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Completion of classes in medical terminology, anatomy and physiology, ICD-9, ICD-10 and CPT coding conventions, and disease process from an accredited program. Responsible for accurate coding of all outpatient services, procedures, diagnoses and conditions, working from the appropriate documentation in the medical record.
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Knowledge of screening criteria such as InterQual as well as DRG, ICD-10 and CPT coding is preferred. Three or more years in Managed Care with experience in service coordination, medical and behavioral health utilization management, medical record review, discharge planning, data analysis, and case management of acute and chronic illness.
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Knowledge of Evidence-based Clinical Practice Standards: American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA)Familiarity with ICD-10 and CPT-4 coding practices.
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Ensure that all pertinent and active medical conditions are documented in the medical record in a manner compliant with CMS/DHHS, Inovalon policy, and client requirements. Ensure that all pertinent and active medical conditions are documented in the medical record in a manner compliant with CMS/DHHS, Inovalon policy, and client requirements.
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Recognize emergent or urgent situations requiring escalation and take appropriate action as specified in Inovalon policies, and as determined by reasonable professional judgment and ethical professional practice standards; andPerform, document, and communicate results of Point of Care (POC) Testing.
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ComplexCare Solutions (An Inovalon Company) specializes in helping those in need by delivering high value in-home and virtual assessments for health plans nationwide. Adhere to all confidentiality and HIPAA requirements as always outlined within Inovalon’s Operating Policies and Procedures in all ways and with respect to any aspect of the data handled or services rendered in the undertaking of the position.
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Familiarity with medical coding systems (ICD, CPT, HCPCS, NDC, LOINC, SNOMED, etc.) 100% Medical, Dental & Vision Coverage for Employees. Familiarity with medical coding systems (ICD, CPT, HCPCS, NDC, LOINC, SNOMED, etc.
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CM/PCS, CPT, and HCPCS coding guidelines with working knowledge of DRG, APC and diagnosis sequencing concepts. Certifications/Licenses:Current Registered Health Information Administrator Certificate (RHIA) or a current Registered Health Information Technician Certificate (RHIT) required, or Certified Coding Specialist (CCS.
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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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Deep understanding of real-world uses of standard medical nomenclatures (for example, ICD, CPT/HCPC, LOINC, NDC, SNOMED) and aspects of the Unified Medical Language System (UMLS.
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Biomedical science, software engineering, and program. Axle is seeking a Data Engineering - Data Quality to join our vibrant team at the National Institutes of Health (NIH) supporting the located in Rockville, MD.
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Knowledge of medical terminology, and CPT, ICD-10 coding. Invision Sally Jobe offers a comprehensive benefits package including medical, dental, vision, term life insurance, AD&D, EAP, Short Term Disability, Long Term Disability, PTO and holiday pay for eligible employees.
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Medical terminology, and basic knowledge base of CPT and ICD-9 codes, insurance coding and billing knowledge, Prefer graduate of Medical Secretary Program. In addition the Central Access Specialist will complete insurance verification/pre-registration and financial clearance for special admissions.
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All work will be carried out in accordance with the: International Classification of Diseases - Official Coding Guidelines for coding and reporting as established by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS); American Medical Association (CPT); National Correct Coding Initiative (NCCI); Uniform Hospital Discharge Data Set (UHDDS), Medicaid (OMAP), and organization/institutional coding directives.
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The PFS Sr. Biller must possess extensive knowledge in Insurance billing, including a wide range of knowledge surrounding ICD10, CPT, HCPCS and other coding principles. Demonstrated knowledge of medical terminology, CPT, ICD-10, HCPCS, and modifier codes, including impact on coverage and reimbursement.
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