What are the responsibilities and job description for the Coding and Reimbursement Specialist position at NJM Insurance Group?
NJM Insurance Group has an opening for a Coding & Reimbursement Specialist in its Medical Claim Services Department. The location for this position will be based in West Trenton. The department is seeking an individual that can be a team player while accurately and efficiently auditing medical bills by applying the correct medical, coding, and regulatory guidelines.
Job Responsibilities :
- Accurately and clearly apply regulatory, coding, and medical guidelines, as well as company policies and procedures to audited bills.
- Bill negotiation.
- Provide concise and clear instructions for bill processing. For those procedures requiring audit reports, cite relevant resources, when appropriate.
- Conduct ongoing review and / or audit of bills as needed for appeals, demands for arbitration, and suit. Provide concise and clear audit reports, including rationale for denials and / or reductions, citing relevant resources and supplying supporting documentation, when necessary.
- Keep abreast of industry trends and requirements that impact the auditing process. Research new procedures and technology and provide feedback to team and management on implications.
- Recommend value-add strategies for addressing new trends and services.
- Report on tasks, audit volume, output, savings, etc., as needed and required by supervisor and / or management.
- Complete continuing education credits needed to maintain certification(s).
Required Qualifications and Experience :
Preferred Experience :
Legal Disclaimer : NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.
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