G-TECH Services - Detroit, MI

posted 3 days ago

Full-time - Senior
Detroit, MI
Fabricated Metal Product Manufacturing

About the position

The Senior Project Manager is responsible for reviewing and researching new code changes released by the Coding Authorities (AMA, CMS) to implement systems for PPO and HMO Commercial Business. This role requires collaboration with various stakeholders, including physicians, to ensure effective mapping activities and compliance with industry standards.

Responsibilities

  • Review and research new code changes released by the Coding Authorities (AMA, CMS).
  • Implement system changes for PPO and HMO Commercial Business.
  • Collaborate with physicians and team members to ensure effective project execution.
  • Analyze and formulate solutions for mapping activities and other applicable areas.

Requirements

  • Bachelor's degree in a related field.
  • Knowledgeable in the use of CPT, HCPCS, ICD-10-CM, and ICD-10-PCS code books.
  • Experience working with BCBSM/BCN benefits and/or claims preferred.
  • Previous experience with NASCO, MOS, and/or BCU systems preferred.

Nice-to-haves

  • RHIT or RHIA with specialty certification of CCS, CCS-P preferred.
  • Knowledge of PPO and HMO claim systems and benefits.
  • Proficient in current industry standard PC applications and systems (e.g. Word, Excel, Microsoft Office).
  • Ability to work independently and handle multiple priorities.
  • Great oral and written communication skills.
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