Healthcare Services Segment Specialist (RAC)

Knowledge, Skills and Abilities Needed: Demonstrates expertise (depth and breadth) of knowledge of payment integrity elements. Examples include: ​ICD-10-CM, ICD-10-PCS, CPT, HCPCS, or HIPPS coding and MS-DRG, APR-DRG, APC, APG, PDPM, or PDGM payment methodologies Strong people skills: ability to communicate with all levels within the organization, with diverse teams as well with external customers. Exceptional written and verbal communication skills. Strong attention to detail. Excellent critical thinking and analytical skills. Time management skills for managing multiple tasks simultaneously, while completing work within allocated time frames. Ability to work independently and in a remote environment. Strong Microsoft suite skills, such as – Excel, Word, Outlook and SharePoint. Required and Preferred Qualifications: Minimum 8+ years of progressive experience in healthcare claim type subject matter specialty specific to the position. Bachelor's degree in related field or equivalent experience Registered Nurse or Certified Coder holding nationally recognized credentials (RHIA, RHIT, AHIMA, AAPC, etc.) required A broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement policies, medical necessity criteria and coding terminology. Progressive health care data analysis experience including gathering and documenting requirements for projects of diverse sizes. 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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