Job Description

Benefits:
401(k) matching
Dental insurance
Health insurance
Vision insurance
Lead the medical claims and coding analyses, identifying and resolving process, payment, and systems issues. Provide support in developing and maintaining bill processing controls, including determining restrictions on service code utilization based on code descriptions (HCPCS/CPT). Analyzing the performance of bill processing contractors by reviewing claim transactions to ensure accurate billing and processing, designing and implementing medical coding studies, and providing analysis and recommendations on medical coding practices, and response to customer inquiries.
RESPONSIBILITIES:
Plans, designs, and implements assignments, projects, and/or studies in the areas of medical coding. Utilizes current medical and scientific knowledge available in reference manuals, books, and other documents on how they clinically and administratively apply to the OWCP Central Bill Processing (CBP) processes.
Develops training materials for staff as necessary.
Determines new techniques and advancements to ensure the accurate application of medical coding on the processing of medical bills.
Monitors the utilization of medical services to identify over-utilization patterns. Produces reports with recommendations to curb this practice.
Participates in OWCP projects related to containment of medical costs.
REQUIREMENTS:
Must be a Certified Professional Coder (CPC) from either the American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA).
Must have either five (5) years general CPC experience or (preferred) two (2) years specifically with a medical insurance company or other payor.

Job Tags

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