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Assistant Manager – High Cost Drug Auditor II

Remote role Full-time Open position

Job Description:

  • Apply expert knowledge of billing HCD claims to perform extensive audit reviews.
  • Utilize HCPCS codes, medical record review, and industry tools in the audit process.
  • Write professional communications documenting audit findings and supporting rationales.
  • Identify audit trends and opportunities.

Requirements:

  • Three or more years' experience in claims processing or HCD medical billing experience with expert knowledge HCPCS codes.
  • Experience reading and interpreting contract language and fee schedules and medical record review.
  • Intermediate skills in Word and basic computer literacy.
  • Intermediate skills in Excel including comfort working with charts, graphs, and percentages.
  • Basic math skills with ability to do conversion calculations.
  • High school diploma obtained
  • Certified Pharmacy Technician or one or more of the following credentials: RHIA or CPC; preference given to those with multiple credentials.
  • Expert in HCPCS codes with advanced knowledge of medical terminology.
  • Experience with encoder tools and industry systems (FACETS, NASCO, Encoder Pro, TrueCode, 3M, Webstrat, Pricers).

Benefits:

  • For more information on benefits and what we offer please visit us at https://www.exlservice.com/us-careers-and-benefits

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