MedReview Inc.
New York, NY
Outpatient Payment Integrity Production Coder MedReview is looking for an Outpatient Payment Integrity Production Coder. The Outpatient Payment Integrity Production Coder is responsible for completing claim-level outpatient coding reviews to identify inaccurate coding, unsupported billing, documentation gaps, and potential overpayments. This role supports payment integrity operations by applying outpatient coding expertise, client payer policy, CMS guidance, CPT/HCPCS requirements, modifier rules, NCCI edits, and medical record documentation standards to ensure audit findings are accurate, defensible, and client savings consistently recovered. Key Responsibilities Perform outpatient coding reviews using medical records, itemized bills, claim lines, payer requirements, CPT/HCPCS guidance, ICD-10-CM guidelines, revenue codes, modifier rules, NCCI edits, APC/EAPG logic, and supporting documentation. Validate whether billed outpatient services are supported by documentation and...