Full-Time Medical Billing Compliance Analyst I

• Extracts information from resources and translates information needed to form appropriate logic for rules.
• Identify necessary and potential changes to existing medical rules through the review of current and historically available medical policies, transmittals and bulletins.
• Completes reviews of medical policies and publications and its integration into the required database on a timely basis.
• Identifies patterns of improper coding or errors in policies and publications and is able to resolve and recommend alternate codes, or code representation in appropriate table(s) (ICD-10, CPT/HCPCS, CCI_Edits)
• Review of National Coverage Determinations for PPH National policies, assigning appropriate diagnosis and procedural codes for incorporation into Medicare Medical Edits.
• Builds and maintain data and medical rules tables for multiple Experian Health products in Microsoft Access.
• Independently reviews, prepares and make appropriate adjustments to data editorial for release to production.
• Independently completes production data release process.
• Complete in-depth, independent review of support cases, responding to and discussing with clients as necessary.
• Responsible for timely and accurate research of resources that update critical information on a scheduled basis. Stay informed about current coding issues.

• Experience with and knowledge of Current Procedural Terminology (CPT) Coding, and International Classification of Disease (ICD-10) Codes required
• Ability to understand and retain coding information and transfer that information into completed product data.
• Knowledge of Medical Terminology
• Knowledge of anatomy and physiology
• Knowledge of Medicare reimbursement guidelines
• Research, analyze and draw conclusions regarding medical edits

What is the last date for applying to the job?

Which countries are accepted for this remote job?