Dane Street, LLC
Finance / FinServ
FreelanceMedical&BillingCoder
Neural analysis suggests this role is
optimal for Mid+ candidates.
“Freelance Medical & Billing Coder at Dane Street, LLC. Skills: Medical billing, Coding, Bill review, Payment integrity. Evaluate the appropriateness of codes. Determine whether codes meet all established program standards”
What You'll Achieve.
Ensure clarity of information; Ensure all questions posed have been addressed; Ensure that reports are returned within client deadlines; Provide complete, timely, and error-free quality assurance of cases
Industry & Context.
What They're Looking For.
Must Have
CPC, APCC, CMBS, or DRG coder certification
Nice to Have
Payment integrity or professional bill review experience, Out-of-network bill review experience, Experience working in a remote environment, Experience in a medical office or health care background
What You'll Do.
Evaluate the appropriateness of codes
Determine whether codes meet all established program standards
Ensure medical records are matched appropriately to codes
Read and apply policy guidelines and healthcare terminology
Evaluate claims for conflict of interest and criteria appropriateness
Work within established timeframes
Provide quality assurance of cases
Provide clinical oversight to complex cases
Serve as an additional level of QA and clinical knowledge/review for cases with quality issues
How You'll Work.
Team & Collaboration
Communicate with other reviewers and their office teams
Communication Scope
Excellent written and verbal communication skills
Full Job Description
Calling all bill review professionals, CPC coders, AAPC, and DRG coders! Dane Street is looking for highly motivated Coders, bill reviewers, and payment integrity reviewers candidates to join our team. Dane Street offers an exciting work environment, competitive compensation, and strong growth potential. Job Summary: A new program offering on the group health side of our business enables you to apply your clinical knowledge to review reports accompanying medical records to ensure that medical billing information and coding are correct. You will communicate with other reviewers and their office teams to ensure clarity of information and ensure all questions posed have been addressed, and ensure that reports are returned within client deadlines. Core Duties & Responsibilities: * Evaluates the appropriateness of codes and determine whether they meet all established program standards. * Ensures that the medical records are matched appropriately to the codes and if not, obtains them. * Read & apply policy guidelines and healthcare terminology and delineate when criteria are/are not met. * Evaluates claims for conflict of interest and criteria appropriateness. * Works within established timeframes set by program parameters. * Provides strong customer service skills and works closely with clients on a case- by-case basis to provide complete, timely, and error-free quality assurance of cases. * Provides clinical oversight to cases that are complex and need additional review prior to return to the client. * Serves as an additional level of QA and clinical knowledge/review for cases with quality Issues. **Requirements** Required Education & Experience: ● Must have a CPC, APCC, CMBS, or DRG coder certification ● Payment integrity or professional bill review experience is strongly preferred. ● Out-of-network bill review experience is a plus. ● Experience working in a remote environment is preferred. ● Experience in a medical office or health care background. Required Skills: ●
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