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Health Care Service Corporation
Health Care Service Corporation
Sponsor pentru viza H1BAsigurăriAsistență medicalăConsultanță
Health Care Service Corporation (HCSC) este un licențiat independent al Blue Cross Blue Shield Association și una dintre principalele organizații de asigurări de sănătate și servicii medicale din Statele Unite. Compania deservește aproape 23 de milioane de persoane prin programe de acoperire și beneficii destinate angajatorilor, persoanelor fizice, familiilor și beneficiarilor Medicare și Medicaid. Pe lângă asigurările de sănătate, HCSC oferă servicii farmaceutice, acoperire pentru viață și servicii stomatologice, precum și tehnologie pentru date medicale. Cu aproape un secol de experiență, compania activează în domeniile asigurărilor, serviciilor medicale și consultanței pentru a extinde accesul la îngrijire, a sprijini rezultate mai bune pentru sănătate și a contribui la gestionarea costurilor pentru membri și comunități. Operațiunile sale ample creează oportunități de carieră în domeniul beneficiilor de sănătate, al serviciilor medicale, al tehnologiei, al datelor și al funcțiilor de afaceri conexe.
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Locurile de muncă ale companiei

Coding Investigator Auditor (Remote, U.S.)

Health Care Service Corporation seeks a remote Coding Investigator Auditor to validate clinical, billing, and coding claims across eligible U.S. locations. The role audits payments, researches discrepancies, documents findings, and coordinates investigations.

USStatele Unite ale AmericiiILIllinoisMTMontanaNMNew MexicoOKOklahomaTXTexas
63.300 $ – 114.300 $ / an
RemoteNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăAuditor

Descriere

  • Review clinical, billing, coding, and lowest-cost-setting services before and after payment
  • Apply medical, contractual, legislative, policy, and related information to validate submitted and billed claims
  • Research relevant issues and records
  • Document audit findings clearly and accurately
  • Consult with special investigations and affordability-of-care teams when needed
  • Coordinate with the medical director, special investigations, customer service, PASS, network management, marketing, case management, medical review, legal, pricing, and database departments

Cerințe

  • Bachelor’s degree required; one year of business, law enforcement, or regulatory agency experience may substitute for each year of college
  • Hold a certified coding credential or obtain one within 24 months of hire
  • Bring three years of experience with claims processing operations and reporting systems, including two years auditing or developing computer system reports
  • Understand accreditation standards such as URAC and NCQA, along with health insurance legislation
  • Understand claims processes and claims processing systems
  • Demonstrate PC proficiency with Microsoft Word, Excel, and health insurance databases
  • Communicate effectively in writing and verbally with physicians, members, and providers, and prepare and explain documented findings
  • Demonstrate strong organization and prioritization skills
  • Current AAPC Medical Coding Certification is preferred
  • Work remotely within the continental United States, excluding California, New York, Alaska, and Hawaii

Beneficii

  • Annual incentive bonus plan
  • Health and wellness benefits
  • 401(k) savings plan
  • Pension plan
  • Paid time off
  • Paid parental leave
  • Disability insurance
  • Supplemental life insurance
  • Employee assistance program
  • Paid holidays
  • Tuition reimbursement
  • Additional incentive programs
  • Professional development opportunities
  • Remote work arrangement

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