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Medical Claims Specialist

Job ID: 1693232
OA Reference: QA Med Claims Auditor

  • $37,400 to $49,900
  • Austin, 78730

We are seeking a seasoned healthcare documentation and coding Quality Assurance Auditor. The ideal candidate will have extensive experience in healthcare documentation and coding. In this role, you will be responsible for documenting patient visit chart notes, auditing completed chart notes for accuracy and thoroughness, and verifying the appropriate ICD-10, CPT, and HCPCS codes are assigned to each chart note.
Responsibilities:
• Listening to and documenting patient visits in the electronic health record
• Auditing chart notes within the electronic health record that have been created by our technology for accuracy and completeness.
• Assigning all appropriate ICD-10, CPT, and HCPCS codes to chart notes
• Auditing ICD-10, CPT, and HCPCS codes that have been applied to chart notes by our technology.
• Working closely with the Quality Assurance Team Lead and/or Director of Quality Assurance to create workflow policies and procedures for the department
• Communicating with the Quality Assurance Team Lead, Training and Implementation Department and/or providers to ensure satisfaction of newly onboarded practices and providers

Requirements:
• 5+ years of experience in healthcare documentation and coding
• One of the following credentials: CPC, COC, CPMA, CPPM, CDEO, CPMS
• Strong knowledge of claims adjudication processes and regulatory requirements
• Strong knowledge of documentation and coding processes and regulatory requirements
• Experience with EHR/EMR technology
• Strong analytical and problem-solving skills, with the ability to use data to drive decision-making and process improvement
• Excellent communication and interpersonal skills, with the ability to build relationships and collaborate effectively with cross-functional teams and external partners
• Ability to work independently and manage multiple priorities in a fast-paced, dynamic environment
• Experience working in a healthcare technology company or similar environment is a plus
We offer a competitive salary, comprehensive benefits package, and a dynamic work environment that fosters creativity, innovation, and growth. If you are a strategic thinker, a strong leader, and passionate about healthcare and operational excellence, we encourage you to apply for this exciting opportunity.



AppleOne is proud to be an Equal Opportunity Employer. We believe in people, and we are committed to working with people of all backgrounds and connecting them with clients and companies who share our goals of diversity and inclusiveness. All qualified applicants will receive consideration for employment without regard to race, religion, ancestry, color, national origin, age, gender identity or expression, genetic information, marital status, medical condition, disability, protected veteran status, sex (including pregnancy), sexual orientation, or any other characteristic protected by applicable federal, state, or local laws..

The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, the Company is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

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https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

Additional Skills

(none specified)

AppleOne Representative Contact Info

Account Executive:
Brooke
Branch Phone:
Location:
San Antonio, TX