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Claims Compliance Remediation Analyst
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$81,000 - $91,000 a year
Full-time
- MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
- As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health 's network includes over 27,000 primary care providers, specialists and participating clinics.
- The Claims Compliance Remediation Analyst will support the Director of Claims Support to ensure claims rules, guidelines, documents, policies and procedures, reporting, job aides, training, and other key components are compliant with CMS and NYSDOH regulatory entities and maintained within a central repository.
- 1+ year of medical coding experience, with demonstrated knowledge in sustained coding quality
- Strong familiarity with CMS and NYS audit protocol
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