Nurse - Medical Bill Reviewer

Founded in 1997, PKSI [Pegasus Knowledge Solutions, Inc.] is an independent, advanced analytics software and services organization, that partners with the industry leading providers to help customers create value from their data, bringing a range of talents, including data integration and preparation, big data environments, data mining, predictive analytics, machine learning and text mining, as well as dashboarding and visualization. PKSI is focused on quality, speed of execution, value and above all, customer satisfaction. Our global solution delivery centers are ISO 9001-2008 and ISMS 27001-2013 Certified. Leading Organizations are harnessing the power of Advanced Analytics today to address business challenges. Our Analytics solutions and services utilize statistical techniques, predictive modeling, text and social data mining to provide customer and operational insights. Our Data scientists can help you sift through customer data (including web and social data) and syndicated data sets to build statistical models to improve business outcomes, like customer and employee retention, fraud reduction, increased sales and many other areas. These models seamlessly integrate into visualization tools which can be accessed on any device to enable collaborative sharing and improved decision making. Our industry-leading technology and platform partnerships enables us to bring best-in-class solutions to you.

ob Title : Nurse - Medical Bill Reviewer Location : Remote Type : Full-time Position Summary: We are seeking a detail-oriented and knowledgeable Medical Bill Coder who can review, validate, and apply appropriate coding to medical bills in compliance with state-specific regulations and industry standards. The ideal candidate will ensure billing accuracy, improve claims efficiency, and reduce compliance risk.

Review incoming medical bills for completeness and accuracy. Assign proper CPT, ICD-10, and HCPCS codes based on medical records and documentation. Ensure coding aligns with state regulations, payer-specific rules, and client's policies. Identify and correct coding discrepancies, unbundled codes, or documentation gaps. Collaborate with billing, claims, and compliance teams to resolve coding-related issues. Stay updated with coding changes, fee schedules, and relevant state legislation. Support audits and internal reviews as needed.