Employer Industry: Healthcare Services

Why consider this job opportunity:
- Salary up to $116,600 annually
- Comprehensive benefits package, including equity stock purchase and 401k contribution
- Opportunity for career advancement and growth within the organization
- Work remotely from anywhere within the U.S.
- Supportive and inclusive work environment that prioritizes health equity
- Recognition and rewards for performance in a challenging role

What to Expect (Job Responsibilities):
- Conduct clinical review of medical records and associated claims
- Manage workload to meet or exceed production and quality goals
- Investigate, research, and analyze claims data for fraudulent or abusive billing activity
- Document clinical review findings, maintaining thorough and objective reviews
- Interface with other teams and clients through correspondence to resolve issues

What is Required (Qualifications):
- RN license or related healthcare field
- Certified Professional Coder (CPC) or Certified Outpatient Coder (COC) or ability to get certified within 6 months of employment
- 5+ years of healthcare industry, medical record/claim review/audit experience
- Proven knowledge of medical terminology

How to Stand Out (Preferred Qualifications):
- 2+ years of CPT & HCPCS coding experience
- SIU experience
- Proven knowledge of claims process
- Proven knowledge of genetic testing or laboratory billing
- Demonstrated computer skills, including navigation through various web-based systems

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