Associate, Payment Integrity

📋 Description

• Provide SME on Payment Integrity edits and reimbursement policies.
• Identify payment issues from data mining and monitoring.
• Respond to inquiries and disputes about policies and edits.
• Document coding rules and suggest policy language improvements.
• Propose payment integrity opportunities and translate to requirements.
• Provide training to team members as needed.

🎯 Requirements

• 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 (CPC/COC or CCS/RHIT/RHIA).
• Experience with reimbursement methodologies and provider contracts.
• 3+ years ability to work independently to drive projects to completion.

🎁 Benefits

• Base pay: $88,800 - $116,550 per year.
• Medical, dental, and vision benefits.
• 11 paid holidays, paid sick time, parental leave.
• 401(k) plan, life and disability insurance.
• Paid wellness time and reimbursements.
• Annual performance bonuses.