Associate, Payment Integrity IBR

📋 Description

• Perform line-by-line review of high-dollar facility itemized bills and UB-04s
• Identify potential billing errors and improper unbundling
• Compare billed charges against contracts and guidelines
• Apply CPT, HCPCS, ICD-10, MS-DRGs codes for service validation
• Review claims under reimbursement scenarios to ensure thresholds are met
• Document findings and suggested claim adjustments clearly

🎯 Requirements

• A bachelor’s degree or 4+ years of commensurate experience
• 2+ years of bill/coding audit experience (hospital/facility UB-04)
• 4+ years of medical coding experience
• Medical coding certification via AAPC (CPC, COC) or AHIMA (CCS, RHIT, RHIA)
• Experience with reimbursement methodologies and payor contracts

🎁 Benefits

• Medical, dental, and vision benefits
• 11 paid holidays
• Paid sick time
• Paid parental leave
• 401(k) plan participation
• Life and disability insurance