Health Claims Auditing in Chicago, IL at CRS Group

Date Posted: 1/13/2020

Job Snapshot

Job Description


Overview: The CRS Group is currently looking for a Health Claims Auditing consultant for one of our clients in the Chicagoland area. The CRS Group is a nationwide Staffing Firm who works primarily with Fortune 500 and Fortune 1000 corporations.


Duration: 6+ month contract (contract to hire)


Location: Chicago, IL 60601
 
Responsibilities:
  • Tests on-going edit changes for the company and Pearl Plans (4,000,000+ edits); includes development of Blue Chip/ITG Test Plan.
  • Researches internal code auditing inquiries from a variety of areas including FSUs, MRUs, PTC, and Plan Network Management/Staff.
  • Researches external code auditing inquiries from Providers
  • Documents Plan decisions and customization to support internal audit review and internal/external inquiries.
  • Participates in the development and cross-divisional implementation of new code auditing logic for Plans.
  • Prepares code auditing informational materials for internal areas (FSUs, MRUs, PTC, and PASS)

Qualifications:
  • Associate’s degree, Bachelor’s Degree preferred
  • 2 years’ experience in the health care industry.
  • HIM certification, RHIT, RHIA, CCS, CCS-P, CPC, CPC-P.
  • Experience working with professional coding structures and claims auditing logic. 
  • Knowledge of medical practice patterns, professional coding and payment structures.
  • Clear and concise interpersonal, verbal and written communication skills.
  • Analytical and quantitative skills.

 
crs_scapozzi
ss # 85908
 
Qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or genetic information.