HCSC is seeking a claims auditing professional to review clinical, billing, coding, and cost-setting reviews pre- and post-payment. You will research findings, document them thoroughly, and consult with special investigations and affordability teams as needed.
The role requires in-depth knowledge of claims processes, URAC/NCQA standards, and strong communication with physicians and providers. A Bachelor's degree and coding certification (or plan to obtain) are required, with remote-friendly
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