Team8 Bluespine-Payment Accuracy Concept Lead AI-Driven 

United States, Oregon 

936678885

Responsibilities

• Leverages the Bluespine platform to develop and refine new audit concepts in healthcare. Leads concept creation across multiple audit verticals.
• Works closely with Medical Coders, Data Sciences, and Engineering teams to ensure alignment and drive impactful results
• Lead in-depth research of new ideas and concepts

• Extensive knowledge of medical terminology, medical records, health information management, medical coding, DRG methodologies, CPT/HCPCS coding guidelines, physician specialty guidelines, reimbursement programs, claims adjudication processes, member contract benefits, and provider billing systems and practices.
• Previous auditing or consulting experience in a provider or payer environment is preferred

Advantages

• Registered Nurse required; Bachelor’s or Graduate degree
• Previous auditing or consulting experience with self-insured companies