Terms of Employment:
• W2, Contract
• 3 Months with possible extension
• Predominantly remote. There will be occasional onsite visits to our client’s office in either: Canton, MD, Washington D.C., Owings Mills, MD or Columbia, MD. Candidates must reside within the Maryland, DC, Virginia or Delaware area.
Overview & Responsibilities
Join our client’s Special Investigations Unit (SIU) as a Medical Coder, leveraging your medical coding expertise to combat fraud, waste, and abuse in healthcare claims. This vital role involves the prepayment review of medical records to ensure accurate billing per industry standards and internal policies. You will be instrumental in clearing a significant backlog of claims and contributing to the integrity of the claims process. This is an excellent opportunity for a certified medical coder seeking a high-impact role with potential for long-term employment. Key responsibilities include:
• Review medical records and claims for fraudulent indicators and coding accuracy.
• Determine if claims are accurately billed per industry standards (e.g., AMA guidance, AAPC guidance) and internal payment/medical policies.
• Render determinations on claims, which may include denying or paying them based on review findings.
• Utilize coding software (e.g., Codify, Optum Encoder Pro) or CPT manuals to aid in code review and ensure all required components of office visits are met.
• Manage a high volume of claim reviews, contributing to the reduction of a significant backlog.
Required Qualifications:
• High School Diploma or GED.
• Active and validated Certified Professional Coder (CPC) certification or equivalent accreditation (e.g., CPMA, COC, or AHIMA accreditation) without Apprentice tag.
• 3 years of experience in risk adjustment coding, ambulatory coding, and/or CRC coding experience in managed care, state or federal healthcare programs, or the health insurance industry.
• Experience in physician coding, specifically reviewing office visits and services rendered in a physician's office.
• Proficiency in reviewing medical records and claims for coding accuracy.
• Detail oriented.
Preferred Qualifications:
• Experience using coding software such as Codify (AAPC) or Optum Encoder Pro.
Restaurant General Manager Luxury Hotel International Concept A leading luxury hotel in the heart of Philadelphia, PA is seeking an experienced Restaurant General Manager to oversee daily operations for a high-end restaurant and adjacent Lobby Lounge. This dynamic...
...technologically savvy and data driven Compensation Package Competitive base salary + discretionary bonus Flexible, hybrid, and remote work options Health benefits & 401K with employer match Employer paid continuing education courses and designations Many...
...The firm is known for its prominent and successful litigation practice, global investigations practice, regulatory and government controversies... ...POSTION SUMMARY Jenner & Block is looking to add a Practice Manager to our Practice Management Team. The Practice Manager...
...monthly housing allowance 2,500- Flight allowance: 6,000 RMB for teachers abroad OR 3,000 RMB for teachers in China- Free lunch (... ...vacation allowance)-Free hotel accommodation upon arrival-Supportive managementSkills:Drama, Music, ESL / English as a Second Language
...gearing up for a record year and currently looking for a highly motivated, aggressive, take-charge, industry leading General Manager in the Automotive, Harley-Davidson, Powersports Marine or RV industries. Come join a proven sales leader! The home of a great brand,...