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sql process improvement data mining lean six sigma payment integrity📋 Description
- Provide SME in Payment Integrity edits and reimbursement policies.
- Identify payment issues from data mining; scope and remediate.
- Respond to inquiries and disputes regarding policies and edits.
- Document coding rules; advise on reimbursement policy language.
- Translate industry knowledge into business requirements; drive changes.
- Provide training and keep stakeholders informed.
🎯 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.
- AAPC CPC/COC or AHIMA CCS/RHIT/RHIA certification.
- Experience with reimbursement methodologies and provider contracts.
- 3+ years ability to work independently to drive projects.
🎁 Benefits
- Base pay: $79,920 - $104,895/year.
- Benefits: medical, dental, and vision; 11 paid holidays.
- Unlimited vacation program and annual performance bonuses.
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