Certified Professional Coder / Bill Review Expert
Location: Remote.
Need to be in the Hamilton NJ office for training.
Responsibilities:
- Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds
- Interpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes
- Assign proper CPT, HCPCs codes based on the review outcome
- Review CPT codes for unbundled services
- Review billed modifiers for accuracy of use
- Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement
- Interpret fee schedule guidelines and apply those guidelines in daily reviews
- Document review outcomes for customers in a professional easy to understand manner
- Use various resources, IE: eBooks, 3M software to support reviews
- Participate in conference calls as needed with customers and/or attorneys
- Participate in virtual and in-person testimony or trial when needed
- Assist with various special projects and other duties as assigned
Qualifications and Experience:
- RN with CPC Certification and PIP experience
- Must have active CPC certification through AAPC
- 3-5 years experience conducting code reviews; specifically NJ / NY PIP fee schedules
- Strong communication skills, must be able to explain the outcome of the review, both written and verbally
- Extensive knowledge of coding /documentation requirements
- Thorough knowledge of CPT, HCPCs, ICD-10
- Ability to multi-task
- Ability to meet critical timelines
- Willingness to testify on a needed basis 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 the team
Medlogix provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
