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HIS - Professional Coding Integrity Specialist - 40 Hrs / Wk
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- Duty 2: Support resolution of claim-scrubber edits (Quadax) resulting from charges entered by the Revenue Integrity Validation team; collaborate with clinical areas, coding, PFS, etc.
- to support resolution of edits; trend, identify opportunities, and collaborate with RI Educator and/or Claims Resolution Specialist to avoid/reduce future edits.
- Duty 4: Identify opportunities related to clinical documentation and/or other system enhancements to support optimal and accurate charge processes; collaborate with CDI Specialist, Claims Resolution Specialist, Revenue Integrity Auditor, Revenue Integrity Educator, clinical area, and other areas to support resolution of issues.
- Demonstrate proficient knowledge of federal, state and third party charging guidelines of clinical areas supported by the Revenue Integrity Validation team to ensure optimal, accurate and compliant charging.
- Understand changes to applicable coding and billing regulations, including annual IPPS/OPPS revisions, by resourcing credible references (i.e. CMS website, Craneware, publications, professional contacts, reliable internet sources, seminars, etc
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