Nurse Coder Auditor – HBA

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Trend Health Partners

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2018

⚕️ Healthcare Insurance

💳 Fintech

🤖 Artificial Intelligence

💰 Private Equity Round on 2023-01

Healthcare Insurance • Fintech • Artificial Intelligence

Trend Health Partners is a healthcare technology company focused on enhancing payer-provider collaboration to improve financial management in healthcare. By leveraging AI-enabled technology, Trend Health Partners offers solutions to reduce credit balances, minimize payment denials, and ensure payment accuracy, ultimately fostering better relationships among stakeholders in the healthcare ecosystem. With a commitment to neutrality and efficiency, they aim to reshape the healthcare financial landscape for the benefit of providers, payers, and patients alike.

📋 Description

• Validate the accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on outpatient and inpatient facility claims. • Review medical records and supporting documentation to confirm that billed services, supplies, and items are appropriately documented and billed accurately. • Apply CMS guidance, coding guidelines, MUE/NCCI edits, industry standards, and policies during claim review. • Perform itemized bill reviews, including validation of revenue code line items and supporting documentation. • Conduct hospital bill audits to evaluate billed line charges and identify potential coding, billing, or documentation issues. • Assess medical necessity as part of claim review activities. • Prepare appeal responses using applicable coding guidance, industry standards, and company/client policies. • Assist with new concept development and claim selection criteria.

🎯 Requirements

• Active coding certification in good standing, such as CCS, CPC, COC, RHIT, or RHIA. • Strong knowledge of CPT, HCPCS, ICD-10, revenue codes, CMS and coding guidelines. • Knowledge of inpatient coding and billing guidelines, hospital bill audits, itemized bill reviews, and line-level claim review. • Ability to review and interpret complex medical documentation. • Experience with coding validation, auditing, or claims review. • Strong verbal and written communication skills. • Ability to prioritize tasks effectively and manage multiple review activities. • Proficiency with Microsoft Office, especially Excel.

🏖️ Benefits

• Competitive salaries • Highly valued health insurance • 401(k) plan with employer match • Paid parental leave