Medical Coding Expert
2 days ago
The role of a Healthcare Content Specialist involves conducting thorough research to identify relevant medical coding and billing documents for an automated claims editing solution. This solution is utilized by medical insurance payers across the United States.
This specialist will be responsible for analyzing clinical content, including additions, deletions, or updates to diagnosis codes, procedure codes, age minimums & maximums, quantity limitations, place of service limitations, and other clinical content criteria.
Key Responsibilities- Conduct research to identify Medicare, Medicaid, and other medical coding and billing documents.
- Analyze clinical content to inform the development of denial criteria.
- Provide written and oral presentations to stakeholders to obtain consensus on proposed denial criteria.
- Offer clinical content support to customers as needed.
- Perform data entry of clinical content updates into databases.
- Bachelor's Degree in Nursing with an Active RN license.
- AHIMA Certified Coding Specialist - Physician (CCS-P) or AAPC Certified Professional Coder (CPC) certification.
- At least 5 years of experience in CPT Coding, HCPCS, Medical Billing, Claims Denials, and/or Chart Review/Auditing.
- Previous experience working with US health insurance payers in a claims, appeals, or coding capacity.
- Excellent Communication Skills (verbal and written).
- Proficient in using MS Office applications.
This is a mid-senior level position that requires a strong understanding of medical coding and billing principles. The ideal candidate will have excellent analytical and communication skills, as well as the ability to work effectively in a remote environment.
BenefitsThis role offers a competitive salary and benefits package, as well as opportunities for professional growth and development.
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