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CERTIFICATE/LICENSE: Core medical coding credential: CPC, CCS-P, or CCS OR Clinical experience such as RN/LPN CRC (Risk Adjustment) credential within 1 year of employment Auditing credential: CPMA, CEMA, CPCO, or relevant experience (Initial demonstration and maintenance of continuing education/membership is required.
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Ensures accurate coding of medical records utilizing JC, MHS and MTF guidelines. Knowledge of a broad range of references such as the ICD-10, CPT, HCPCS, medical dictionaries, manuals relating to coding textbooks and glossaries.
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Nuvance Health has a network of convenient hospital and outpatient locations — Danbury Hospital, New Milford Hospital, Norwalk Hospital and Sharon Hospital in Connecticut, and Northern Dutchess Hospital, Putnam Hospital Center and Vassar Brothers Medical Center in New York — plus multiple primary and specialty care physician practices locations.
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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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CSI Companies Coding and Clinical Data Integrity Practice is immediately seeking a Risk Adjustment Coding Project Manager (Remote) for a contract position with one of our clients in the payer space.
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Associates degree in medical billing/coding, health insurance, healthcare, or related field. 3 years of medical billing/coding, health insurance, and/or healthcare experience.
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Includes audits as directed by the Office of Medical Center Compliance Committee, and/or audits related to Office of Inspector General (OIG) Work plan items, Pre-Billing & Retrospective audits (i.e., Correct Coding, Facility E/M, Infusion Coding), Claims Resolution Audits, RAC audits, Modifier Audits, Charge Capture Audits, and other audits as needed or requested, Outpatient or Inpatient.
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Explain the responsibilities of the billing and coding specialist to protect patient rights under HIPAA. Demonstrate a basic understanding of the anatomy and physiology of body systems and related medical terminology in order to properly process clean claims.
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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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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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The Coding Audit Education and Quality Assurance Manager will directly supervise the provision of medical audit reviews and corresponding analysis to support acceptable and compliant charging, billing and documentation practices for the Maine Health system.
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The coders primary responsibilities are to code, abstract and analyze outpatient medical records using ICD.10 and CPT coding guidelines and educate network providers on proper documentation and coding practice.
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Please check our (Search Category: Medical Coding) for other remote or non-remote coder opportunities in and outside of the State of California. Completion of an AHIMA or APPC accredited coding certification program that includes courses that are critical to coding success such as Anatomy and physiology pathophysiology pharmacology Anatomy I Physiology Medical Terminology and ICD-10 and CPT coding courses etc.
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Successful completion of an American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) coding certification preparation course for professional services or facility coding that includes medical terminology, anatomy and physiology, health information management concepts, and pharmacology; OR.
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We are currently seeking a motivated and detail-oriented individual to join our team as an Entry-Level Medical Billing and Coding Specialist. Engage in a comprehensive on-the-job training program to learn the fundamentals of medical billing and coding.
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