Healthcare Coding Expert – Certified Professional Coder

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $77.8k - $105.2k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🏥 Medical Billing and Coding

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

General Dynamics Information Technology

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1954

💼 Consulting

🏥 Healthcare

📦 Logistics

Consulting • Healthcare • Logistics

General Dynamics Information Technology is a company at the forefront of technological innovation, offering a wide range of services including consulting, digital modernization, and application services. The company is heavily involved in implementing solutions related to artificial intelligence, cloud computing, cybersecurity, high-performance computing, and quantum technologies. GDIT is committed to supporting government and defense sectors, providing mission-critical services such as logistics and supply chain management, intelligence, and homeland security. The company also focuses on diverse and inclusive hiring practices and actively promotes employee well-being. Through its digital accelerator solutions and pioneering use of emerging technologies, GDIT aims to propel agencies' missions forward and address complex technological challenges.

📋 Description

• Perform analytical tasks supporting the Healthcare Fraud Prevention Partnership (HFPP) program • Identify fraud, waste, and abuse referrals and leads from HFPP Analytics • Collaborate on development of HFPP analytic reports • Drive outcome metrics for fraud, waste, and abuse referrals and leads shared with Partners • Analyze health claims data and generate study referrals and leads • Develop provider background profiles • Identify opportunities for Partner collaboration meetings • Review and analyze medical claims for accuracy, completeness, and compliance with insurance policies, coding guidelines, and reimbursement criteria • Identify fraud, waste, and abuse schemes • Research and investigate insurance policies, coding guidelines, and reimbursement criteria • Participate in quality assurance initiatives ensuring deliverables comply with regulatory requirements, medical and company policies, and industry standards • Evaluate and respond to analytic output questions from internal and external parties • Coach and provide guidance to less experienced professionals when needed • Support CMS through a 50-person team supporting the Trusted Third Party established to reduce healthcare fraud, waste, and abuse

🎯 Requirements

• Bachelor's degree or equivalent year of work experience • 8+ years’ experience in healthcare claims analysis • Certified Professional Coder (CPC) through the American Academy of Professional Coders (AAPC) or Certified Coding Specialist (CCS) through the American Health Information Management Association (AHIMA) • Expertise in medical terminology and healthcare coding, including ICD-10, CPT, and HCPCS • Experience in program integrity and healthcare fraud, waste, and abuse activities, including edits, audits, pre-payment and post-payment review, investigations, and referrals • Extensive knowledge of insurance regulations, reimbursement methodologies, and healthcare compliance requirements • Strong oral and written communication skills with ability to present to management-level staff • Expert-level knowledge of Microsoft Office suite • Experience with Tableau, Amazon WorkSpaces, Jira, and Confluence • Working knowledge of HIPAA privacy and security rules • Certified Fraud Examiner (CFE) or Accredited Healthcare Fraud Investigator (AHFI) designation strongly desired • Strong decision-making, organizational, and leadership qualities • Commitment to confidentiality, privacy, and professionalism • Ability to independently follow through on problems • Detail-oriented and able to prioritize multiple tasks and work under pressure • Ability to work on complex projects with general direction and minimal guidance • Ability to build effective relationships and demonstrate strong interpersonal skills • Ability to work effectively both independently and in team environments • No work visa sponsorship; US citizenship is not required

🏖️ Benefits

• Medical plan options, some with Health Savings Accounts • Dental plan options • Vision plan options • 401(k) plan with pre-tax and post-tax contributions and company match • Full flex work weeks where possible • Paid vacation, sick, and personal time • Paid holidays • Paid parental, military, bereavement, and jury duty leave • Typically 15 days of paid leave per calendar year • Additional 10 paid holidays per year • Up to 160 hours of paid family leave in a rolling 12-month period for eligible employees • Short- and long-term disability benefits • Life insurance • Accidental death and dismemberment insurance • Personal accident insurance • Critical illness insurance • Business travel and accident insurance • Identity verification process with biometric data protection and security measures