Assistant Manager – High Cost Drug Auditor II
Job Description:
- Apply expert knowledge of billing HCD claims to perform extensive audit reviews.
- Utilize HCPCS codes, medical record review, and industry tools in the audit process.
- Write professional communications documenting audit findings and supporting rationales.
- Identify audit trends and opportunities.
Requirements:
- Three or more years' experience in claims processing or HCD medical billing experience with expert knowledge HCPCS codes.
- Experience reading and interpreting contract language and fee schedules and medical record review.
- Intermediate skills in Word and basic computer literacy.
- Intermediate skills in Excel including comfort working with charts, graphs, and percentages.
- Basic math skills with ability to do conversion calculations.
- High school diploma obtained
- Certified Pharmacy Technician or one or more of the following credentials: RHIA or CPC; preference given to those with multiple credentials.
- Expert in HCPCS codes with advanced knowledge of medical terminology.
- Experience with encoder tools and industry systems (FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat, Pricers).
Benefits:
- For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits
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