The Medical Claims Coding Auditor and Itemized Bill Reviewer is responsible for auditing medical claims and itemized bills to ensure accuracy, compliance, and cost-effectiveness. The role supports cost containment efforts by validating coding accuracy, identifying billing discrepancies, and reviewing complex or high-dollar claims.
The position also helps maintain compliance with payer policies, CMS guidelines, and healthcare regulations while contributing to internal quality assurance and training efforts.
Requirements & Qualifications
- High school diploma required
- Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or equivalent required
- 1–3 years of health plan experience
- 1+ years of medical claims auditing, coding, or billing experience
- Familiarity with payer policies, CMS regulations, and medical necessity guidelines
- Strong analytical, organizational, and communication skills
- Proficiency with claims systems, EMRs, and Microsoft Office Suite
- Strong problem-solving and critical thinking skills
- Ability to work independently in a deadline-driven environment
Benefits & Perks
- Full-time benefits package
- Medical, dental, vision, and prescription insurance
- Disability, life, and AD&D insurance
- HSA and FSA pre-tax programs
- 401(k) retirement plan with company match
- Paid time off, holidays, personal day, and volunteer day
- Wellness incentive and wellness reimbursement
- Remote work reimbursement and continuing education reimbursement
- Discount program
- Parental leave
- Annual charitable giving match
Location
Washington, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
2 weeks ago