Coding & Reimbursement Specialist

Personal, compassionate service is what we're known for at NJM. We seek the best and brightest to help our customers when they need us most. As part of the NJM team, you'll not only enjoy some of the best benefits in the industry, you'll also be joining a company that's committed to professional development, diversity and innovative thinking.

West Trenton, New Jersey

NJM Insurance Group

<p><strong>Come Grow with Us!</strong></p> <p>&nbsp;</p> <p>For more than a century, our policyholders have trusted us to serve them in their times of need. For just as long, we have supported our employees by providing a competitive compensation package and opportunities for growth. If you are looking to be part of something special and make a difference each day, we invite you to come grow with us. There's never been a better time to join the NJM family.&nbsp;</p> <h3>This isn't just insurance.&nbsp;&nbsp;<strong>It's NJM</strong><strong>.<br /><br /><br /></strong>If you don't see the job you're looking for below, please click <a href=";cws=47" target="_blank" rel="noopener noreferrer">here</a> to create a search agent, or log in to check the status of your previous application.&nbsp;</h3> <h3><em><strong>&nbsp;</strong></em></h3>

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Full Time

Overview: NJM has an opening for a Coding & Reimbursement Specialist in its Medical Services – PIP Department. The PIP Department is seeking an individual that can be a team player while accurately and efficiently auditing medical bills by applying the correct medical, coding, and regulatory guidelines.
Responsibilities: <ul> <li>Accurately and clearly apply regulatory, coding, and medical guidelines, as well as company policies and procedures to audited bills.</li> <li>Bill negotiation.</li> <li>Provide concise and clear instructions for bill processing.&nbsp; For those procedures requiring audit reports, cite relevant resources, when appropriate.</li> <li>Conduct ongoing review and/or audit of bills as needed for appeals, demands for arbitration, and suit.&nbsp; Provide concise and clear audit reports, including rationale for denials and/or reductions, citing relevant resources and supplying supporting documentation, when necessary.</li> <li>Keep abreast of industry trends and requirements that impact the auditing process.&nbsp; Research new procedures and technology and provide feedback to team and management on implications.</li> <li>Recommend value-add strategies for addressing new trends and services.</li> <li>Report on tasks, audit volume, output, savings, etc., as needed and required by supervisor and/or management.</li> <li>Complete continuing education credits needed to maintain certification(s).</li> </ul>
Requirements: <ul> <li>Billing/Coding knowledge (CPT/ICD-10).</li> <li>High School Diploma/GED.</li> <li>Bachelor&rsquo;s Degree preferred.</li> <li>Knowledge of Excel, Word and Outlook.</li> <li>Strong communication and writing skills.</li> <li>Accuracy and attention to detail.</li> <li>Knowledge of Mitchell DecisionPoint and/or Guidewire Claim Center preferred.</li> <li>Certified Professional Coder (CPC) designation preferred.</li> </ul>