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Working knowledge of medical coding (ICD-9, CPT-4, etc.) , AHCCCS (Arizona Health Care Cost Control System) plans, FQHC, UDS, government reporting, RVU, and Medicare reimbursement methodology.
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Familiar with billing all major medical insurances, including Medicare, Tricare, and commercial payers. Knowledge of CPT, ICD-10, and HCPCS codes, as well as appropriate modifier usage for billing and following up on open AR claims.
$21 - $22 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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The applicant must have a working knowledge of the Centers for Medicare and Medicaid Services (CMS) guidelines for documentation, coding, and billing services provided by supervising physicians in a teaching setting.
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The Medical Billing Specialist is responsible for accurate claims submission, accounts receivable follow-up, payment posting, EOB and COB processing, credit balance refunds, bad debt and collections.
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Minimum 2 years Medicare MediCal billing and follow up experience in a hospital setting. Comply with hospital and federal policies and guidelines in the billing and collection of Medicare MediCal claims.
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If you are passionate about changing lives, we are looking for you Minimum Education High school diploma or equivalent required Associate's degree preferred Required Skills Must have thorough understanding of ICD-10 Official Coding Guidelines for Coding and Reporting and AHA Coding Clinic; HCPCS/CPT coding systems and CPT Assistant and Coding Clinic for HCPCS guidelines; Medicare Outpatient Prospective Payment System (OPPS), and Ambulatory Payment Classification (APC.
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The Specialist is responsible for reviewing (auditing) medical records to ensure proper billing of professional claims by comparison of provider or coder chosen CPT, HCPCS, HCC, and ICD-10 codes to the providers' documentation to substantiate the appropriate code level, code choice, or necessity of the service.
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This Coding Auditor or Educator is responsible for monitoring compliance with applicable clinical documentation to support coding and billing regulations to ensure appropriate reimbursement for services across all practices/units (acute and ambulatory settings) to include review of accurate and timely assignment of ICD-10 CM/PCS, HCPCS/CPT codes.
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Assist with annual CMS updates and implementation of identified changes, and maintain knowledge of Medicare and Medicaid billing practices, coding guidelines, laws, and regulations. Review and assess supporting documentation in patient medical records for appropriate ICD-10, CPT, HCPCS coding.
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Advanced knowledge of CPT, ASA, and ICD-10 codes, and Managed Care, Medicare, Medicaid and Workers Comp. billing and coding rules, regulations and guidance, as they relate to anesthesia.
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1+ years of experience in Medical Coding (ICD-10, CPT, HCPC) and Billing. Familiarity or experience with the Commercial and Medicare Risk Adjustment Payment Models is strongly preferred.
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Certified Professional Medical Auditor (CPMA), or Certified Healthcare Auditor (CHA) US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factor.
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Certification in coding required (Certified Professional Coder, Certified Coding Specialist) Advanced certification as Certified Anesthesia and Pain Management Coder (CANPC) Requires eye-hand coordination and manual dexterity sufficient to operate keyboard, scanner, copier, telephone and other office equipment.
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Working knowledge of computers and ability to use word-processing, spreadsheet and data base programs. Involves frequent contact with professional staff and managed care organizations. This position is responsible for auditing the accuracy of assigned diagnostic and procedure codes to records of patients; ensuring compliance with federal, state and regulatory requirements; payer requirements; and USAP policies and procedures; providing accurate, meaningful andtimely audit reports and findings to management.
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Certified Professional Medical Auditor (CPMA) completed through American Academy of Professional Coders preferred. Facilitates education during time of on-boarding for all new clinicians regarding effective documentation, coding, and billing guidelines.
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