Claims Auditor

We are seeking a Claims Auditor to join our dynamic Payment Integrity team. The role involves conducting comprehensive professional and facility coding reviews to ensure the accuracy of code assignment and reimbursement.

Requirements

• Conduct comprehensive coding reviews to ensure accuracy in code assignment and reimbursement
• Apply expert knowledge of coding guidelines and utilize industry-leading tools to maximize overpayment identifications
• Craft clear, concise, and well-supported audit findings, backed by AHA Coding Clinic Guidelines and ICD-10-CM/PCS regulations
• Meet or exceed company quality and productivity standards, including strong uphold rates for appeals
• Stay ahead of industry trends, coding updates, and compliance regulations to maintain expert-level knowledge
• Adhere to HIPAA and company policies and procedures to ensure data security and regulatory compliance
• Maintain and apply superior knowledge of changes and updates to coding guidelines, reimbursement trends, and health payment policy language

Benefits

• Competitive salary
• Opportunity to work with a dynamic team
• Chance to make a meaningful impact in the healthcare industry