Smithfield, RI30+ days ago
Qualifications: Required: • Registered Nurse with an active, current, unrestricted license in RI in good standing • Minimum of three (3) years experience in healthcare coding directly related to determining appropriate diagnosis, procedure and other codes used in billing for services, utilization management, medical record auditing, or health care quality improvement • Knowledge of clinical medical record documentation requirements • A high-level knowledge of medical terminology • Proficient with various technology software tools, including Microsoft Office • Excellent written and verbal communication skills, and strong attention to detail • Ability to maintain confidentiality • Ability to take direction and support a multitude of individuals • Ability to work independently and prioritize activities. Preferred: • Working knowledge of fraud, waste and abuse policies and practices • Evaluation and management coding and auditing expertise • Knowledge of Behavioral Health billing & coding guidelines and/or regulatory guidelines • Electronic medical record review experience • Electronic investigative case management and/or healthcare claims data mining tool experience.