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