Remote Medical Claims Reviewer (CPC/CPC-A)

TEKsystems; Chicago (IL); Remote; USD 28,000 - 40,000; Part time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) Retirement Plan

Paid Time Off

Job summary

TEKsystems is seeking detail-oriented Medical Coders for a remote contract role focused on claim payment determinations. Candidates should hold an active CPC/CPC-A certification and have experience with EOBs and appeals processing.

The role emphasizes analysis of CPT codes and reimbursement methodologies, with a focus on NSA-related claim reviews. Responsibilities include reviewing claims, validating data, documenting payment rationales, and collaborating with teams to ensure timely resolutions

Qualifications

• Active CPC or CPC-A certification is required.
• Experience with EOBs and appeals processing is preferred.
• Understanding of CPT codes and insurance reimbursement methodologies.

Responsibilities

• Review medical claims and supporting documentation to determine payment outcomes.
• Analyze CPT codes, EOBs, and reimbursement data to support determinations.
• Validate and verify claim data for accuracy and completeness.
• Review disputes involving NSA-related services and ambulance billing.
• Document rationale for payment decisions per guidelines and regulations.
• Work within claims systems to process and review case files.
• Maintain productivity and quality while handling a high volume of cases.
• Collaborate with internal teams to ensure timely resolutions.

Skills

CPC CPC-A

CPT codes knowledge

Analytical skills

Problem solving

Job description

TEKsystems is seeking detail-oriented Medical Coders for a remote contract role focused on claim payment determinations. Candidates should hold an active CPC/CPC-A certification and have experience with EOBs and appeals processing.

The role emphasizes analysis of CPT codes and reimbursement methodologies, with a focus on NSA-related claim reviews. Responsibilities include reviewing claims, validating data, documenting payment rationales, and collaborating with teams to ensure timely resolutions