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Concept Development Specialist – DME Focus, RN/Coder

Medical Billing and CodingMedical Billing and CodingFull TimeRemoteTeam 10,001+Since 1865H1B SponsorCompany Site LinkedIn

Location

United States

Posted

38 days ago

Salary

$85K - $115K / year

Professional Certificate2 yrs expEnglish

Job Description

• Provide support to assigned Segment Specialists by maintaining current audit concepts • Responsible for the review and update of existing concepts based upon required periodic review cycle • Collaborates with and leverages Segment Specialist expertise to ensure on-point results • Ensure training material updates as necessary for changes to existing concepts • Conduct research, identify impact on existing concepts, and document accordingly • Support activities required to "package" concepts, including, but not limited to, pulling together necessary documents • Ensure audit concepts are well formulated for Offerings • Manage, progress, and track multiple tasks within multiple workflows for audit concept maintenance • May contribute to responses to provider/client representative from written inquiries as it pertains to audited Medicare claims

Job Requirements

At least 2-4 years of audit or Payment Integrity experience
CPC, COC, RHIA, or RHIT certification and/or RN
Demonstrated knowledge of applicable Medicare and Commercial policy and claims process
Relevant knowledge and experience with ICD-10-CM/PCS, CPT-4, and HCPCS coding
Knowledge of the national coding standards, particularly payment rules
Knowledge of Medicare and commercial claims processing systems
Strong verbal communication and interpersonal skills
Excellent written communication skills; including proofing and editing
Good critical thinking, analytical, questioning, and listening skills
Strong proficiency in Microsoft Word, Excel, SharePoint (advanced skills highly desirable)