State Licensed Medical Claims Auditor

A company is looking for a Medical Claims Auditor. Key Responsibilities Review professional and facility claims for accuracy and compliance with coding rules and guidelines Analyze medical records and itemized bills to validate billing and coding procedures Audit codes and services according to industry standards and apply appropriate reimbursement methodologies Required Qualifications High School Diploma or equivalent Minimum 2 years of Claims Coding or Medical Billing experience Coding Certification (CPC, CCA, CCS, RHIA, etc.) and/or Nursing Licensure (RN, LPN, etc.) Proficiency in ICD-10 coding Familiarity with CMS-1500 and UB-04 Medical Claim Forms

Feb 25, 2025 - 18:40

A company is looking for a Medical Claims Auditor. Key Responsibilities Review professional and facility claims for accuracy and compliance with coding rules and guidelines Analyze medical records and itemized bills to validate billing and coding procedures Audit codes and services according to industry standards and apply appropriate reimbursement methodologies Required Qualifications High School Diploma or equivalent Minimum 2 years of Claims Coding or Medical Billing experience Coding Certification (CPC, CCA, CCS, RHIA, etc.) and/or Nursing Licensure (RN, LPN, etc.) Proficiency in ICD-10 coding Familiarity with CMS-1500 and UB-04 Medical Claim Forms