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PI Medical Coding Reviewer I, CPC, RHIT, RHIA required
CareSourceMedical Coding Reviewer focusing on accuracy in medical records and claims processing at CareSource. Ensuring compliance with coding guidelines while supporting audit processes.
About the role
Key responsibilities & impact- Responsible for assuring medical records requests are accurate
- Process incoming medical records and assign to appropriate claims
- Support the audit process - error exception reporting
- Make claim payment audit decisions on uncomplicated medical codes
- Research and make payment decisions based on medical coding guidelines
- Refer suspected Fraud, Waste, or Abuse to the SIU when identified
- Identify process improvements and refer system enhancement ideas
- Report claim problems/concerns to management
Requirements
What you’ll need- Associates degree required
- 1 year of medical bill coding preferred
- Medicaid/Medicare experience preferred
- Knowledge of diagnosis codes and CPT coding guidelines
- Proficient in Microsoft Office Suite
- Experience reviewing medical records
- General understanding of claims payment preferred
Benefits
Comp & perks- Comprehensive total rewards package
- Bonus tied to company and individual performance
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
medical codingdiagnosis codesCPT coding guidelinesclaims paymenterror exception reportingprocess improvementspayment decisionsmedical records reviewFraud, Waste, or Abuse identification
Soft Skills
attention to detailanalytical skillsproblem-solvingcommunicationorganizational skills
Certifications
Associates degree