Job Details

A company is looking for a Payment Integrity Professional to ensure accuracy and compliance in healthcare payments.Key ResponsibilitiesIncrease accuracy of provider contract payments and ensure correct claims processingSupport investigations related to fraud, waste, abuse, and financial recovery effortsReview and analyze Medicare appeal cases, ensuring compliance with guidelinesRequired QualificationsAAPC Coding Certification - CPCMinimum 2 years of post-certification experience with Medicare claimsStrong understanding of CMS guidelines and coding initiativesProficiency in Microsoft Word and ExcelExperience with Medicare Appeals and reading medical claims