About this role
Role Overview
- 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
- Respond to client inquiries in a timely manner in compliance with policy and procedures
- Review and analyze CV related client inquiries and Change Requests for clarity of intent
- Provide support and resources to clients for provider abrasion issues
- Appropriately and effectively communicate quality review results and revisions (if applicable) to clients
- Proactively offer benefit of CV knowledge and experience
- Collaborate and provide input from a client-based perspective on changes in edit configuration
- Support CPE Clinical Services quality assurance processes including pre and post release testing
- Maintain Client Information Workbooks with updated information as needed
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 working for a managed care or healthcare insurance company, or related experience
- 1+ years of experience in customer service or client management with a strong focus on healthcare setting
Benefits
- Health insurance
- Dental insurance
- Vision insurance
- Disability insurance
- 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