NJM Insurance Group has an opening for a Coding & Reimbursement Specialist in its Medical Claim Services Department. The location for this position will be based in West Trenton. The 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. Job Responsibilities: + Accurately and clearly apply regulatory, coding, and medical guidelines, as well as company policies and procedures to audited bills. + Bill negotiation. + Provide concise and clear instructions for bill processing. For those procedures requiring audit reports, cite relevant resources, when appropriate. + Conduct ongoing review and/or audit of bills as needed for appeals, demands for arbitration, and suit. Provide concise and clear audit reports, including rationale for denials and/or reductions, citing relevant resources and supplying supporting documentation, when necessary. + Keep abreast of industry trends and requirements that impact the auditing process. Research new procedures and technology and provide feedback to team and management on implications. + Recommend value-add strategies for addressing new trends and services. + Report on tasks, audit volume, output, savings, etc., as needed and required by supervisor and/or management. + Complete continuing education credits needed to maintain certification(s). Required Qualifications and Experience: + High School Diploma/GED required + Bachelor’s Degree preferred + Knowledge of Excel, Word and Outlook + Strong communication and writing skills + Accuracy and attention to detail Preferred Experience: + Knowledge of PIP, Workers Compensation, and/or Medicare coding regulations and guidelines + Knowledge of Mitchell DecisionPoint and/or Guidewire Claim Center + Certified Professional Coder (CPC) designation Legal Disclaimer: NJM is proud to be an equal opportunity employer. We are committed to attracting, retaining and promoting a diverse and inclusive workforce that is fully representative of the diversity that exists in the communities in which we do business.