Payment Integrity Associate - Itemized Bill Review

Added
3 days ago
Type
Full time
Salary
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Related skills

data analysis sql cpt hcpcs icd-10

📋 Description

  • Perform line-by-line review of high-dollar itemized bills (UB-04) and claims.
  • Identify and document potential billing errors, including improper unbundling.
  • Compare billed charges against contracts and guidelines for accuracy.
  • Apply CPT, HCPCS, ICD-10, MS-DRGs to validate service codes.
  • Review claims under reimbursement scenarios and thresholds.
  • Document findings and recommended claim adjustments.

🎯 Requirements

  • Bachelor’s degree or 4+ years of commensurate experience.
  • 2+ years of hospital/facility billing (UB-04) bill/coding audit experience.
  • 4+ years experience in medical coding.
  • AAPC CPC/COC or AHIMA CCS/RHIT/RHIA certification.
  • Experience with reimbursement methodologies and provider contracts.

🎁 Benefits

  • Base pay $82,717-$108,566/year; eligible for bonuses.
  • Full-time role with medical, dental, and vision benefits.
  • Unlimited vacation program and annual performance bonuses.
  • 11 paid holidays, sick time, parental leave, 401(k) plan.
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