by helping healthcare payers manage the cost of care, improve competitiveness and inspire positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by interpreting our client's needs and tailoring innovative healthcare cost management solutions.
Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine!
2. Utilize analytics and data mining techniques to client paid claims data, develop creative and innovative algorithms and queries that facilitate identification of new savings opportunities.
3. Evaluate medical claims for coding and pricing errors using accurate HCPCS, ICD-10, and CPT codes.
4. Lookup and review medical claims in payer system to determine methods of payment and validate savings identified.
5. Aid in the training of others in the Payment Accuracy department for data mining and auditing best practices.
6. Act as a mentor by answering questions regarding contracts, policies, and medical coding.
7. Assist in provider collection efforts and appeal resolution as needed.
8. Utilize official coding guidelines and resources as required, including CMS directives and bulletins.
9. Collaborate, coordinate, and communicate across disciplines and departments.
10. Ensure compliance with HIPAA regulations and requirements.
11. Demonstrate Company's Core Competencies and values held within.
12. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role.
13. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.