Payment Integrity Professional - Remote

Overview

Become a part of our caring community and help us put health first. The Payment Integrity Professional 2 contributes to overall cost reduction by utilizing code editing guidelines and data anomalies to ensure correct claim payment.

In Short

• 100% remote/work at home.
• Contributes to overall cost reduction.
• Utilizes coding knowledge to identify/validate new code edit opportunities.
• Requires expert level coding knowledge specific to Medicare and Medicaid guidelines.
• Fosters relationships between stakeholders and external vendors.
• Drives process improvements.
• Requires minimal direction and guidance.
• Typical business hours are Monday-Friday, 8 hours/day.
• Must maintain confidentiality.
• Occasional travel for training or meetings may be required.

Requirements

• Certified Professional Coder with AHIMA or AAPC certification.
• Minimum of 2 years of coding experience.
• Knowledge of CPT, HCPCS, and ICD code sets.
• Exceptional understanding of CMS and state Medicaid guidelines.
• Proficient in Microsoft Office programs.
• Strong analytical thinking and attention to detail.
• Ability to work independently and manage diverse priorities.
• Excellent written and verbal communication skills.
• Comfortable presenting to large audiences.
• Experience with code editing vendor tools preferred.

Benefits

• Competitive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off, including holidays and volunteer time.
• Short-term and long-term disability coverage.
• Life insurance and other opportunities.