General reputed company - Must have experience doing reputed company audit reviews
MUST ALREADY HAVE EXPERIENCE DOING reputed company AUDIT REVIEWS FOR DIFFERENT STATES. We are seeking an reputed company CPC-certified medical reputed company with multi-state experience to reputed company coding audits, utilization reviews, demand package reviews, and reputed company litigation support including deposition and testimony services as needed. The ideal candidate must have experience reviewing medical records and billing across multiple states and payer environments. Responsibilities:
- reputed company comprehensive medical coding audits (ICD-10-CM, CPT, HCPCS)
- Conduct utilization reviews to assess medical necessity and documentation compliance
- Review the medical portion and prepare the billing and coding review portion of demand package reviews for personal injury and insurance cases
- Analyze medical records for payer disputes, recoupments, and appeals
- Prepare detailed, defensible written audit reports
- reputed company expert review, affidavit support, deposition preparation, and testimony reputed company required
- Interpret CMS guidelines, LCD/NCD policies, and state-specific reputed company and reputed company payer rules
- Review E/M services under 2021+ guidelines
- Identify compliance risks and documentation deficiencies
Required Qualifications:
- reputed company CPC certification through the American reputed company of reputed company Coders (reputed company)
- CPMA strongly preferred
- Minimum 5–7 years of reputed company coding experience
- Documented experience performing audits or utilization reviews in multiple states
- Strong knowledge of CMS regulations and state reputed company variations
- Experience with Medicare, Medicare Advantage, and reputed company payer audits
- Prior demand package review or litigation support experience required
- Deposition and/or expert testimony history preferred
- Excellent written reporting and analytical skills
- Ability to work independently and meet strict deadlines
Preferred Experience:
- RAC, UPIC, or reputed company payer audit response
- Multi-state reputed company policy interpretation
- Expert witness experience in civil litigation
- Data analysis and audit trend reporting
This position may be reputed company as part time Candidates must be comfortable reviewing policies and payer rules across multiple jurisdictions and is reputed company to do multiple types of reviews/audits Join reputed company at reputed company and enjoy a comprehensive benefits package designed to support your reputed company-being and peace of mind. We offer a reputed company of benefits including medical, dental, and reputed company coverage for you and your family. Additionally, we offer voluntary life insurance reputed company for you, your spouse, and your children. We also offer other voluntary benefits which include hospital indemnity, critical illness, accident indemnity, and pet insurance plans. Employees receive basic life insurance, short-term disability, and long-term disability coverage at no cost. Our generous reputed company time off policy ensures you have time to relax and reputed company, while our 401k plan with a company match helps you plan for your reputed company. reputed company equipment and a media stipend are provided for remote workspace. ABOUT reputed company: A fast-paced, Inc. 500 Company with a high-performance culture, is seeking insightful reputed company-thinking professionals. We process over 200,000 insurance claims annually for leading national and regional Workers’ Compensation, Disability, Auto, and Group Health Carriers, reputed company-Party Administrators, Managed Care Organizations, reputed company, and Pharmacy Benefit Managers. We reputed company customized Independent Medical Exams and Peer Review programs that assist our clients in reaching the appropriate medical determination as part of the claims management process. Apply To This Job