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Medical & Billing Coder - Texas
Posted about 1 month agoViewed
💎 Seniority level: Experience is a must
📍 Location: United States
🔍 Industry: Healthcare and Insurance Services
🏢 Company: Dane Street, LLC
🗣️ Languages: English
⏳ Experience: Experience is a must
Requirements:
- Must have a CPC, APCC, or DRG coder certification.
- Payment integrity or professional bill review experience preferred.
- Out-of-network bill review experience is a plus.
- Experience in a remote environment preferred.
- Must have access to billing references/engine.
- Extensive knowledge of Texas billing resources is preferred.
- CPC, CCS, or CCA certification is preferred but not required.
- Deposition/Testimony experience is preferred but not required.
Responsibilities:
- Evaluates the appropriateness of codes and ensures they meet established program standards.
- Ensures medical records are correctly matched to codes and obtains them if necessary.
- Applies policy guidelines and healthcare terminology to assess criteria compliance.
- Evaluates claims for conflicts of interest and appropriateness.
- Works within defined timeframes set by program parameters.
- Provides customer service and collaborates with clients for quality assurance.
- Offers clinical oversight for complex cases needing additional review.
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