Certified Payment Integrity Specialist

A company is looking for a Payment Integrity Professional. Key Responsibilities Utilize coding knowledge to identify and validate new code edit opportunities for accurate claim processing Conduct in-depth research and collaborate across departments to ensure correct claim payments Drive process improvements and maintain relationships with internal stakeholders and external vendors Required Qualifications Certified Professional Coder with AHIMA or AAPC certification Minimum of 2 years of experience with coding guidelines and claims interpretation Extensive knowledge of CPT, HCPCS, and ICD code sets Strong understanding of CMS and state Medicaid guidelines Proficient in Microsoft Office Programs including Word, PowerPoint, and Excel

Mar 6, 2025 - 16:33

A company is looking for a Payment Integrity Professional. Key Responsibilities Utilize coding knowledge to identify and validate new code edit opportunities for accurate claim processing Conduct in-depth research and collaborate across departments to ensure correct claim payments Drive process improvements and maintain relationships with internal stakeholders and external vendors Required Qualifications Certified Professional Coder with AHIMA or AAPC certification Minimum of 2 years of experience with coding guidelines and claims interpretation Extensive knowledge of CPT, HCPCS, and ICD code sets Strong understanding of CMS and state Medicaid guidelines Proficient in Microsoft Office Programs including Word, PowerPoint, and Excel