Payment Integrity Specialist-w2 Only
Terms of Employment
• Contract, Six Months (Possible Extension)
• This position is 100% remote. Candidates must be based in EST or CST and must be comfortable working EST-hours. Candidates based in Washington, DC, Maryland, or Virginia are preferred, but not required.
Overview & Responsibilities
Work with a leading healthcare payer within their Payment Integrity division. Unlike traditional enrollment roles, this position focuses on the analytical side of healthcare finance. You will be responsible for reviewing medical correspondences, analyzing itemized bills, and determining if additional documentation provided by healthcare providers warrants a change in claim payment. This is a non-phone, research-heavy role perfect for someone with a strong background in claims, medical coding, or payment integrity systems. You will…
• Analyze medical record documentation and correspondences to understand routing requirements.
• Utilize systems such as Facets, NASCO, and Conduit (SIR) to look up member information and claim details.
• Update and maintain detailed spreadsheets in Excel with notes regarding received documentation.
• Review ICD-10 and CPT codes to identify denial reasons and coordinate with vendors for final claim review.
• Route itemized bills and medical records to the appropriate internal parties for payment integrity review.
Required Qualifications
• High School Diploma or GED and 3+ years of experience in healthcare claims, medical billing, or member services.
• Strong proficiency in Microsoft Excel.
• Experience with the Facets.
• Prior experience analyzing medical records and possess an understanding of basic ICD-10 and CPT coding.
• Exceptional attention to detail for data entry and record-keeping.
Preferred Qualifications
• Previous experience in a Payment Integrity or Appeals unit.
• Familiarity with NASCO or Conduit (SIR) systems.
Benefits Information
• Medical Insurance; Vision Insurance; Dental Insurance
• 401K Retirement Plan (Discretionary Match Offered)
• Ancillary Coverage (Life, AD&D, Short Term / Long Term Disability)
• Employee Referral Bonus
• Bi-Weekly Direct Deposit
• Note: As a contingent worker with nTech, you'll be paid for all approved hours worked; paid time off and paid holidays are not provided.
nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.
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• Contract, Six Months (Possible Extension)
• This position is 100% remote. Candidates must be based in EST or CST and must be comfortable working EST-hours. Candidates based in Washington, DC, Maryland, or Virginia are preferred, but not required.
Overview & Responsibilities
Work with a leading healthcare payer within their Payment Integrity division. Unlike traditional enrollment roles, this position focuses on the analytical side of healthcare finance. You will be responsible for reviewing medical correspondences, analyzing itemized bills, and determining if additional documentation provided by healthcare providers warrants a change in claim payment. This is a non-phone, research-heavy role perfect for someone with a strong background in claims, medical coding, or payment integrity systems. You will…
• Analyze medical record documentation and correspondences to understand routing requirements.
• Utilize systems such as Facets, NASCO, and Conduit (SIR) to look up member information and claim details.
• Update and maintain detailed spreadsheets in Excel with notes regarding received documentation.
• Review ICD-10 and CPT codes to identify denial reasons and coordinate with vendors for final claim review.
• Route itemized bills and medical records to the appropriate internal parties for payment integrity review.
Required Qualifications
• High School Diploma or GED and 3+ years of experience in healthcare claims, medical billing, or member services.
• Strong proficiency in Microsoft Excel.
• Experience with the Facets.
• Prior experience analyzing medical records and possess an understanding of basic ICD-10 and CPT coding.
• Exceptional attention to detail for data entry and record-keeping.
Preferred Qualifications
• Previous experience in a Payment Integrity or Appeals unit.
• Familiarity with NASCO or Conduit (SIR) systems.
Benefits Information
• Medical Insurance; Vision Insurance; Dental Insurance
• 401K Retirement Plan (Discretionary Match Offered)
• Ancillary Coverage (Life, AD&D, Short Term / Long Term Disability)
• Employee Referral Bonus
• Bi-Weekly Direct Deposit
• Note: As a contingent worker with nTech, you'll be paid for all approved hours worked; paid time off and paid holidays are not provided.
nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.
Apply tot his job
Apply To this Job