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SUMMARY: We are seeking a qualified and experienced individual to join our team as Clinical Data Abstraction Team Lead. In this role, you will lead a team of clinical abstraction specialists responsible for analyzing patient medical records to ensure accurate coding for Risk Adjustment and HEDIS purposes.
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This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
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Or similar”) Willingness to learn medical terminology, medical coding systems; ICD-10, CPT4, DRG, GPI. Familiarity with software development, data, and integration architecture Hours/Location: M-F; Days May work remotely but will prefer local applicants for occasional onsite needs.
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Proficiency with drug safety databases (i.e., Argus), electronic data capture (EDC) systems, Medical Dictionary for Regulatory Activities (MedDRA) and World Health Organization (WHO) Drug dictionary coding.
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The Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management.
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In addition to observing and documenting all patient encounters in real time, our Scribes become experts in our value-based care model and the documentation and care of chronic conditions, including ICD-10 and CPT coding.
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This job will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits.
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Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10- CM codes are accurately assigned and supported by clinical documentation to ensure adherence with CMS Risk Adjustment guidelines.
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Minimum of three years of experience in medical coding with ICD-10 and CPT coding systems required. - Perform random and focus-selected medical records review for accurate coding and MS-DRG assignment.
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This job will deliver value to the Health Plan and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and/or Affordable Care Act (ACA) using skills including but not limited to Hierarchical Condition Category (HCC) Coding, medical coding, clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines.
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The CDI Specialist must be devoted to ongoing, continuous learning of clinical medicine; practical understanding of International Classification of Disease coding systems and have the ability to education physicians.
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At least 2 years of CPT / HCPCS and ICD-10 coding experience and medical terminology is required. At least 2 years medical coding and/or billing background. Knowledge of IV drug administration coding and billing is a plus.
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Optometric medical billing and coding. An Optometric Office Technician role may combine skills of a medical office administrator, medical billing and collections, appointment scheduler or medical records clerk and direct patient care.
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Medical billing/coding experience or pre-authorization experience preferred. Medical terminology necessary. Medical billing/coding experience or pre-authorization experience preferred.
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Demonstrates the ability to provide direction to coding staff as it relates to coding integrity, established coding guidelines and Parkland's policies to ensure accuracy of recorded patient medical information and appropriate reimbursement for services rendered.
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