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Thorough knowledge of ICD-10, CPT, HCPS, and Revenue Billing Codes. The Sr. Claims Auditor utilizes CPT and ICD-10 coding to review physician claims and medical records for coding accuracy.
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Knowledge of medical billing, HCPCS, CPT and ICD codes. Proficient in the use of end-user computer applications regarding productivity (MS Word, Excel, Outlook), database and patient billing and other medical information systems.
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Knowledge of third party billing requirements, ICD and CPT codes. High School diploma or GED with experience in medical billing. Physical Demands: Requires walking, bending, sitting, standing, writing, reading, telephone use, data input into computer, pulling medical records.
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Accurately transcribes order entry in the electronic medical record, based on physician written orders, when scheduling within the Cancer Center; Demonstrates knowledge of CPT and ICD codes in order to meet billing requirements when scheduling.
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We are searching for an Billing Specialist Sr to performs a variety of duties in support of Revenue Cycle Management functions, including but not limited to the effective and efficient management of revenue related billing work queues and management and oversight of denials and appeals process.
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ICD-10, CPT, HCPCS codes and coding processes Hospital and professional billing processes and reimbursement. Verifies medical necessity in accordance with Centers for Medicare & Medicaid Services (CMS) standards and communicates relevant coverage/eligibility information to the patient.
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The Revenue Coding Specialist is responsible for maintaining a working knowledge of coding and billing regulations for all payers. Maintain knowledge of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), ICD-10- CM/PCS , Ambulatory Payment Classification (APC), and Outpatient Prospective Payment System (OPPS) reimbursement structures and Outpatient Coding Edits (OCE)/Correct Coding Initiative (CCI) edits.
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QUALIFICATIONS Required Qualifications : - The Claims Resolution Specialist must have excellent knowledge of insurance carrier billing and reimbursement with knowledge of medical terminology, ICD-9, and CPT codes.
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Accurately assign appropriate medical codes (CPT, ICD-10, HCPCS) to dermatological procedures and services for billing purposes. We are looking to fill two full-time Billing Specialist vacancies.
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Working knowledge of medical terminology, anatomy and physiology, and disease processes. Working knowledge of anatomy and physiology, medical terminology and insurance reimbursement policies and regulations.
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Prior knowledge of health claims, with experience in computerized medical billing systems in a healthcare environment and familiarity with ICD/CPT coding. Prior experience with medical billing is required.
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Responsible for reviewing medical records to assure proper billing of the medical record, comparison of physician chosen CPT and ICD-10 codes to the physicians' documentation to substantiate the level of coding, physician services to include identification of professional services in and complete review of medical records to accurately optimize all professional services documented for billing.
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Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes, and procedural/surgical techniques through participation in continuing education programs to effectively apply ICD-10-C M and CPT-4 coding guidelines to inpatient and outpatient diagnoses and procedures.
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Perform claims resolution or medical billing and appeals or claims denials in Athena within the last two years. Working knowledge of CPT, ICD-10, and medical terminology. 3+ years of experience in claims resolution or medical billing.
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Audit alpha, numeric or symbolic data from the EMR for patient billing purposes using knowledge of CPT and ICD-10 codes. 1-2 yrs experience as an AR follow-up/Billing specialist Required.
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