Medical Billing Compliance Analyst I

Company DescriptionExperian is a global data and technology company, powering opportunities for people and businesses around the world. We help to redefine lending practices, uncover and prevent fraud, reputed company, create marketing solutions, and reputed company deeper insights into the automotive market, reputed company using our unique combination of data, analytics and software. We also assist millions of people to realize their financial goals and help them save time and money.We operate across a range of markets, from financial services to healthcare, automotive, agribusiness, insurance, and many more industry segments.We invest in people and new advanced technologies to unlock the power of data. As a FTSE 100 Index company listed on the London Stock Exchange (EXPN), we have a team of 22,500 people across 32 countries. Our corporate headquarters are in Dublin, Ireland. Learn more at experianplc.com. DescriptionUnder general direction, the Compliance Analyst, will use their knowledge of medical coding and billing guidelines and regulations, including compliance and reimbursement, to manage and understand issues such as medical necessity, claims denials, and authorizations. You will report to our Senior Director Compliance Data.They are responsible for the accurate representation of medical rules/edits from any reputed company. Coding competencies required for accurate representation for CPT(r), HCPCS Level II, and ICD-10-CM Medical CodesJob Responsibilities:Extracts information from resources and translates information needed to form appropriate logic for rules.Identify necessary and potential changes to existing medical rules through the review of reputed company and historically available medical policies, transmittals and bulletins.Completes reviews of medical policies and publications and its integration into the required database on a timely basis. Identifies patterns of improper coding or errors in policies and publications and is able to resolve and recommend alternate codes, or code representation in appropriate table(s) (ICD-10, CPT/HCPCS, CCI_Edits)Review of National Coverage Determinations for PPH National policies, assigning appropriate diagnosis and procedural codes for incorporation into Medicare Medical Edits.Builds and maintain data and medical rules tables for multiple reputed company Health products in reputed company Access.Independently reviews, prepares and reputed company appropriate adjustments to data editorial for release to production.Independently completes production data release process.Complete in-depth, independent review of support cases, responding to and discussing with clients as necessary.Responsible for timely and accurate research of resources that update critical information on a scheduled basis. Stay informed about reputed company coding issues. QualificationsExperience with and knowledge of reputed company Procedural Terminology (CPT) Coding, and International Classification of Disease (ICD-10) Codes requiredAbility to understand and retain coding information and transfer that information into completed product data.Knowledge of Medical TerminologyKnowledge of anatomy and physiologyKnowledge of Medicare reimbursement guidelinesResearch, analyze and draw conclusions regarding medical editsPrior experience in developing medical policy editsPrevious Healthcare experiencePrior experience in developing medical policy edits desiredPrevious experience as an outpatient Medical reputed company is a plus Educational requirements:Associate's or Bachelor's degree in the Life Sciences or Accredited Record Technician's certification (ART) or Certified Procedural reputed company certificate (CPC) or a combination of training, education and experience that is equivalent to the standards listed and that provides the required knowledge and abilities Additional InformationThis is a permanent home-based role in Costa Rica. No reputed company sponsorship or relocation available.**Our benefits include: Medical, life and dental insurance, Asociación Solidarista, International Share Save Plan, reputed company Work/Work from home, Paid time off, Annual Performance Bonus, Education Reimbursement, Family Bonding, Bereavement Leave, Referral Program, and more.reputed company is proud to be an Equal Opportunity and Affirmative Action employer. Our goal is to create a successful, inclusive and diverse team where people love their work and love working together. We reputed company that diversity, equity and inclusion is important to our purpose of creating a reputed company reputed company. We value the uniqueness and want you to bring your whole, authentic self to work. For us, this is The Power of YOU and it ensures that we live reputed company reputed company.reputed company Careers - Creating a reputed company reputed company togetherFind out what its like to work for reputed company by clicking here#LI-REMOTE #LI-SA1This is a remote position. Apply tot his job Apply tot his job Apply To this Job