J29, Inc. is an employee-centered healthcare management consulting company supporting commercial, State, and Federal health and human service programs. The team focuses on processing, review, and analysis of medical claims, records, data, and audits with expertise in compliance, policy, and clinical review.
RVC Reviewers perform automated and complex reviews of Medicare Fee-for-Service claims, including Part A/B, DMEPOS, and Home Health/Hospice, to assess overpayments, underpayments, and proper payments as determined by Recovery Audit Contractors. They apply Medicare policies and guidelines, evaluate claims according to National and Local Coverage Determinations and CMS rules, and document clear, accurate findings for each claim.
Reviewers also participate in dispute resolution, provide supporting documentation, support quality assurance through audits and ongoing training, maintain CMS security and privacy compliance, and collaborate with key personnel to improve consistency and accuracy in review activities.
- Experience with inpatient coding and DRG validation, including accuracy review, compliance monitoring, and reimbursement optimization.
- 5+ years of direct medical coding or medical billing experience in a healthcare environment.
- 3+ years working in a productivity-based claims or case working environment within a queued case management system.
- 3+ years working remotely with various technology systems.
- Preferred: 3+ years of Medicare Fee-for-Service experience in a medical coding role or program.
- Preferred: Experience with low-code or no-code case management systems as an end user.
- Certification from an accredited association such as AAPC or AHIMA.
- RHIA or RHIT credentials accepted.
- Active medical coder certification required.
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Location
N/A
Employment Type
Full-time
Experience Level
Senior
Salary Range
$50,000 - $68,000
Remote work allowed
Yes
Posted
2 weeks ago