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Certified Outpatient Coder (COC) Certified Professional Coder (CPC) Certified Fraud Examiner (CFE) Audits consist of contract, commissions, surveillance, workers' compensation and IME. In addition, this position will complete Office of Foreign Asset Control (OFAC) to ensure payments are not issued to unauthorized parties.
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Accredited Healthcare Fraud Investigator (AHFI) 3 years in professional billing, facility Patient Financial Services, HIM, Internal Audit, Professional/Facility Reimbursement or Provider Contracting. Must have knowledge of provider facility payment methodology, claims processing systems and coding and billing proficiency.
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Strong personal computer skills, along with the ability to use fraud/abuse data mining tools are required. Conduct audits for proactive and investigative purposes to comply with internal audit and regulatory requirements.
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The ideal candidate should possess a Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification and a minimum of 3 years of Inpatient and/or Outpatient coding experience.
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Coding Certifications: The following are recognized professional certifications: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Coding Associate (CCA); Certified Professional Coder (CPC); Certified Outpatient Coder (COC); Certified Inpatient Coder (CIC); Certified Coding Specialist (CCS); or Certified Coding Specialist – Physician (CCS-P); Certified Professional Medical Auditor (CPMA.
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The primary responsibility of the Hospital Outpatient Coder III position will be to work through the extreme complex coding and charging structure for interventional cardiology, interventional radiology, and other high risk outpatient coding encounters to ensure the highest level of code accuracy based on physician documentation.
$18.27 - $37.14 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Licenses and Certifications:Minimum – Certification as Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC), Certified Coding Specialist (CCS), or Certified Coding Specialist Physician-Based (CCS-P) required.
$97,500 - $146,100 a yearFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Certified Outpatient Coder (COC) by the American Academy of Professional Coders (AAPC). Certified Professional Coder - Associate (CPC-A) by the American Academy of Professional Coders (AAPC.
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This would be a hybrid position and would require you to be onsite at either our Camp Hill, PA or Pittsburgh, PA location up to 3 days a week. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.
Full-timeExpandApply NowActive JobUpdated 3 days ago - UpvoteDownvoteShare Job
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Certified Professional Coder (CPC), Certified Medical Coder (CMC) with certification from the American Academy of Professional Coders (AAPC); graduate of a comparable Healthcare/HIM program eligible to sit for Certified Professional Coder (CPC), Certified Medical Coder (CMC) or an experienced coder with the Certified Coder Specialist (CCS) credentials would also be considered.
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In addition to the audit and review work, the Coder 1 will work side by side with outpatient providers providing ongoing feedback, coaching, and support with the code entry process, documentation, ICD-9, ICD-10, and HCC coding in alignment with current medical group reimbursement requirements.
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Professional coder certification with credentialing from AHIMA and/or AAPC (CCA, CCS, RHIA, RHIT, CPC-H/COC, CIC, CCS-P, CPC, and CPC-A) to be maintained annually. Identify appropriate assignment of CPT and ICD-10 Codes for outpatient Ambulatory Observation services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility.
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Certified Coding Associate OR Certified Coding Specialist OR Certified Inpatient Coder ICD-10 OR Certified Outpatient Coding OR Certified Professional Coder OR Registered Health Information Administrator OR Registered Health Information Technician.
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Certifications in one or more of the following is preferred: a) American Academy of Professional Coders (AAPC) Certifications: Certified Professional Coder (CPC), Certified Outpatient Coding (COC), Certified Inpatient Coder (CIC), and/or Certified Professional Medical Auditor (CPMA.
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The incumbent is also responsible for the field investigative work necessary to complete a review of a special project, potential fraud, waste and abuse case, conducting the initial investigations and coordinating the recovery/savings of money related to fraud, waste and abuse.
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