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Remote Coder/Clinical Investigator Job in Franklin, Tennessee

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Job Title: Remote Coder/Clinical Investigator

Employer:The CSI Companies
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:3000 Meridian Blvd Suite 160 Franklin 37067, TN, US
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. 


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 


Please contact Sarah Carrigan with an updated resume included! 


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