Large managed care company looking for Coding Quality Analysts to review and make decisions on medical records received from providers. This is a full-time, contract position ending on March 20, 2022. Must be available to work Mon - Fri from 8:00am - 4:00pm (with some flexibility).

JOB DESCRIPTION

• Conducts reviews on records that have been identified as suspicious and/or potentially fraudulent, utilizing most current reference materials to include, but not limited to, Current Procedural Terminology (CPT), Internal Classification of Disease (ICD-9/ICD-10) and Healthcare Common Procedure Coding System (HCPCs) guidelines.
• Work within internal systems to pull up and review medical records received to validate if the documentation supports the code billed.
• Leverage internal resources including but not limited to, policies, guidelines, manuals, and state rules in order to support their coding decision.
• Meet/exceed set production goal of service lines each day.
• Work with a Pre-Pay team which is currently 3 Coders and a Team Lead. All teammates are experienced Coders with a variety of Coding certifications.
  

QUALIFICATIONS

• MUST have a current and valid CPC (Certified Professional Coder) certification
• Associates degree is preferred
• 3+ years' experience in coding and medical billing
  2+ years' of clinical and/or coding expertise in a physician office, SNF, ALF, hospital setting, or billing office
• Strong knowledge of CMS 1500 and UB04 data elements
• Strong knowledge of ICD, CPT, HCPC and Revenue Codes
• Good oral and written communication skills
  
• Must have good organizational/time management skills and be able to work independently or as a team
• Ability to support heavy workload volume and meet unit standards while engaging multiple priorities
• Strong healthcare background
• Behavioral Health Experience