Behavioral Health Outpatient Medical Coding Auditor

This is a fully remote position, open to applicants in United States.

📋 Description

• Address provider disputes in a metrics-driven and results-oriented environment

• Concentrate on outpatient Behavioral Health coding disputes as a member of the PPI Coding Disputes Team

• Collaborate and consult with coding experts both within and across various departments

• Ensure accountability for coding dispute outcomes regarding timeliness, compliance, and quality

• Maintain accuracy and compliance in coding dispute reviews by following established coding guidelines

• Communicate dispute outcomes to providers in a professional and concise manner

• Make coding decisions in accordance with standard industry guidelines and best practices

• Manage multiple tasks effectively to ensure prompt resolution of outpatient coding disputes

• Report directly to the Manager

• Engage in the HireVue assessment as part of the recruitment process

⛳️ Requirements

• CPC or CCS Certification is required

• Experience in CPT/HCPCS auditing

• Over 1 year of experience interpreting and reviewing Behavioral Health claims

• More than 3 years of experience conducting Behavioral Health coding audits in health insurance and/or hospital environments, along with managing coding-related disputes and analyzing trends

• Proficiency in Microsoft Office applications including Word, PowerPoint, and Excel

• Ability to work autonomously and determine the appropriate course of action

• Exceptional written and verbal communication skills

• A dedicated workspace free from interruptions to safeguard member PHI/HIPAA information

• Home internet connection with a minimum download speed of 25 Mbps and upload speed of 10 Mbps

• Suggested connection types include wireless, wired cable, or DSL; satellite, cellular, and microwave connections require approval from leadership

🏝️ Benefits

• Health benefits begin on day 1

• Paid time off, holidays, volunteer time, and jury duty pay

• Recognition pay

• 401(k) retirement savings plan with employer matching

• Tuition assistance

• Scholarships for qualified dependents

• Parental and caregiver leave

• Employee charity matching program

• Access to Network Resource Groups (NRGs)

• Opportunities for career development

• Medical, dental, and vision coverage

• Short-term and long-term disability insurance

• Life insurance coverage

• Bonus incentive plan based on company and/or individual performance

• Internet expense reimbursement for employees working remotely in California, Illinois, Montana, or South Dakota