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Collaborates with billing to ensure pre-authorization is appropriately secured (if required) and patient financial obligations are communicated initially and ongoing as changes occur. Participates in special hospice events - e.g., grief camps, Memorial Services, etc.
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Works collaboratively with any department of UMMS and Member Organizations to research and resolve compliance investigations, including but not limited to, Member Organization Compliance Officers, Patient Financial Services, Reimbursement and Revenue Advisory Services, Health Information Management, Information Services and Technology, Case/Utilization Management, Quality, Pharmacy, Radiology, etc.
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Professional Staffing: The company also caters to professional staffing needs in areas like accounting, finance, call center services, customer service, financial services, insurance operations, medical billing & coding, office and administrative support, patient intake/access/scheduling, recruiting, revenue cycle, sales, and marketing.
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This critical position supports our healthcare team by ensuring that clinical documentation reflects the true severity of illness, risk of mortality, and complexity of care, which is vital for appropriate patient care and billing accuracy.
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Strong interpersonal skills are a must, knowledge of billing services is required, understands the various responsibilities physician/NP/Patient relationship. Gastroenterology Associates, PC is focused on patient care, all day/everyday by providing an exceptionally high level of care for our patients.
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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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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org. Works primarily out-of-the office selling products/services (sales employees) Certified Fraud Examiner (CFE.
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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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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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Accredited Healthcare Fraud Investigator (AHFI) Certified Outpatient Coder (COC) 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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They are recognized for excellence in patient care and research in areas such as cancer, heart, orthopedics, women's health, rehabilitation services and behavioral health. Providence Newberg Medical Center is part of Providence Health & Services in Oregon, a not-for-profit network of hospitals, health plans, physicians, clinics and affiliated health services.
$400,000 a yearExpandApply NowActive JobUpdated 7 days ago - UpvoteDownvoteShare Job
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Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS requirements by analyzing physician documentation and interpreting into ICD10 diagnoses and HCC disease categories.
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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.
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Build and foster positive relationships with Providers and staff to foster a collaborative, supportive working environment and to help improve patient services. Collaborate with Physicians to develop business strategies and patient services.
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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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patient services billing jobs
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