Claim Review Specialist (CCS, COC, CPC) - Riverside California

Company: VirtualVocations
Location: Riverside, California
Posted On: 02/06/2025

A company is looking for a Claim Review Specialist (CCS, COC, CPC required).



Key Responsibilities

Assist in preparing claim audits and reviewing coding changes on outpatient and Profee claims
Audit medical record entries and coding accuracy, providing recommendations for documentation improvement
Develop standardized reports and participate in client presentations and education


Required Qualifications

5+ years of claims auditing/review experience
CCS, COC, or CPC certification required
Experience with outpatient and Profee coding, including infusion/injection coding
Proficient with Microsoft Office and various EMR systems
Strong understanding of CMS guidelines and Medicare claims processing More...

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