Job Summary

One of the most diversified healthcare companies has a current position open for a Work from Home Healthcare Economic Consultant.

Individual must be able to fulfill the following responsibilities:

• Presenting the findings for solution approval in a clear and concise manner
• Researching and developing potential claim overpayment hypotheses
• Understanding healthcare payment methodologies and policies as well as coding

Position Requirements Include:

• Knowledge of Medicare, Medicaid and/or Commercial health plan and payment methodology
• 3 years of experience with claims processing or adjudication systems (Such as UNET, COSMOS, Facets, Diamond, etc. or provider billing/coding knowledge on Professional and Facility claims)
• 3 years of experience in healthcare (billing, coding, auditing claims)
• Strong computer skills: MS Excel, Word, PowerPoint
• Maintains working knowledge of Medicare rules and regulations and knowledge of procedure and diagnosis codes (CPT, ICD10 coding, HCPCS, APC and DRGs)
• 3 years of data analysis experience