Certified Professional Coder, PIP Adjuster

This is a fully remote position, open to applicants in New Jersey.

📋 Description

• Utilize a variety of resources to assist in reviews, including CPT guidelines, CPT Assistant, Encoder Pro, and 3M Software.

• Examine medical bills submitted by insurance companies associated with MVA injuries for NJ and/or NY-covered insureds.

• Analyze medical documentation to ensure the accuracy of billed services, including CPT and HCPCs codes.

• Assign the appropriate CPT and HCPCs codes based on the outcomes of the review.

• Evaluate CPT codes for unbundled services.

• Assess billed modifiers for correct usage.

• Crosswalk CPT codes according to regulatory requirements to guarantee accurate reimbursement.

• Interpret fee schedule guidelines and implement these guidelines during daily reviews.

• Document review outcomes for clients in a clear and professional manner.

• Leverage various resources, including eBooks and 3M software, to support the review process.

• Engage in conference calls as necessary with clients and/or attorneys.

• Participate in virtual and in-person testimonies or trials when required.

• Assist with various special projects and other assigned duties.

⛳️ Requirements

• 3-5 years of experience in conducting code reviews, particularly with NJ / NY PIP fee schedules.

• Must possess keen attention to detail and the ability to quickly identify errors in written reports and legal documents.

• Strong communication skills are essential, with the ability to articulate review outcomes both in writing and verbally.

• In-depth knowledge of coding and documentation requirements is necessary.

• Comprehensive understanding of CPT, HCPCs, and ICD-10 codes.

• Active CPC certification through AAPC is required.

• Ability to multitask effectively.

• Capability to meet critical deadlines.

• Willingness to testify on behalf of clients regarding coding outcomes as needed.

• Readiness to travel for testimony as necessary.

• Proficient computer skills.

• Experience with Excel beyond a beginner level.

• Ability to work independently.

• Strong time management skills, especially when working remotely.

• Must be able to travel to the Hamilton, NJ office as needed.

• Ability to communicate effectively with the team.

🏝️ Benefits

• Competitive salary and benefits package.

• Opportunities for professional development and growth.

• Supportive work environment.