This role reviews provider documentation and claims to ensure coding accuracy, billing compliance, and adherence to regulatory requirements. Responsibilities include auditing medical coding, performing billing functions, and managing third-party billing follow-up. The specialist ensures claims submitted to Medicare, Medicaid, Railroad Retirement, Medicare Advantage, and commercial payers are accurate and compliant with payer and state-specific guidelines.
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Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed