Related skills
data analysis sql process improvement data mining lean six sigma📋 Description
- Contribute as SME for reimbursement policies and payment integrity edits.
- Respond to inquiries and disputes regarding policies and edits.
- Research coding rules; summarize input into policy language.
- Translate research into business requirements; collaborate with partners.
- Ingest partner data; scope, size, prioritize items; deliver solutions.
- Use data insights to identify opportunities and drive improvements.
🎯 Requirements
- A bachelor's degree or 4+ years of commensurate experience
- 3+ years of experience in claims processing, coding, auditing or health care claims operations
- 3+ years experience in medical coding within payment integrity
- Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)
- Experience with reimbursement methodologies, provider contract concepts and common claims processing/resolution practices
- 2+ years experience deriving business insights from datasets and solving problems
🎁 Benefits
- Medical, dental, and vision benefits
- 11 paid holidays, sick time, and parental leave
- 401(k) with life and disability insurance
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