Home > Medical Coding Jobs > Tennessee > Remote Coder/Clinical Investigator Job in Franklin

Remote Coder/Clinical Investigator Job in Franklin, Tennessee

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: Remote Coder/Clinical Investigator

Employer:The CSI Companies
Skills:Coding
Specialties:E/M, Evaluation & Management
Required Certifications:COC,CCS,CCA,RHIT,CPC
Preferred Certifications:RHIT,CCS,COC,CPC,CCA
Required Experience:1 to 2 years
Preferred Experience:3 to 4 years
Location:Franklin, TN
Date Posted:8/23/2019

Remote E/M Medical Coding Specialist/Clinical Investigator 

The CSI Companies is looking for a certified medical coder with 2 years of experience for CPT Coding position.  This is a temp to perm position with our Fortune 500 healthcare company.

This position is set to start on October 1st, 2019. 

Hours:

M-F 8am-5pm CST (100% remote) 

Primary Responsibilities: 

  • Performs clinical coverage review of CPT and HCPCS coded claims in a telecommuting work environment determining payment recommendation 
  • Determines appropriate level of service utilizing Evaluation and Management Coding principles 
  • Ensures adherence to state and federal compliance policies, reimbursement policies and contract compliance 
  • Responsible for Clinical and Coding expertise in the application of medical and reimbursement policies within the claim adjudication process through file review. 
  • This could include Medical Director/physician consultations, interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies and consideration of relevant clinical information 
  • Performs clinical coverage review of post-service, pre-payment claims, which requires interpretation of state and federal mandates, applicable benefit language, medical & reimbursement policies, coding requirements and consideration of relevant clinical information on claims with aberrant billing patterns 
  • Performs clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding & billing 
  • Identifies aberrant billing patterns and trends, evidence of fraud, waste or abuse, and recommends providers to be flagged for review 
  • Maintains and manages daily case review assignments, with accountability to quality and productivity standards 
  • Provides clinical support and expertise to the other investigative and analytical areas 
  • Participates in team and network meetings, engaging in a collaborative work environment 
  • Serves as a clinical resource to other areas within the clinical investigative team 


Required Qualifications: 

  • High School Diploma or GED 
  • 2+ years of current E/M, CPT and HCPCS coding experience (entering codes, auditing etc.) 
  • Current and active certified coder (CPC / CCS / RHIT etc.) 
  • Experience with and ability to work independently with technology 
  • Ability to work 8:00 am to 4:30 pm CST Monday through Friday and available to work overtime as business needs require 
  • 100% Attendance is required during the first 8 weeks of training

Preferred Qualifications: 

  • Healthcare Claims experience 
  • Managed Care experience 
  • Investigation and/or Auditing experience 

Applying

Please contact Sarah Carrigan with an updated resume included! 

scarrigan@thecsicompanies.com
615-349-1456

Looking for Exhibiting Opportunities or Group Discounts?

Contact us at 844-825-1679.