Elap Services
  • Chesterbrook, PA, USA
  • Full Time

ELAP provides a comprehensive, reference based pricing solution that helps self-funded employers across the US significantly reduce their healthcare costs. 

With double digit incremental growth,  we are guided by an entrepreneurial culture that rewards innovation and teamwork. We foster the free flow of ideas and value initiative, trust, creativity and passion - qualities we consider essential to our success. There are many reasons why it's good to be an ELAP employee; and one of them is our generous, 100% paid (for employees / 60% for dependents) comprehensive benefits program that helps you and your family stay healthy, feel safe and maintain balance work / life. Another is our exceptional 401K match, in which you are vested 100% immediately. To learn more, apply today!

ELAP's Values

  • We level the playing field
  • We Passionately Challenge the Status Quo
  • We Innovate
  • We Advocate
  • We Empower Clients and Families
  • We are Accountable

Job Summary

The Auditor is responsible for auditing medical facilities and professional claims for accuracy and compliance with industry laws and contractual language in behalf of our clients. Candidate must possess a strong understanding of Medicare and Medicare guidelines. Must display a high degree of independent judgement and professional skepticism that enhances the work performed in order to achieve success in this position.  This is a WORK FROM HOME position.

Summary of Essential Job Functions

  • Review medical facility and professional claims for accuracy and apply standard coding rules, guidelines and conventions
  • Enter billing information into the appropriate report format for the client requesting the work
  • Review contracts and is able to apply contractual adjustments to the medical charges
  • Audit charges for CPT coding and compliance with state and federal regulations
  • Process and Access coding patterns and be able to identify signs of fraud and abuse
  • Review medical records to verify accurate coding
  • Ensure accuracy of work product
  • Proficient in meeting quality and quantity standards
  • Able to learn and properly utilize proprietary software programs essential to support the job function.
  • Adhere to HIPAA guidelines and regulations

Education and Experience

  • Minimum 2 years Claims Coding or Medical Billing experience
  • Knowledge and understanding of CMS-1500 and UB-04 Medical Claim Forms
  • Medicare Reimbursement / Denial experience preferred
  • AAPC/AHIMA Certification and ICD-10 Proficient is required
  • Prior experience in the Self-Funded Industry is desired

Summary of Essential Job Requirements

  • Communication (written, verbal and listening), interpersonal and analytic skills
  • Ability to use software related to job responsibilities including MS Office with proficiency in Excel and Outlook
  • Ability to be detail oriented
  • Ability to maintain a grasp on business and departmental process rules
  • Ability to produce quality work while meeting production goals
  • Ability to work well in an individual and team environment
Elap Services
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