About this role

Support most complex medical record audit programs
Generate concise in-depth reporting and analysis to track performance
Provide Provider Pre Pay production and progress reports
Recommend process or procedure changes
Demonstrate leadership ability
Identify knowledge gaps and provide training opportunities
Serve as a primary resource for provider escalation support
Maintain a working knowledge of all state and federal laws, rules, and billing guidelines

Associates degree required
Five (5) years of medical billing and coding experience
Minimum of three (3) years of SIU/FWA medical billing and coding experience required
Prior experience with claim pre-payment, medical claim and documentation auditing required
Medicaid/Medicare experience required
Three (3) years of experience in Facets preferred
Experience with reimbursement methodology (APC, DRG, OPPS) required
Inpatient coding experience preferred
Leadership experience preferred

Medical Coding Reviewer III, CPC, RHIT/RHIA Required

Key skills