About this role
Role Overview
- Support Clinical Services teams in the validation of quality and processes consistency on the CPE editing engine
- Provide support and subject matter expertise on Coding Validation (CV)
- Act as a liaison for clinical information between internal partners and external customers
- Provide resources to facilitate client understanding of Coding Validation policies and concepts
- Review and analyze CV related client inquiries and Change Requests for clarity of intent
- Collaborate with Client Teams to develop and maintain excellent client relationships
- Support CPE Clinical Services quality assurance processes including pre and post release testing
- Maintain Client Information Workbooks with updated information as needed for CV review
Requirements
- Associate or Bachelor’s degree in Nursing (active/unrestricted license)
- Registered Nursing license (RN) – active and unrestricted in state of residence
- Professional coder certification (CPC, CPC-H, CPC-P, or CCS-P), RHIT or RHIA certification required
- 2+ years of clinical experience as a Registered Nurse
- 1+ years of experience in Coding Validation
- 1+ years of experience in coding including professional and outpatient facilities
- 1+ years of experience in claims adjudication, medical/payment policy, or utilization review
- 1+ years of experience in customer service or client management with a strong focus on healthcare setting
- Ability to analyze complex data
- Strong research capabilities and knowledge of CMS guidelines and regulatory compliance guidelines
- Proficient with Microsoft Office Suite (Word, Excel, Power Point)
- Ability to work well independently and in a collaborative team environment
Benefits
- medical, dental, vision, disability, and life insurance coverage
- 401(k) savings plans
- paid family leave
- 9 paid holidays per year
- 17-27 days of Paid Time Off (PTO) per year