Medical & Billing Coder - Texas

Dane Street, LLC • TX

90d

About The Position

Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. 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.

Requirements

• Must have a CPC, APCC, or DRG coder certification.
• Payment integrity or professional bill review experience is strongly preferred.
• Out-of-network bill review experience is a plus.
• Experience working in a remote environment is preferred.
• Experience in a medical office or health care background.
• CPC, CCS, or CCA certification is preferred, but not required.
• Experience is a must.
• Must have access to your own billing references/engine.
• Deposition/Testimony experience is preferred, but not required.
• Extensive knowledge of Texas billing resources- for example: (FairHealth, Medicaid Texas, Texas Healthcare, etc.).
• Coding counter-audit experience is a plus.

Nice To Haves

• CPC, CCS, or CCA certification is preferred, but not required.
• Deposition/Testimony experience is preferred, but not required.
• Coding counter-audit experience is a plus.

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 are/are 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-by-case basis to provide complete, timely, and error-free 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 knowledge/review for cases with quality Issues.

Benefits

• Generous Paid Time Off
• Excellent benefits package
• Competitive salary

What This Job Offers

• Career Level: Entry Level
• Education Level: No Education Listed