[Hiring] Certified Professional Coder/ PIP Adjuster @MEDLOGIX, LLC

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 (e.g., 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 (e.g., 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.