BASF

Concept Development Specialist – DME Focus, RN/Coder

BASF

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $85,000 - $115,000 per year

About the role

  • Provide support to assigned Segment Specialists by maintaining current audit concepts
  • Responsible for the review and update of existing concepts based upon required periodic review cycle
  • Collaborates with and leverages Segment Specialist expertise to ensure on-point results
  • Ensure training material updates as necessary for changes to existing concepts
  • Conduct research, identify impact on existing concepts, and document accordingly
  • Support activities required to "package" concepts, including, but not limited to, pulling together necessary documents
  • Ensure audit concepts are well formulated for Offerings
  • Manage, progress, and track multiple tasks within multiple workflows for audit concept maintenance
  • May contribute to responses to provider/client representative from written inquiries as it pertains to audited Medicare claims

Requirements

  • At least 2-4 years of audit or Payment Integrity experience
  • CPC, COC, RHIA, or RHIT certification and/or RN
  • Demonstrated knowledge of applicable Medicare and Commercial policy and claims process
  • Relevant knowledge and experience with ICD-10-CM/PCS, CPT-4, and HCPCS coding
  • Knowledge of the national coding standards, particularly payment rules
  • Knowledge of Medicare and commercial claims processing systems
  • Strong verbal communication and interpersonal skills
  • Excellent written communication skills; including proofing and editing
  • Good critical thinking, analytical, questioning, and listening skills
  • Strong proficiency in Microsoft Word, Excel, SharePoint (advanced skills highly desirable)
Benefits
  • medical, dental, vision, HSA/FSA options
  • life insurance coverage
  • 401(k) savings plans
  • family/parental leave
  • paid holidays
  • paid time off annually
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
audit experiencePayment Integrity experienceICD-10-CM codingICD-10-PCS codingCPT-4 codingHCPCS codingnational coding standardsMedicare claims processingcommercial claims processing
Soft Skills
verbal communicationinterpersonal skillswritten communicationproofingeditingcritical thinkinganalytical skillsquestioning skillslistening skills
Certifications
CPCCOCRHIARHITRN