Hospital Compliance Specialist Job in Worcester, Massachusetts Us
Experience with CPT/ICD-9 coding required
Summary: We are searching for a Hospital Compliance Auditor to perform a range of duties pertaining to hospital billing. In this role you will research appeals denied for both inpatient and outpatient claims in a hospital setting; you will also research coding reviews and various compliant issues. To be considered for this position, you will have an understanding of government regulations, Medicare Medicaid and experience auditing and reviewing medical records. You will also have experience in coding, payer practices as well as billing practices. A clinical background is needed.
Qualifications: Bachelor's degree in Business Administration, Health Care or related field, with three to five years of experience with large integrated health care delivery system as well as third-party billing requirements and regulations. Strong working knowledge of ICD-9 and CPT-4 coding is essential. RN and coding certification a significant plus. Knowledge of charge master or DRG coding is a significant plus. Strong oral and written communication skills and analytical and presentation skills. Ability to utilize a variety of computerized software applications such as word processing, spreadsheets, databases, presentation, etc. in order to conduct research of above regulations.
MNST
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