Healthcare Services Specialist (RN/Coder)

Job Summary

A company is looking for a Healthcare Services Concept Specialist (RN and/or Professional Coder) focused on MolDX.

Key Responsibilities:

• Review and update existing audit concepts based on regulatory changes and client needs
• Develop and coordinate training materials for existing and new audit concepts
• Conduct research to document impacts on existing concepts and support Segment Specialists with new concepts

Required Qualifications:

• At least 2-4 years of audit or Payment Integrity experience
• CPC, COC, RHIA, or RHIT certification and/or RN
• Demonstrated knowledge of Medicare and Commercial policy and claims processes
• Relevant experience with ICD-10-CM/PCS, CPT-4, and HCPCS coding
• Strong understanding of national coding standards and Medicare claims processing systems