Quality Assurance Claims Auditor & Coding Specialist

Planned Systems International; United States; On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Paid leave

Employer-sponsored medical, dental, and vision options

401(k) retirement plan with employer match

Job summary

Planned Systems International is seeking a Claims Auditor and Coder with expertise in claims processing, medical coding, and quality assurance for the WTC Health Program. The successful candidate will support audit planning, conduct claims reviews, and analyze data for trends.

This role requires at least 5 years’ experience in health insurance claims and knowledge of CPT, HCPCS, and ICD codes. The position offers a competitive compensation package, including benefits and opportunities for professional growth.

Qualifications

• Minimum of 5 years’ experience with health insurance payor claims data.
• Demonstrated expertise in CPT, HCPCS, ICD billing codes.
• Registered health information administrator (RHIA) or similar certification desirable.

Responsibilities

• Support quality assurance and audit planning for the WTC Health Program.
• Conduct claims reviews and audits.
• Analyze claims data to identify trends and issues.

Skills

Expertise in medical coding

Claims processing knowledge

Quality assurance

Data analysis

Communication skills

Education

Bachelor's or Master's degree in health profession

Tools

MS Office (Word, Excel, Outlook)

Communication tools (Teams, SharePoint)

Job description

Planned Systems International is seeking a Claims Auditor and Coder with expertise in claims processing, medical coding, and quality assurance for the WTC Health Program. The successful candidate will support audit planning, conduct claims reviews, and analyze data for trends.

This role requires at least 5 years’ experience in health insurance claims and knowledge of CPT, HCPCS, and ICD codes. The position offers a competitive compensation package, including benefits and opportunities for professional growth.