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About the role
Key responsibilities & impact- Handle provider disputes in a result-oriented and metrics-driven environment
- Focus on outpatient Behavioral Health coding disputes as part of the PPI Coding Disputes Team
- Consult and collaborate with coding professionals within and across departments
- Ensure accountability of coding dispute outcomes for timeliness, compliance, and quality
- Ensure accuracy and compliance of coding dispute reviews by adhering to coding guidelines
- Communicate dispute outcomes to providers professionally and concisely
- Make coding decisions using standard industry guidelines and best practices
- Manage multiple priorities and ensure timely completion of outpatient coding disputes
- Report to the Manager
- Participate in HireVue assessment during the hiring process
Requirements
What you’ll need- CPC or CCS Certification
- CPT/HCPCS auditing experience
- 1+ years' work experience reading and interpreting Behavioral Health claims
- 3+ years' experience performing Behavioral Health coding audits in health insurance and/or hospital settings and working coding-related disputes and trending results
- Working knowledge of Microsoft Office Programs Word, PowerPoint, and Excel
- Ability to work independently and determine appropriate course of action
- Excellent written and verbal communication skills
- Dedicated workspace without ongoing interruptions to protect member PHI/HIPAA information
- Home internet with minimum download speed of 25 Mbps and upload speed of 10 Mbps
- Wireless, wired cable, or DSL connection suggested; satellite, cellular, and microwave connections require leadership approval
Benefits
Comp & perks- Health benefits effective day 1
- Paid time off, holidays, volunteer time and jury duty pay
- Recognition pay
- 401(k) retirement savings plan with employer match
- Tuition assistance
- Scholarships for eligible dependents
- Parental and caregiver leave
- Employee charity matching program
- Network Resource Groups (NRGs)
- Career development opportunities
- Medical, dental and vision benefits
- Short-term and long-term disability
- Life insurance
- Bonus incentive plan based upon company and/or individual performance
- Internet expense payment for employees working from home in California, Illinois, Montana, or South Dakota