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Role and Responsibilities:
- Validate accuracy of CPT, HCPCS, revenue codes, and billed charges on facility claims.
- Review medical records and apply CMS guidelines, coding standards, and policies during claim review.
- Perform hospital bill audits and itemized bill reviews to identify coding or billing issues.
Qualifications:
- Active coding certification in good standing (CCS, CPC, COC, RHIT, or RHIA).
- Strong knowledge of CPT, HCPCS, ICD-10, revenue codes, and CMS guidelines.
- Ability to review complex medical documentation and manage multiple review activities.
Preferred Skills:
- Registered Nurse (RN) license.
- Hospital bill audit/itemized bill review experience.
- Experience with encoder or coding platforms such as 3M, TruCode, or Codify.
Trend Health Partners
Trend Health Partners is a tech-enabled payment integrity company that facilitates collaboration between payers and providers to reduce waste and improve access to healthcare. It is a dynamic growing organization with a collaborative and innovative work environment.