Medical Coding Specialist At Claritev, we pride ourselves on being a dynamic team of innovative professionals.
Our purpose is simple - we strive to bend the cost curve in healthcare for all.
Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations.
We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare.
Onward and Upward!!! JOB SUMMARYThe Medical Coding Specialist is responsible for providing billing analysis of claims and applying coding standards and federal regulations to ensure correct billing practices.
In this role, you will perform bill and chart reviews to identify any variation from quality billing practices and monitor patient bills for accuracy and compliance.
This position also requires awareness of international coding systems and healthcare billing practices to support global operations and ensure alignment with international regulatory standards.
DUTIES Review and analyze inpatient, outpatient, and provider billing for medical appropriateness of treatment; analyze charges across various revenue centers with consideration to patient diagnosis, procedures, age, facility type, and international healthcare norms where applicable.
Apply recommendation of national coding and international coding and regulation standards (e.
, ICD-10-AM, OPCS-4, SNOMED CT) to claims billed.
Prepare clear, concise and legible findings, including documentation that may be used in cross-border audits or international compliance reviews.
Research, review and provide internal response based on receipt of itemized bills, claims, operative notes and other documentation, including those from international providers or translated medic.