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Claims Theory

Certified Professional Coder

Claims Theory, Buffalo, New York, United States, 14266

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Job description ​ Certified Professional Coder / Bill Review Expert ​ Responsibilities: ​ ​ Review medical bills related to MVA injuries sustained for NJ and/or NY covered insureds ​ Conduct reviews of medical bills and supporting documentation to ensure proper codes are assigned ​ Assign proper codes as needed based on review outcome ​ Use various resources, e.g., eBooks and 3M software to support reviews ​ Interpret fee schedule guidelines and apply those guidelines in daily reviews ​ Document review outcomes for the customer in a professional, easy-to-understand manner ​ Participate in conference calls as needed with customer and/or attorneys ​ Assist with various special projects and other duties as assigned ​ ​ Qualifications and Experience: ​ ​ 3–5 years of medical billing experience specifically with NJ/NY PIP fee schedules ​ Strong communication skills; must be able to explain the outcome of the review, both written and verbally ​ Extensive knowledge of coding and documentation requirements ​ Thorough knowledge of CPT, HCPCS, ICD‑10 ​ CPC/AAPC certification required ​ Ability to multi‑task ​ Ability to meet critical timelines ​ Computer experience (including MS Office) ​ Excel experience beyond beginner level ​ Independent worker ​ Ability to manage time when working remotely ​ Must be able to travel to the Hamilton, NJ office as needed ​ Effective communication with the team ​ #J-18808-Ljbffr