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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong attention to detail and excellent communication skills while effectively validating overpayments and documenting findings. Proficient in applying coding methodologies and maintaining compliance with CMS guidelines.
Highest-signal resume keywords
Attention To DetailExcellent Written And Oral Communication SkillsKnowledge Of CMS GuidelinesStrong Knowledge Of HCPC And CPT Coding Methodologies1-2 Years’ Experience With Medical Claims Processing
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Overpayment ValidationClaims System UtilizationDocumentation Of ClaimsAnalytical Problem SolvingSpreadsheet KnowledgeWord Processing KnowledgeDatabase Knowledge
Soft Skills
Flexibility During ChangeEffective CommunicationFeedback Provision
Certifications & Qualifications
OIG/GSA Clearances
Industry Keywords
Medical Claims ProcessingAuditor ExperienceCoding Methodologies
About the role
Key responsibilities & impact- Review output of queries for overpayments
- Follow Query Step-by-Step Documentation to validate overpayments
- Utilize claims system(s), if available, to verify overpayments
- Document overpayments/non-overpayments in production systems, articulating clear reasons for claims not overpaid
- Meet quality and production standards
- Record production tasks and time in the format outlined by Management
- Communicate issues that may impede completion of assigned work to Management
- Work with Management to resolve issues
- Provide feedback to Management on areas of improvement
Requirements
What you’ll need- High School Diploma or Equivalent Required
- College Degree or Equivalent Work Experience
- Maintain OIG/GSA clearances
- Attention to Detail
- Excellent written and oral communication skills
- Flexible during times of change; able to adjust to shifting priorities and timelines through analytical and problem solving capabilities
- Must be able to learn, understand, and apply new technologies
- Knowledge of CMS guidelines
- Strong knowledge of HCPC, CPT and other coding methodologies
- Spreadsheet, word processing, and database knowledge
- Preferred: 1-2 Years’ Experience Auditor
- Preferred: 1-2 Years’ Experience with Medical Claims Processing
Benefits
Comp & perks- Benefits information provided at https://www.exlservice.com/us-careers-and-benefits
- Work from home