Medical & Billing Coder

Work set-up: 
Full Remote
Contract: 
Work from: 

Offer summary

Qualifications:

Certified Professional Coder (CPC), AAPC, or DRG certification is required., Experience in payment integrity or professional bill review is preferred., Background in healthcare or medical office work is advantageous., Strong attention to detail and ability to meet deadlines are essential..

Key responsibilities:

  • Evaluate the appropriateness of medical codes and ensure they meet program standards.
  • Review medical reports and records to verify accurate coding and billing information.
  • Communicate with review teams and clients to clarify information and address questions.
  • Provide clinical oversight and quality assurance for complex cases before submission.

Dane Street, LLC logo
Dane Street, LLC Insurance SME https://www.danestreet.com/
51 - 200 Employees
See all jobs

Job description

Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential.


Job Summary:

A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines.


Core Duties & Responsibilities:

  • Evaluates the appropriateness of codes and determine whether they meet all established program standards.
  • Ensures that the medical records are matched appropriately to the codes and if not, obtains them.
  • Read & apply policy guidelines and healthcare terminology and delineate when criteria areare not met.
  • Evaluates claims for conflict of interest and criteria appropriateness.
  • Works within established timeframes set by program parameters.
  • Provides strong customer service skills and works closely with clients on a case bycase basis to provide complete, timely, and errorfree quality assurance of cases.
  • Provides clinical oversight to cases that are complex and need additional review prior to return to the client.
  • Serves as an additional level of QA and clinical knowledgereview for cases with quality Issues.

    • Requirements

      Required Education & Experience:

      ● Must have a CPC, APCC, or DRG coder certification

      ● Payment integrity or professional bill review experience is strongly preferred.

      ● Outofnetwork bill review experience is a plus.

      ● Experience working in a remote environment is preferred.

      ● Experience in a medical office or health care background.


      Required Skills:

      ● Must work with a sense of urgency and meet deadlines.

      ● Must be selfmotivated, with a strong drive for performance excellence.

      ● Excellent written and verbal communication skills are required.

      ● Proficiency in navigating a variety of computer programs (Experience with Google Chrome, Gmail, Docs, Sheets, etc., is a plus).

      ● Attention to detail REQUIRED.



      PLEASE BE AWARE: In the interest of the security of both parties, please be aware that

      Dane Street will never conduct an interview via text or request checks from candidates

      for purchasing equipment.

      Benefits

      We offer generous Paid Time Off, an excellent benefits package, and a competitive salary. If you are an outstanding candidate for this position, if you thrive in a fastpaced environment, and if you are interested in doing meaningful work that impacts others lives, then we encourage you to apply!


      ABOUT DANE STREET

      A fastpaced, Inc. 500 Company with a highperformance culture, Dane Street is seeking

      insightful, astute forwardthinking professionals. We process over 200,000 insurance

      claims annually for leading national and regional Workers’ Compensation, Disability,

      Auto and Group Health Carriers, ThirdParty Administrators, Managed Care

      Organizations, Employers and Pharmacy Benefit Managers. We provide customized

      Independent Medical Exam and Peer Review programs that assist our clients in

      reaching the appropriate medical determination as part of the claims management

      process.

Required profile

Experience

Industry :
Insurance
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Customer Service
  • Detail Oriented
  • Quality Assurance
  • Google Sheets
  • Self-Motivation
  • Communication
  • Time Management

Medical Billing Specialist Related jobs