Certified Professional Coder - PIP Adjuster

Certified Professional Coder - PIP Adjuster

Location: Remote, Remote, US

Job Description:

Certified Professional Coder / Bill Review Expert

Location: 

Remote- Anywhere in US

 

Responsibilities:

• • 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
     
    Qualifications and Experience:
    • 3-5 years experience conducting code reviews;  specifically NJ / NY PIP fee schedules
    • 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