Healthcare Services Concept Specialist - RAC Focus (Certified Coder or RN)

Knowledge, Skills & Abilities Needed: Demonstrated knowledge of applicable Medicare and Commercial policy and claims process, and ability to research and analyze the same, to successfully perform the job. Relevant knowledge and experience with ICD-10-CM/PCS, CPT-4, and HCPCS coding. Knowledge of the national coding standards, particularly payment rules. Knowledge of Medicare and commercial claims processing systems. Ability to understand and apply complex policies, procedures, regulations, and legal statutes. Strong verbal communication and interpersonal skills; ability to communicate with all levels within the organization and with diverse teams. Excellent written communication skills; including proofing and editing. Good critical thinking, analytical, questioning, and listening skills; excellent attention to detail. Flexibility to handle non-standard situations as they arise; and adaptable to changing business needs in a fast-paced dynamic environment. Time management skills for managing multiple tasks simultaneously, while completing work within allocated time frames. Strong proficiency in Microsoft Word, Excel, SharePoint (advanced skills highly desirable), and easily learns and adapts to new applications and systems. Required & Preferred Qualifications: At least 2-4 years of audit or Payment Integrity experience. CPC, COC, RHIA, or RHIT certification and/or RN. Physical Requirements & Additional Notices: If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee’s responsibility to maintain this Internet access at their home office location. The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary. Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse. Regularly reads and comprehends information in electronic (computer) or paper form (written/printed). Regularly sit/stand 8 or more hours per day. Occasionally lift/carry/push/pull up to 10lbs. Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position: Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions. Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists. Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures. Other requirements may apply.

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