Senior Payment Integrity Coding Professional - Remote

Overview

The Senior Payment Integrity Coding Professional within Code Edit Vendor Management (CEVM) contributes to overall cost reduction by utilizing code editing guidelines and data anomalies to ensure correct claim payment.

In Short

• Utilizes code editing guidelines and data anomalies to ensure correct claim payment.
• Conducts in-depth research and cross departmental collaboration.
• Analyzes Code Edit performance metrics to identify inefficiencies.
• Partners with internal business partners to support initiatives.
• Builds and maintains strong internal working relationships.
• Engages in implementations and ad hoc projects.
• Requires AAPC or AHIMA Coding Certification.
• 5+ years experience utilizing coding guidelines.
• Excellent data analysis skills with SQL, Power BI, and Excel.
• Standard business hours are Monday - Friday, 8 hours/day.

Requirements

• AAPC or AHIMA Coding Certification.
• 5 or more years work experience utilizing coding guidelines.
• Exceptional understanding of CMS guidelines and Medicaid guidelines.
• Excellent data analysis and experience with SQL, Power BI, and Excel.
• Excellent verbal and written presentation skills.
• Preferred Bachelor's degree.
• Experience leading people, projects, and/or processes.
• Experience using CAS, MTV, and Code Edit vendor tools.
• Experience in a fast paced, metric driven operational setting.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off including personal holidays and volunteer time off.
• Paid parental and caregiver leave.
• Short-term and long-term disability.
• Life insurance.
• Incentive opportunity based on performance.