REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
5 years' experience in healthcare insurance; medical review, program integrity, or appeals.
5 years' experience working with IT developers/programmers in a payor environment.
5 years' experience Medical Coding in payer environment.
3 years' clinical experience in a healthcare environment (Strong clinical assessment and critical thinking skills.)
5 years' strong knowledge of ICD/CPT/HCPCS translation and coding methodologies.
PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
5 years' experience in policy remediation.
5 years' Medical Claim processing systems experience.
Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and / or other medical coding software programs).
REQUIRED EDUCATION:
Bachelor's degree in Health Information, Healthcare Administration, or related field; equivalent experience may be considered with a minimum of 3+ years of direct supervisor experience.
ADDITIONAL SKILLS/DUTIES:
Superb written and oral communications skills, strong proficiency in English.
Strong knowledge of formal business process documentation.
Ability to effectively communicate with executive management, line management, project management, and team members.