Healthcare Coding Quality Specialist (Remote/Hybrid)

L3Harris Technologies, Inc.; Wayne (NJ); Híbrido; USD 56.000 - 101.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

401K

Stock purchase plans

Tuition reimbursement

Paid time off

Descripción de la vacante

Centene is hiring a Specialist Integration Test Engineer role? No—this page describes a Coding Quality Coordinator II responsible for complex reviews of clinical documentation and coding accuracy. You will validate payment methods and communicate findings to hospital and peer review teams, drawing on up-to-date Coding Clinics and related resources.

The role requires two years in DRG/ICD-CM coding, AA in Health Information Technology, and U.S. work authorization without sponsorship.

Formación

• AA in Health Information Technology preferred.
• Two years experience with DRG, ICD-9-CM/ICD-10-CM/PCS, CPT, HCPCS coding.
• Authorization to work in the U.S. without visa sponsorship.

Responsabilidades

• Perform complex reviews of physician clinical documentation on inpatient and outpatient records.
• Validate accuracy of coding, payment methodology, and reimbursement amounts.
• Develop case-specific written rationale to communicate findings to stakeholders.
• Conduct coding re-reviews per guidelines and sequencing rules.
• Identify questions and refer cases to Medical Director as needed.
• Stay updated with Coding Clinics and coding newsletters.
• Participate in in-service programs; identify fraud or abuse patterns.
• Other duties as assigned.

Conocimientos

Quality analysis

Medical coding

Provider communication

Educación

AA in Health Information Technology

Descripción del empleo

Centene is hiring a Specialist Integration Test Engineer role? No—this page describes a Coding Quality Coordinator II responsible for complex reviews of clinical documentation and coding accuracy. You will validate payment methods and communicate findings to hospital and peer review teams, drawing on up-to-date Coding Clinics and related resources.

The role requires two years in DRG/ICD-CM coding, AA in Health Information Technology, and U.S. work authorization without sponsorship.