Terms of Employment:
• W2, Contract
• 3 Months with possible extension
• Predominantly remote. There will be occasional onsite visits to our client’s office in either: Canton, MD, Washington D.C., Owings Mills, MD or Columbia, MD. Candidates must reside within the Maryland, DC, Virginia or Delaware area.
Overview & Responsibilities
Join our client’s Special Investigations Unit (SIU) as a Medical Coder, leveraging your medical coding expertise to combat fraud, waste, and abuse in healthcare claims. This vital role involves the prepayment review of medical records to ensure accurate billing per industry standards and internal policies. You will be instrumental in clearing a significant backlog of claims and contributing to the integrity of the claims process. This is an excellent opportunity for a certified medical coder seeking a high-impact role with potential for long-term employment. Key responsibilities include:
• Review medical records and claims for fraudulent indicators and coding accuracy.
• Determine if claims are accurately billed per industry standards (e.g., AMA guidance, AAPC guidance) and internal payment/medical policies.
• Render determinations on claims, which may include denying or paying them based on review findings.
• Utilize coding software (e.g., Codify, Optum Encoder Pro) or CPT manuals to aid in code review and ensure all required components of office visits are met.
• Manage a high volume of claim reviews, contributing to the reduction of a significant backlog.
Required Qualifications:
• High School Diploma or GED.
• Active and validated Certified Professional Coder (CPC) certification or equivalent accreditation (e.g., CPMA, COC, or AHIMA accreditation) without Apprentice tag.
• 3 years of experience in risk adjustment coding, ambulatory coding, and/or CRC coding experience in managed care, state or federal healthcare programs, or the health insurance industry.
• Experience in physician coding, specifically reviewing office visits and services rendered in a physician's office.
• Proficiency in reviewing medical records and claims for coding accuracy.
• Detail oriented.
Preferred Qualifications:
• Experience using coding software such as Codify (AAPC) or Optum Encoder Pro.
...our contractors and our service clients, handling thousands of events a year company wide, while developing industry professionals... ...------- If you hope to become or are currently working as a Photographer or Videographer or Editor, we welcome you to join our team to...
...Advancement Opportunities Great Work Environment Job Summary We are seeking an experienced and energetic Afternoon (Part Time) Daycare Teacher to join our team! You will be responsible for encouraging childrens intellectual, psychological, and physical growth....
...Company Description Austin Legal Group is a proactive and professional legal firm that provides sound advice to businesses, helping... ...experience as a licensed attorney. Will consider newly barred with intern experience. ~ Litigation experience that includes skills...
...Administrative $16.00-$26.00 Summary CANDIDATES MUST RESIDE IN MD, DC, PA, VA OR WVA POTENTIAL FOR HYBRID REMOTE! JOB SUMMARY: The Medical Billing Collector collects unpaid physician claims. Researches and resolves denials and payment variances, completing...
Job Description Job Description Benefits: Bonus based on performance Competitive salary Flexible schedule Free food & snacks Opportunity for advancement Free uniforms Training & development MaidPro est contratando de inmediato a un limpiador...