About the position Dane Street is seeking highly motivated Coders, bill reviewers, and payment integrity reviewers to join our team. This role involves applying clinical knowledge to review reports accompanying medical records to ensure the accuracy of medical billing information and coding. You will collaborate with other reviewers and their office teams to ensure clarity, address questions, and meet client deadlines. The position offers an exciting work environment, competitive compensation, and strong growth potential.

Responsibilities

• Evaluates the appropriateness of codes and determine whether they meet all established program standards.
• Ensures that the medical records are matched appropriately to the codes and if not, obtains them.
• Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met.
• Evaluates claims for conflict of interest and criteria appropriateness.
• Works within established timeframes set by program parameters.
• Provides strong customer service skills and works closely with clients on a case- by-case basis to provide complete, timely, and error-free quality assurance of cases.
• Provides clinical oversight to cases that are complex and need additional review prior to return to the client.
• Serves as an additional level of QA and clinical knowledge/review for cases with quality Issues.

Requirements

• Must have a CPC, APCC, CMBS, or DRG coder certification
• Payment integrity or professional bill review experience is strongly preferred.
• Experience in a medical office or health care background.
• Must work with a sense of urgency and meet deadlines.
• Must be self-motivated, with a strong drive for performance excellence.
• Excellent written and verbal communication skills are required.
• Attention to detail REQUIRED.

Nice-to-haves

• Out-of-network bill review experience is a plus.
• Experience working in a remote environment is preferred.
• Proficiency in navigating a variety of computer programs (Experience with Google Chrome, Gmail, Docs, Sheets, etc., is a plus).

Benefits

• Robust opportunity for supplemental income
• Schedule flexibility and predictable work hours-conduct reviews based on your schedule availability
• Fully prepped cases, streamlined case flow, transcription services at no cost, and a user-friendly work portal