Payment Integrity Professional

📋 Description

• Research claims, coding guidelines, and data anomalies to identify opportunities that can improve
• Apply advanced knowledge of CPT, HCPCS, ICD, Medicare, Medicaid, and correct-coding requirements to
• Conduct in-depth analysis and independently determine appropriate courses of action, including in
• Collaborate with Code Edit Management, internal stakeholders, and external code-editing vendors to
• Identify opportunities for process improvement that enhance the accuracy, efficiency, and
• Support projects and processes, potentially taking on a leadership role in implementation

🎯 Requirements

• Active Certified Professional Coder (CPC) certification from AHIMA or AAPC
• At least 2 years of experience applying coding guidelines and submitting, reading, or interpreting
• Knowledge of CPT, HCP, and ICD code sets and their practical application
• Strong understanding of Centers for Medicare & Medicaid Services (CMS) requirements and
• Experience with code-editing vendor tools and payment integrity processes
• Experience leading projects or operational processes

🎁 Benefits

• Annual base salary of $65,000–$88,600 based on location, skills, and experience
• Eligibility for a bonus incentive plan based on company and/or individual performance
• Remote work-from-home opportunity with a standard 40-hour workweek
• Medical, dental, and vision coverage
• 401(k) retirement savings plan
• Paid time off, company and personal holidays