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Smarter, better, faster healthcare
Certified Medical Coding Auditor
Location
United States
Posted
46 days ago
Salary
0
Seniority
Senior
Job Description
Certified Medical Coding Auditor
Vālenz® Health
• Review medical bills to identify appropriate billing, coding, and savings opportunities. • Analyze and resolve claim discrepancies that require a deeper level of expertise beyond initial review. • Collaborate with the Negotiation team to resolve more complex claim issues and secure additional savings. • Communicate findings to clients through detailed Bill Review Reports and assist in discussing complex bill-related inquiries. • Evaluate and respond to bill reconsideration requests, including those requiring additional research or analysis. • Handle escalated provider inquiries, resolve disputes, and conduct direct negotiations for billing discrepancies. • Provide guidance and mentor junior analysts in claim review best practices. • Assist in identifying trends in billing issues, proposing system/process improvements, and contributing to policy development. • Support training efforts by educating internal teams and clients on changes to codes, edits, and bill review procedures. • Work cross-functionally with internal teams to identify and implement process efficiencies that improve savings and client satisfaction. • Ensure compliance with HIPAA and other regulatory standards. • Perform other duties as assigned.
Job Requirements
- 3+ years of auditing, claims, review and/or billing experience within a healthcare organization
- CPC and/or CIC certification
- Working knowledge of industry coding, ICD-10, CPT, HCPCS Revenue codes etc.
- Excellent communication skills, both verbal and written.
- Knowledge of CMS guidelines
- A plus if you have:
- Experience in DRG validation.
- Knowledge of Health Insurance, Medicare guidelines and various healthcare programs.
- RevCycle Pro, Encoder Pro, and/or SuperCoder software experience.
Benefits
- Competitive benefits package with generous employer subsidies
- Flexible and remote working options
- 401k with generous employer match and immediate vesting
- Personal and professional development opportunities
- Supportive family benefits, including paid leave for new family members
- Companywide philanthropic program, Valenz Communities Connection
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