Associate, Payment Integrity

📋 Description

• Respond to internal and external inquiries and disputes regarding policies and edits.
• Ideate payment integrity opportunities based on a deep knowledge of industry standard coding rules.
• Provide subject matter expertise and in-depth understanding of Payment Integrity internal claims
• Ingest information from internal and external partners regarding adverse claim outcomes
• Use insights from partner submissions, data mining, process monitoring, etc., work with the team to
• Perpetuate a culture of transparency and collaboration by keeping stakeholders well informed of

🎯 Requirements

• A bachelor’s degree or 4+ years of commensurate experience
• 4+ years of experience in claims processing, coding, auditing or health care operations
• 4+ years experience in medical coding within payment integrity
• Medical coding certification through AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)
• Experience with reimbursement methodologies, provider contract concepts and common claims
• 2+ years experience deriving business insights from datasets and solving problems

🎁 Benefits

• Base pay: $82,717 - $108,566 per year
• Employee benefits
• Unlimited vacation program
• Annual performance bonuses