You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a highly skilled CPC Coder responsible for reviewing medical bills and documentation to ensure accuracy and compliance with coding standards. This position involves interpreting medical documentation, assigning codes, reviewing billed services, and communicating outcomes professionally.

Key Responsibilities

• Use various resources like CPT guidelines, CPT Assistant, Encoder Pro, and 3M Software to support reviews.
• Review medical bills related to Motor Vehicle Accident (MVA) injuries for NJ and NY-covered insureds.
• Ensure the accuracy of billed services by interpreting medical documentation and assigning the proper CPT and HCPCs codes.
• Review CPT codes for unbundled services and billed modifiers for accuracy.
• Crosswalk CPT codes per regulatory requirements for proper reimbursement.
• Apply fee schedule guidelines in daily reviews and document review outcomes clearly for customers.
• Participate in conference calls, virtual, and in-person testimonies, or trials when needed, and assist with special projects as assigned.

Qualifications

• PIP experience with a high level of understanding of fee schedule guidelines in NY, NJ, FL, or MI.
• Must have active CPC certification through AAPC; consideration may be given to candidates with strong PIP experience, such as NJ/NY PIP adjuster.

Experience

• 3-5 years of experience conducting code reviews, specifically with NJ/NY PIP fee schedules.
• Extensive knowledge of coding/documentation requirements and CPT, HCPCs, ICD-10.

Skills

• Attention to detail and ability to quickly identify errors in written reports and legal documentation.
• Strong communication skills for explaining review outcomes, both in writing and verbally.

Additional Requirements

• Schedule: M-F 8am-4:30pm

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

^*As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients