Medical Code Review Processor
Job Description Summary
The 1st Party Code Reviewer is responsible for reviewing medical codes to determine that appropriate coding is applied, proper supporting documentation submitted and duplicate identification.
- Make coding and payment determinations based on fee schedule, CPT, AMA, Medicare guidelines and standard of practice guidelines.
- Problem-solving skills and independent decision-making skills.
- Communication with Clients, Attorney’s, and Providers to solve denial issues.
- Provide summaries regarding coding decisions.
- Attend arbitration hearings, if needed.
- Reviews appeals for reconsideration of payment.
- Other duties as assigned.
Typical schedule for this role will be: Monday thru Friday - 8 a.m. – 4:30 p.m. (central standard time) with the ability and flexibility to work weekends (specifically Saturdays).
Ability to work in a home environment (requires broadband internet access such as cable or Verizon FIOS – DSL and Satellite are not acceptable) is required. Minimum download speed of 15mbps and a minimum upload speed of 5mbps is required.
- 3 years’ prior coding experience is required
- Professional coding certification through AAPC (CPC) or AHIMA (CCS, CCA) is required
- Knowledge of ICD9, CPT, HCPCs, and CDT codes
- Knowledge of medical terminology and anatomy
- Computer literate
- Excellent organizational skills
- Excellent verbal and written communication skills
- Ability to work in a fast-paced environment
- Detail oriented
- Team player
- Ability to work weekends
Why Choose CCC:
We promote a healthy work-life balance and offer generous benefit plans and resources designed with employee satisfaction in mind.
What we value is simple - customers, employee commitment, collaboration and clear communication.
We hire people who will embrace the company’s goals and productively contribute in ways that help us serve the customer, innovate, and stay strong.
We make it a priority to keep employees healthy, happy and enriched.
- Healthy - Wellness programs, competitive medical benefit offerings
- Happy – Recognition programs, a confidential employee assistance program, Perkspot/employee discount program and potentially flexible work arrangements such as staggered start times
- Enriched – Tuition reimbursement, training and learning programs, and leadership development opportunities
Our corporate headquarters is located in downtown Chicago within the historic Merchandise Mart—a certified LEED (Leadership in Energy and Environmental Design) building.
Please Note: Contingent Workers, Field Inventory Representatives and Interns are not eligible for the benefits above.
CCC Information Services was recognized by Forbes as one of America’s Best Mid-Sized Employers in 2018 and ranked #17 in the Top 100 Digital Companies in Chicago in 2017 by Built In Chicago.
CCC is ready to help you shift your career into high gear. Let's get started!