Certified Professional Coder - Claims Theory : Job Details

Certified Professional Coder / Bill Review Expert

Responsibilities:

• Review medical bills related to MVA injuries sustained for NJ and or NY covered insureds
• Conduct reviews of medical bills and supporting documentation to ensure proper codes assigned
• Assign proper codes as needed based on review outcome
• Use various resources, IE: eBooks, 3M software to support reviews
• Interpret fee schedule guidelines and apply those guidelines in daily reviews
• Document review outcomes for customer in a professional easy to understand manner
• Participate in conference calls as needed with customer and/or attorneys
• Assist with various special projects and other duties as assigned

Qualifications and Experience:

• 3-5 years of medical billing experience specifically NJ / NY PIP fee schedules
• Strong communicate skills, must be able to explain outcome of review, both written and verbally
• Extensive knowledge of coding /documentation requirements
• Thorough knowledge of CPT, HCPCs, ICD-10
• CPC/AAPC certification required
• Ability to multi-task
• Ability to meet critical timelines
• Willingness to testify on a as needed bases on behalf of customer to coding outcomes
• Willingness to travel for testimony as required
• Computer experience
• Excel experience beyond beginner
• Independent worker
• Ability to manage time when working remotely
• Must be able to travel to Hamilton NJ office as needed
• Ability to effectively communicate with team