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We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad.
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Understanding of Medicare/Medicaid, Commercial insurance billing and reimbursement, and value-based care. Understanding of Medicare/Medicaid, Commercial insurance billing and reimbursement, and value-based care.
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Active CPC-A or CPC from AAPC; Knowledge of CPT ICD-10 and HCPCS coding and medical terminology. 2 years of experience working in an ambulatory healthcare setting and working with HMOs, Medicare, Medicaid, PPO, and third-party payers.
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Must have one of the following: - AHIMA (American Health Information Management Association) certification and credential - AAPC (American Academy of Professional Coders) certification and credential·Four (4) years of experience in hospital inpatient coding.
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Participates in DRG Reconciliation with Clinical Documentation Specialist (CDS). QUALIFICATIONS:·High School diploma or GED·Successful completion of the UNC HCS IP Coder Proficiency Test (including AMC.
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Working knowledge of HMO's, Medicare, Medicaid, PPO and third-party payors. All State of Florida requirements met for a Licensed Clinical Social Worker (LCSW) or Licensed Mental Health Counselor (LMHC), with two years post-degree supervised experience.
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Responsible for review and appeal, if warranted, on Medicare and/or third-party denialson charts processed through the MS DRG Assurance program. Responsible for reviewing inclusions and exclusions specific to 30 Day Readmissions andMortality quality measures on specific cohorts for traditional Medicare payers forspecific clients.
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AHIMA credential of CCS, CDIP or ACDIS credential of CCDS is required. Experience with electronic health records (i.e., Cerner, Meditech, Epic, etc.) Graduate of an accredited Health Information Technology or Administration programwith AHIMA credential of RHIT or RHIA preferred.
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Not hiring out of CA, DC, MN, CO, HI, NJ, CT, IL, NV, DE, MA, or NY.Job Summary: The Clinical Coding Analyst is responsible for pre-bill inpatient chart reviewsspecific to MS DRG assignment. AHIMAApproved ICD-10 CM/PCS Trainer preferred.
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Minimum of 7 years of acute inpatient hospital coding, auditing and/or CDI experiencein a large tertiary hospital required. Extensive knowledge of ICD-10 CM/PCS required. Provide verbal review on all cases with a potential MS DRG recommendation and/orphysician query opportunities with the Company Physician(s) via telephone call prior tosubmitting recommendations to the client.
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Audit Manager/Team Lead Meeting – Video Call (1 hour) Ensures that the daily work list is uploaded into the MS DRG Database for assignedclient(s) and enter required data elements for each patient recommendation into MSDRG Database.
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Must have a High-speed internet connection and a dedicated secure workspace to ensureadherence to HIPAA Privacy and Security policies and procedures when viewing protectedhealth information (PHI). Experience with CDI (Clinical Documentation Improvement) programs preferred.
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Provides daily client volumes to Audit Manager no later than 7am EST. Schedule: You choose your specific work hours, however, all CCAs are required to report dailyclient volumes to the Audit Manager by 7am EST for appropriate assignment.
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Your primary objective will be to assess the overall health and well-being of Medicare beneficiaries to ensure accurate and comprehensive risk adjustment coding, leading to greater value-based care.
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Are you passionate about the Medicare population, looking for an opportunity to work in sales, and wanting the ability to directly impact your own income potential? Experience selling Medicare products.
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aapc medicare jobs in Jacksonville, FL
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