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5 days ago
This Healthcare Compliance Officer role requires a skilled professional with experience in medical billing, revenue cycle management, and healthcare compliance. The ideal candidate will have a strong focus on analyzing reports to calculate accurate anesthesia units, modifier usage, Payment Posting, claim follow-up, denial management, and efficient resolution of denied claims while staying informed about new payers and policies.
Key Responsibilities:
- Must have sound knowledge of billable CPT and ICD codes for GI procedures, Anesthesia, and Pathology.
- Should be familiar with LCD and NCD policies for payers to ensure billing compliance with insurance guidelines.
- Must understand reading reports to calculate accurate anesthesia units, modifier usage for GI procedures, Anesthesia, and Pathology CPT codes.
- Ensure accurate processing of claims, including eligibility verification and benefit coordination.
- Communicate with insurance providers and patients to resolve claim-related issues.
Job Requirements:
- Minimum graduation with relevant experience in medical billing.
- Experience in GI procedures, Anesthesia, and Pathology billing, Payment Posting, Follow-up.
- Must have experience with AdvantX Practice Management solutions and Waystar Clearing House.
- Strong knowledge of insurance processes, billing guidelines, and new payer policies.
- Excellent communication, problem-solving, and organizational skills.
- Proficiency in Excel.
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