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Marshfield Clinic Health System · 5 days ago

Claims Auditor (Remote - WI or MN)

United States

Full-time

Remote

Mid Level

3+ years exp

Marshfield Clinic Health System is committed to enriching the lives of others through accessible, affordable and compassionate healthcare. The Claims Auditor is responsible for performing audits related to payment accuracy and compliance while applying effective auditing procedures.

Health CareMedicalOncologyWellness

Responsibilities

Performing payment, procedural accuracy, turnaround time, compliance and operational audits as directed by management

Applying effective, appropriate and efficient audit procedures in collecting, analyzing and reporting concise and relevant findings

Qualification

CPT codingICD codingHCPCS codingClaims auditingMicrosoft Office SuiteAnalytical problem solvingCertified Professional CoderAnatomy & physiologyWritten communicationOral communication

Required

High school diploma or equivalent

Successful completion of the following courses per departmental procedures, within one year of hire: current procedural terminology (CPT), current international classification of diseases (ICD), health care procedure coding system (HCPCS) and medical terminology

Three years' experience related to health insurance claim processing

Three years' experience related to CPT/HCPCS and current ICD coding

Demonstrated proficiency with analytical problem solving, written and oral communications and the Microsoft Office Suite

Working knowledge of anatomy & physiology

Certified Professional Coder (CPC) or Certified Professional Coder – Payer (CPC-P) certification awarded by the American Academy of Professional Coders (AAPC) within three years of hire based on the department position the resides in

Employee may not at any time have been or be excluded from participation in any federally funded program, including Medicare and Medicaid

Preferred

Associate degree in business, medical or related field

One year experience in claims auditing

Certified Professional Coder (CPC) or Certified Professional Coder – Payer (CPC-P) certification awarded by the American Academy of Professional Coders (AAPC) at time of hire