3-5 years of Health Care Quality Improvement experience in a managed care or health care services vendor relationship setting.
Bachelor's degree or equivalent experience
Certified Billing and Coder: CPC (Certified Professional Coder) and/or CCS (Certified Coder Specialist), CPMA (Certified Professional Medical Auditor)
Working knowledge of Medical Policies and medical coding.
Strong knowledge of Health Plan claims, medical billing, and medical coding
Expert proficiency in computer skills including Microsoft Office Suite products (Excel a must).
Strong understanding of health insurance claims and terminology.
Strong understanding of laboratory billing and reimbursement practices.
Clinical experience with a background of ICD-10, CPT, and HCPCS coding principles.
