Certified Professional Coder, PIP Adjuster

🕒 May 6

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

💵 $55k - $60k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🏥 Medical Billing and Coding

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Medlogix

WebsiteLinkedInAll Job Openings

201 - 500 employees

⚕️ Healthcare Insurance

🤝 B2B

💰 Private Equity Round on 2017-06

Healthcare Insurance • B2B • Workers Compensation

Medlogix is a company that specializes in providing comprehensive medical services, including workers' compensation, auto medical services, and group health services. They offer online referral systems and eBilling solutions to streamline the management of medical claims. With a focus on technology, Medlogix employs innovative platforms like MyMedlogix™ and MedlogixU™ to enhance their services and ensure exceptional client experiences.

📋 Description

• Use various resources to support reviews; IE: CPT guidelines, CPT Assistant, Encoder Pro, 3M Software • Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds • Interpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes • Assign proper CPT, HCPCs codes based on the review outcome • Review CPT codes for unbundled services • Review billed modifiers for accuracy of use • Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement • Interpret fee schedule guidelines and apply those guidelines in daily reviews • Document review outcomes for customers in a professional easy to understand manner • Use various resources, IE: eBooks, 3M software to support reviews • Participate in conference calls as needed with customers and/or attorneys • Participate in virtual and in-person testimony or trial when needed • Assist with various special projects and other duties as assigned

🎯 Requirements

• 3-5 years experience conducting code reviews; specifically NJ / NY PIP fee schedules • Must have attention to details, ability to quickly identify errors in written reports, legal documentation • Strong communication skills, must be able to explain the outcome of the review, both written and verbally • Extensive knowledge of coding /documentation requirements • Thorough knowledge of CPT, HCPCs, ICD-10 • Must have active CPC certification through AAPC • Ability to multi-task • Ability to meet critical timelines • Willingness to testify on a needed basis on behalf of customer to coding outcomes • Willingness to travel for testimony as required • Computer experience • Excel experience beyond beginner • Independent worker • Ability to manage time when working remotely • Must be able to travel to Hamilton NJ office as needed • Ability to effectively communicate with the team