Get Hired Faster With COMPANY_NAME!
Don't you ever think you landed here by any accident, You are here because you are searching for something bigger. You know what?
- A better Job
- A better Future
- A better Knowledge
- A better Paycheck
- A greater Path to walk on.
And COMPANY_NAME is here to give you exactly what you've been missing for so long. The reality is that most job seekers chase job postings, but successful job seekers attract job offers by chasing the accurate information. Therefore, that's the shift COMPANY_NAME is going to help you make. Here are the top 10 ideas to up-skill yourself, so lean in to begin:
1: COMPANY_NAME Smart Tools and Direct Employer Connections Help Speed Up Your Hiring Process
COMPANY_NAME is a career-changing advantage that most seekers never get access to. Imagine...
- Instead of applying for job after job and still not getting any callbacks, you suddenly bump into a tool that can do the heavy lifting for you.
- Instead of wondering, "What do employers actually want?", you are getting insights straight from the employer's desk.
- Instead of hoping your resume gets noticed, it’s kept on the table of decision-makers who are hiring right now.
That's the difference COMPANY_NAME makes. Our tools will let you reach employers directly, which automatically speeds up your hiring process.
2: With Better Matches, Real-time Job Alerts, and Direct Employer Responses, COMPANY_NAME Helps Many Candidates Secure Interviews and Job Offers Within 15 to 30 Days!
How does COMPANY_NAME make this possible?
On COMPANY_NAME, you get notified for roles aligned with your profile right from the start. When an employer posts a role that matches your qualifications and skills, you’ll know first. When you apply early, your chances of getting noticed and shortlisted increase by 20%.
COMPANY_NAME also offers direct employer responses—no more waiting for weeks. Here you engage with hiring managers who are actively looking for candidates.
When all these features combine in one place, you move from your first match to your first interview within days. And ultimately, from application to offer—all within 15 to 30 days!
3: The Type of Resume You Need to Get Priority Placement
With COMPANY_NAME, you don’t just need a resume—you need a strategy. A system that pushes your name to the right tables. We’ll show you exactly how the most successful candidates take initiative and get noticed.
4: Browse Full-Time, Part-Time, and Freelancing Roles With COMPANY_NAME
The job market isn’t one-size-fits-all—and your career shouldn’t be either. COMPANY_NAME gives you access to a wide range of opportunities including full-time, part-time, and freelancing roles all in one place.
5: COMPANY_NAME Helps You Grow Your Career
COMPANY_NAME provides insights, tools, and role-matching that help you find the right direction, the right skills, and the opportunities aligned with your ambition.
6: The Easiest Way To Find A Job
COMPANY_NAME cuts the noise, the endless scrolling, and the confusion. With accurate matches, direct employer connection, and real-time updates, you get a clear and simple path from application to interview.
7: Find Roles That Offer Growth, Culture & Benefits
COMPANY_NAME helps you find roles where you grow, feel supported, and thrive—not just survive. With us, you discover opportunities that elevate your professional life.
8: Get Support With Resume, Interviews & Career Planning
COMPANY_NAME provides expert guidance on resumes, interviews, and planning so employers instantly recognize your strengths and value.
9: Your Future Starts Today
COMPANY_NAME gives you everything you need—tools, guidance, and opportunities—to step forward confidently and begin a new chapter where your potential is seen and supported.
10: Get Hired Within 15 to 30 Days With COMPANY_NAME
COMPANY_NAME follows a smart, strategic, and proven approach that gets your profile noticed faster and moves you toward interviews and offers within 15 to 30 days.
[Hiring] Program Integrity Medical Coding Reviewer II @CareSource
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.
Role Description
The Program Integrity Medical Coding Reviewer II is responsible for review of vendor audit activities, pended claim work queues, medical records work queues as well as claim reviews for provider pre-payment and post-payment functions.
- Responsible for making claim payments decisions on a wide variety of claims within department standards
- Responsible for researching, analyzing, and making payment decisions on moderately complicated claims based on medical coding guidelines and policies
- Refer suspected Fraud, Waste, or Abuse to the SIU when identified in normal course of business
- Acts as a technical resource to new associates by reviewing claims, training staff, responding to claim questions
- Responsible for identifying and implementing process improvements and referring system enhancement ideas to manager
- Collaborates with internal departments to facilitate claim processing and to come to appropriate claim resolutions
- Responds to claim questions and concerns
- Prepares claims for Medical Director review by completing required documentation and ensuring all pertinent medical information is attached as needed
- Ensure adherence to all company and departmental policies and standards for timeliness of review and release of claims
- Responsible for identifying systemic claim problems/concerns and reporting them to management
- Responsible for supporting provider pre-pay and post-pay teams with coding reviews and clinical documentation reviews
- Provide support for provider appeals to denied claims
- Perform any other job related instructions as requested
Qualifications
- Associate’s degree or equivalent years of relevant work experience is required
- Minimum of three (3) years of medical bill coding is required
- Medicaid/Medicare experience is preferred
- Clinical background with a firm understanding of claims payment is preferred
- Experience with reimbursement methodology (APC, DRG, OPPS) is preferred
Requirements
- Knowledge of diagnosis codes and CPT coding guidelines; medical terminology; anatomy and physiology; and Medicaid/Medicare reimbursement guidelines
- Proficient in Microsoft Office Suite
- Possess a general knowledge and healthcare claim payment processing
- Knowledge of Facets
- Healthcare claim system configuration knowledge or experience is preferred
- Experience reviewing medical records for the purpose of determining proper medical coding
- Firm understanding of basic medical billing process
- Excellent written and verbal communication skills
- Ability to work independently and within a team environment
- Effective problem solving skills with attention to detail
- Knowledge of Medicaid/Medicare and familiarity of healthcare industry
- Effective listening and critical thinking skills
- Ability to develop, prioritize and accomplish goals
- Strong interpersonal skills and high level of professionalism
Licensure and Certification
- Certified Medical Coder (CPC, RHIT or RHIA) is required at time of hire
Working Conditions
- General office environment; may be required to sit or stand for extended periods of time
Compensation Range
$54,500.00 - $87,300.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level.
In addition to base compensation, you may qualify for a bonus tied to company and individual performance.
We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type
Salary
Organization Level Competencies
- Fostering a Collaborative Workplace Culture
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Influence Others
- Pursue Personal Excellence
- Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
