Healthcare Services Specialist (RN / Coder)

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