Home > Medical Coding Jobs > Missouri > Compliance Coding Reviewer Job in Chesterfield

Compliance Coding Reviewer Job in Chesterfield, Missouri

It is the responsibility of the job seeker to validate the information posted for each job. AAPC cannot validate or guarantee the accuracy of the information posted below.

Job Title: Compliance Coding Reviewer

Employer:Centene Corporation
Skills:Medical Coding
Required Certifications:CPC
Required Experience:1 to 2 years
Location:1350 Timberlake Manor Chesterfield 63017, MO, US
Date Posted:7/14/2018
Position: Perform retrospective and prepayment reviews of medical records to identify potential abuse and fraud and inappropriate billing practices; Investigate, analyze, and identify provider billing patterns to recommend payment based on medical records, claim history, billing codes, regulatory and state guidelines, and policies; Prepare summary of findings and recommend next steps for providers; Identify preventative measures and recommend changes to internal policies and procedures and/or provider practices to prevent future fraudulent and erroneous practices; Consult investigators to identify abuse and fraud by utilizing clinical and coding expertise to analyze patterns in billing activities; Audit medical records to identify inappropriate billing practices and recommend next steps through extensive review of claims data, medical records, corporate policy, state/federal policy, and practice standards. Experience: Associate’s degree in a related field or equivalent experience. Coding Certification and 2+ years of medical coding experience; or RN, LPC, LCSW, LMHC, PT, OT or ST license and 2+ years of related clinical experience in the field of obtained license. Experience in provider education preferred.


Pat Pino, Talent Acquisition Specialist PH: 512-404-8026 Email: ppino@centene.com

Looking for Exhibiting Opportunities or Group Discounts?

Contact us at 877-524-5027.

Which certification is right for you?

Call 877-290-0440 or have a career counselor call you.

Which eNewsletters are right for you?

Call 844-334-2816 to speak with a specialist now.

Which books are right for you?

Call 877-524-5027 to speak to a representative.