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Job DescriptionJob Description Job Title: Medical Billing and Coding SpecialistJob Description:MD Billing Firm is seeking a qualified and experienced Medical Billing and Coding Specialist to join our team.
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3 years HCC coding and/or coding and billing. 5 years HCC coding and/or coding and billing. Associate degree in medical billing/coding, health insurance, healthcare or related field preferred.
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Certified Coding Specialist (CCS) 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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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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Performs HCC coding on projects for MA, ACA, and End Stage Renal Disease (ESRD). Adheres to CMS Guidelines for Coding and Highmark's Policy and Procedures to guide HCC coding decision making. Works closely with physicians, team members, Quality, Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding.
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Engages in RPM Coding educational meetings and annual coding Summit. Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing reports, and identifying process improvements.
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Build partnerships and work within coding teams and internal partners critical to HCC coding. Maintains RPM coding accuracy and productivity requirements. Flexes between coding projects, including Retro and Prospective, with different MA, ESRD, and ACA HCC Models; works independently in various coding applications and electronic medical record systems to support departmental goals.
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Certified Risk Coder (CRC) 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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Registered Health Information Technician (RHIT) Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.
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One (1) year of experience in reception, customer service, and/or record keepingExperience in patient access, billing, cash collections, insurance, pre-certification requirements, or directly related hospital experience.
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These activities include: mainly billing and collections as well as quality assurance, contracting, project management, budgeting, sales administration, financial metrics and reporting, follow ups, etc.
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The CPO works in concert with HDSW administration to complete reports as required, represent the agency as community liaison and work with program Directors to maintain census, corporate compliance, quality improvement activities, and maintain revenue cycle management through Medicaid billing.
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Support the integration of CPQ and Billing application to the Workday Financials. 5+ years of experience implementing and supporting large scale, technically complex solutions on Salesforce ecosystem Experience integrating the Salesforce platform with internal and external systems Programming background using one or more of the languages such as APEX, Visualforce, Lightning, Java. Enterprise integration architectures such as SOA, RESTful, ETL Deep understanding of CPQ, SaaS and subscription billing processes.
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Licensed Practical Nurse Assessment Coordinator (LPNAC) must have Medicare billing knowledge and experience. The LPNAC must be familiar with PPD and medicare/medicaid billing and reimbursements.
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Act as functional SME for all Unanet modules, such as: accounts payable, accounts receivable, general ledger, project setup, cost revenue, billing, employee, labor, payroll, compensation, personnel, cost pools, fixed assets, procurement, etc.
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billing job Title: specialist Company: Medix
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