Job Description

Job Title : Clinical Certified Coder

Location : 50 Water St #7, New York, NY 10004, United States

Duration : 2-3 Months

Education : Bachelor’s degree in Nursing, Medical Billing/Medical Coding, Healthcare or other related fields

Shift Details : Hybrid, 9am-5pm

General Description:

• We need a clinician to review medical records to validate clinical and coding assessments Medical coding Review medical records and healthcare claims to determine the accuracy and compliance of billed codes with appropriate regulations, standards, policies, and procedures.
• Collaborate with other team members to evaluate suspected cases of fraudulent activities, such as over-utilization of services, upcoding, and billing for non-medically necessary services.
• Assist in preparing documentation for audits, recoupments, compliance/legal reviews and regulatory inquiries.
• Maintain thorough documentation of investigations, including clinical findings, coding discrepancies and all communication with healthcare providers and investigators.

Stay updated to changes to coding guidelines, healthcare regulations, and fraud detection methods to ensure compliance and effective investigations.

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