[Hiring] Certified Professional Coder/ PIP Adjuster @EDI Staffing

Role Description

• Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds
• Interpret medical documentation to ensure accuracy of billed services (i.e., CPT, HCPCs codes)
• Assign proper CPT, HCPCs codes based on the review outcome
• Review CPT codes for unbundled services
• Review billed modifiers for accuracy of use
• Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement
• Interpret fee schedule guidelines and apply those guidelines in daily reviews
• Document review outcomes for customers in a professional, easy-to-understand manner
• Use various resources (i.e., eBooks, 3M software) to support reviews
• Participate in conference calls as needed with customers and/or attorneys
• Participate in virtual and in-person testimony or trial when needed
• Assist with various special projects and other duties as assigned

Qualifications

• 3-5 years experience conducting code reviews; specifically NJ / NY PIP fee schedules
• Strong communication skills, must be able to explain the outcome of the review, both written and verbally
• Extensive knowledge of coding/documentation requirements
• Thorough knowledge of CPT, HCPCs, ICD-10
• Must have active CPC certification through AAPC
• Ability to multi-task
• Ability to meet critical timelines
• Willingness to testify on a needed basis on behalf of customer to coding outcomes
• Willingness to travel for testimony as required
• Computer experience
• Excel experience beyond beginner
• Independent worker
• Ability to manage time when working remotely
• Must be able to travel to Hamilton NJ office as needed
• Ability to effectively communicate with the team

Requirements

• Certified coder from AAPC

Benefits

• Salary range: $65,000 - $70,000