PacificSource
Bend, OR, USA
Are you ready to make a difference in the healthcare industry? Join PacificSource and play a vital role in helping our members access quality, affordable care! As an equal opportunity employer, PacificSource is committed to diversity and inclusivity in our hiring practices. All qualified candidates will be considered without regard to any protected status. The Medical Coding Auditor Specialist will engage with complex claims by utilizing advanced adjudication skills, and providing clinical interpretation to resolve grievances and appeals. You'll work collaboratively to refine our claims research policies with an emphasis on process improvement. Your expertise will be crucial in identifying potential fraud and managing erroneous payment recoveries. Key Responsibilities: Engage in the provider and member appeals process, addressing intricate claim issues with advanced adjudication expertise. Offer guidance on claims requiring in-depth research, conducting clinical...