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CPC - Certified Professional Coder (AAPC) High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.
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CPC Logistics Solutions is an Equal Opportunity Employer that fully supports diversity in the workplace. The Best Drivers Drive CPC! These flexible positions can supplement your income if you are retired or to make extra money.
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Basic understanding of digital marketing metrics (CPC, CTR, CPM, CPA, ROAS, CVR) and the ability to review data and develop actionable insights. As the Growth Marketing Coordinator & Project Manager, you will play a crucial role in driving the company's growth through strategic marketing initiatives and effective project management.
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Completion of an AHIMA accredited HIM Program with current credentialing as an RHIT, CPC or CCS preferred. Minimum of two years post-secondary education with coursework in business, medical assistant program or nursing assistant program OR equivalent combination of education/experience in coding (one year of education equals one year of experience) required.
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Acts as a liaison for issues affecting various teams (coding, revenue integrity, accounts receivable (AR) follow up, etc.) At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding specific clinical charges and denial management and appeals process in a collaborative environment with revenue cycle management and clinical partners at various Houston Methodist facilities.
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S/he will collaborate with other departments to align with FMV, HCC, and CPC processes, and partner with external vendor aggregators. The role will lead logistics related to SP data RFPs, contracting, and CPC reviews and will drive the day-to-day operations and integration of specialty pharmacy data in downstream processes, including the Patient E2E ecosystem and third-party syndicated data use for field operations.
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Works with revenue cycle management and staff to ensure claim edit/denial trending data is accurate and that all metrics are reported appropriately including specific current procedural terminology (CPT)/healthcare common procedure coding system (HCPCS), denial reasons, and appeals.
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Additionally, this position will collaborate with key stakeholders and assist in developing appeal strategies to include reference material for staff, letter templates, and regular feedback for revenue cycle coding staff; and functions as clinical subject matter expert related to coding denials and appeals.
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CCS - Certified Coding Specialist (AHIMA) Functions as an educational liaison to clinical staff and revenue cycle staff as needed on payer denials, denial reason and trending, interpretation of payer manuals, medical policies, and local/national coverage determinations.
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Possess and maintain one or more of the following coding credentials: CPC, CCS-P, CCS, CPMA or equivalent. Proven familiarity of SNOMED, LOINC, NDC and CDT. Possess and maintain one or more of the following coding credentials: CPC, CCS-P, CCS, CPMA or equivalent.
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Performs data mining and reporting activities that identify net positive impactful opportunities in denials and adjustments for the individual facilities and the system. This position will collaborate with physicians, revenue cycle personnel, and payers to successfully clear front end claim edits, appeal clinical denials, and address customer service inquiries.
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This position will be responsible for working assigned specialties and combines clinical knowledge to reduce financial risk and exposure caused by front end claim edits and retrospective denial of payments for services provided.
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Certification as Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), or Certified Coding Specialist Physician Based (CCS-P), Certified Coding Associate (CCA) required.
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Partners with revenue cycle leadership and peers and clinical operations to reduce denials. Five years of certified coding experience with coding denials+ Accounts receivable follow up experience preferred.
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Associates Degree (RHIT); Bachelors degree preferred and at least one of the following professional certifications: CCS-P, CPC, CPC-H/COC. The Payment Integrity Edits Manager is a Registered Nurse (RN) with active, unrestricted licensure through the Board or Agency charged with providing such licensure in the Auditor's state of residence or RHIA/RHIT/CCS certified through the American Health Information Management Association.
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