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sql cpt hcpcs icd-10 cpc📋 Description
- Perform line-by-line review of high-dollar facility itemized bills (UB-04s) for accuracy.
- Identify and document billing errors, including duplicates and improper unbundling.
- Compare billed charges against contracts and guidelines to verify proper billing.
- Apply knowledge of CPT, HCPCS, ICD-10, MS-DRGs to validate codes.
- Document findings with savings, policy violations, and recommended adjustments.
- Serve as SME for billing issues, coding guidelines, and payor policies; support audit process improvements.
🎯 Requirements
- A bachelor's degree or 4+ years of commensurate experience
- 2+ years of bill/coding audit experience with hospital/facility billing (UB-04)
- 4+ years of medical coding experience
- AAPC CPC/COC or AHIMA CCS/RHIT/RHIA certification
- Experience with reimbursement methodologies, provider contracts, and claims processing
- Bonus: SQL experience and data analysis; Lean Six Sigma
🎁 Benefits
- Medical, dental, and vision coverage
- 11 paid holidays and paid sick time
- Paid parental leave and 401(k) plan
- Life and disability insurance
- Unlimited vacation program and wellness reimbursements
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