid, Medicare, and commercial lines.
- Collaborate with Content, Engineering and Data teams to develop and validate edits.
- Grow revenue cycle knowledge by turning policy into processing rules for payers and providers.
🎯 Requirements
- 8+ years in Healthcare with medical coding familiarity.
- Experience with a payer or claims editing vendor.
- Payment accuracy experience (pre/post-payment).
- Excel proficiency: pivots, VLOOKUP, data manipulation.
- Knowledge of claims workflow and CMS 1500/UB-04.
- Nice-to-have: Medicare/Medicaid data and policy experience.
🎁 Benefits
- Flexible, remote-friendly work with home office stipend.
- Equity and 401(k) matching.
- Unlimited PTO and comprehensive health plans.
- Wellness support via TalkSpace, Teladoc and One Medical.
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