Senior Coding Quality Analyst – Special Investigations Unitremoterocketship • New York, New York, United States
Senior Coding Quality Analyst – Special Investigations Unit
remoterocketship
- New York, New York, United States
- New York, New York, United States
Über
Perform medical claim reviews for the Special Investigations Unit (SIU) Conduct comprehensive quality reviews of completed medical coding reviews Perform in depth medical record reviews across medical, behavioral health, transportation Analyze data, documentation, and evidence to identify potential billing errors, abuse, or fraudulent activity Handle complex coding reviews, including those related to legal, compliance, escalations, audits, and rework initiatives Prepare detailed written summaries of findings and clearly articulate conclusions to leadership Independently research and apply state, CMS, and payer specific guidelines relevant to audits and reviews Identify opportunities for process improvements, cost savings, and cases that may warrant prepayment review Maintain accurate documentation, records, files, and tracking logs Provide mentorship and training to coders Encourage innovative approaches to operational challenges. Requirements:
AAPC CPC certification 1+ year of reviewing coding consultant decisions for quality purposes 1+ year of developing and implementing quality remediation plans 1+ year of experience in medical coding in a Fraud, Waste, Abuse and/or error department Strong knowledge of standard industry coding guides and guidelines including CPT, HCPCS, ICD-10 Experience with researching coding and policies Experience with Microsoft products; Excel and Word Strong attention to detail and ability to review and interpret data. Demonstrates strong communication skills. Benefits:
medical, dental, and vision coverage paid time off retirement savings options wellness programs comprehensive benefits package
Sprachkenntnisse
- English
Hinweis für Nutzer
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