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 Payment Integrity Analyst to conduct thorough reviews, analyses, and internal audits or appeals. The role involves applying client policies and CMS guidelines with acute precision and conducting timely audits while maintaining excellent written communication skills.
Key Responsibilities
- Conduct reviews, analyses, and internal audits or appeals following client policy and CMS guidelines.
- Apply clinical judgment to interpret and apply client policies and CMS guidelines in various audits.
- Utilize applicable tools to execute internal audits or appeals.
- Ensure timely completion of all audit and appeal tasks.
- Participate in clinical team meetings, company meetings, and training sessions.
- Perform additional duties as assigned.
Qualifications
- Valid RN license in the residing state.
- Inpatient Coding Certification preferred (CCS/CIC). RHIT/RHIA accepted.
- Experience in acute clinical areas such as O.R., I.C.U., C.C.U., E.R., Telemetry, Medical/Surgical, OB or L&D, Geriatrics, and Orthopedics.
- Preferred experience with health insurance denials, appeals, payer audits, or vendor audits.
Skills
- Proficiency in reviewing codes and making necessary coding changes.
- Strong written communication skills.
- Ability to work independently in a remote setting.
Schedule/Shift
M-F 8am-5pm CST
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.
Required Employment / Compliance Language
Medix is an equal opportunity employer. Candidates with legal rights to work in the United States are encouraged to apply.
*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.
Any required state or Joint Commission training is compensated at the state or local minimum wage rate.
*As a job position within our Revenue Cycle 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 financial and confidential information, handling financial and other payment data, 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.
