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The Payment Integrity Edits Manager is a Registered Nurse (RN) with active, unrestricted licensure through the Board or Agency charged with providing such licensure in the Auditor's state of residence or RHIA/RHIT/CCS certified through the American Health Information Management Association.
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Must have and maintain one of the following nationally accepted Certified Coding Credentials (I.e., RHIT, RHIA, CPC, CPC-H, CCA, CCS, NRCCS, CCS-P, ROCC or CHONC). Must have and maintain one of the following nationally accepted Certified Coding Credentials (I.e., RHIT, RHIA, CPC, CPC-H, CCA, CCS, NRCCS, CCS-P, ROCC or CHONC.
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RHIT/RHIA certification is Required. Performs comprehensive pre-billing coding data quality reviews on inpatient and/or outpatient records to ensure proper coding guidelines have been followed and appropriate DRG (MS/APR) or APC assignments have been made for appropriate reimbursement.
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RHIA, RHIT, CPHIMS, or other relevant certification based on professional curriculum teaching assignment. RHIA, RHIT, CPHIMS, or other relevant certification based on professional curriculum teaching assignment.
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AHIIMA: RHIT, RHIA, CCS, or CCS-P, or from AAPC - either CPC, COC, CIC, CRC, CPMA, or CPCO. AHIIMA: RHIT, RHIA, CCS, or CCS-P, or from AAPC - either CPC, COC, CIC, CRC, CPMA, or CPCO. Certification as a CPC-A, CPC, specialty AAPC coding certification required, or CCS-P through AHIMA.
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RHIT, RHIA, CCS, or coding certificateSkills and Abilities. Maintain knowledge of current laws and regulations related to insurance, Medicare, Medicaid, and DRG coding, sequencing, and CPT coding.
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Qualifications Education: Graduate as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Professional Coder (CPC), or a Certified Coding Specialist (CCS) from an approved program by the American Health Information Management Association (AHIMA)or the American Academy of Professional Coders (AAPC.
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Registered Health Information Technician (RHIT) / Registered Health Information Administrator (RHIA) preferred. Nestled in the Rocky Mountains of western Montana, between Glacier and Yellowstone national parks.
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At least one of the following recognized professional coding certifications from AHIMA and or AAPC is required: Registered Health Information Technician (RHIT); Registered Health Information Administrator (RHIA); Certified Professional Medical Auditor (CPMA); Certified Professional Coder (CPC); Certified Outpatient Coder (COC);Certified Coding Specialist (CCS); or Certified Coding Specialist Physician (CCS-P.
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Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) or Certified Coding Specialist (CCS) preferred. - Successful completion of RHIA. CCS, RHIT exam, or 2 years supervisory experience without credentials.
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Required Certifications, Registrations, LicensesRegistered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS) or other approved coding credential.
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Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC) Coding credential required from AHIMA/AAPC (RHIA, RHIT, CCS and/or CPC) Review pre-bill cases simultaneously with a physician during each work shift excluding breaks and meetings to analyze and validate diagnosis and procedure codes for inpatient services via coding compliance and clinical knowledge to support accurate DRG assignment.
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Health plan payer or health system experience (5 years minimum) in a payment integrity or revenue integrity related role required. The Payment Integrity Edits Manager has a sound knowledge base in edit research and development in pre- and post-payment medical claims auditing in conjunction with maintaining a robust quality assurance program.
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Below) Active certification through the AAPC or AHIMA (CRC, CCS, CPC, CIC, COC, RHIT, or RHIA) Minimum GED/high school diploma A reliable high-speed internet connection (the faster the better.
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Our goal is to offer above market compensation to talented coders and coding professionals with RHIT, RHIA, CCS, CPC, and other coding certifications. TTF is a search and staffing company that partners with hospitals, physician groups, TPA's, medical management companies, pharmaceutical and pharmacy benefit plan organizations, surgery centers, DME/home health, consulting companies, and all other healthcare fields.
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rhia job
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