Outpatient Medical Billing and Coding Analyst and Cost Reviewer [PR0001C]
Core
Review outpatient health records and EMRs to validate provider, vendor, and internal diagnosis coding for accuracy; resolve claim denials and perform charge corrections.
Role type
Outpatient Medical Billing and Coding Analyst and Cost Reviewer
Builds
Accurate billing claims and statistical reports for US Armed Forces Regional Health Command
Domain
Military Healthcare / Medical Billing & Coding
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
CPT codes, ICD-10-CM codes, HCPCS Level II, HCC coding, chart audits, claim denial resolution, medical terminology, anatomy & physiology
Preferred skills
Risk adjustment methodology, clinical background, chart abstraction experience
Technologies
Microsoft Office (Word, Excel, PowerPoint), EMR systems
Responsibilities
Review outpatient records for quality and comprehensive coding; resolve daily coding scrubber errors; advise providers on billing policies and documentation; compile HCC statistical data
Seniority
Mid-level, hands-on IC