- Gather appropriate claims data, analyze and prepare summary of analysis to assist in the development of resource allocation strategies to meet changing business needs.
- Respond to internal and external inquiries regarding specific medical procedure coding issues and provide education on proper coding techniques via written and/or telephonic communications.
- Develop educational materials for providers identified as outliers and collaborate with Network Management on delivery/communication of information to provider.
- Maintain documents for tracking audit results, status/outcomes of reviews etc.
- Participate in or lead special projects based on business area needs requiring independent, sound decision making and broad based understanding of impact on the individual department as well as impact on corporate objectives.
What You’ll Bring (Hiring Requirements)
- RN or LPN with a valid NC license
- 3+ years of experience in related field.
- If LPN, 7+ years of experience in related field.
- Certified Professional Coder (or certificate obtained within 18 months of employment)