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Researches, analyzes, and responds to inquiries regarding compliance, inappropriate coding, denials, and billable services identified as part of the review for primary care providers. Provides training, instruction, and support to primary care providers and coders, as appropriate, regarding coding compliance documentation, regulatory provisions, and third party payer requirements as a result of the review or as request by management.
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Experience coding and testing data visualizations using open source or visualization packages such as Tableau or SAS.Strong communication and management skills. Work you’ll doProvide expertise on Medicare (preferably Claims) Healthcare AnalyticsDevelop healthcare data analysis visualizations and support data linkages to those visualizationsPerform data modeling, database development and managementDevelop user stories and mockups for data visualizationPerform coding and testing of data visualizations using open source or visualization packages such as Tableau.
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Acts as a liaison for issues affecting various teams (coding, revenue integrity, accounts receivable (AR) follow up, etc.) At Houston Methodist, the Coding Charges & Denials Specialist is responsible for coordinating and monitoring the coding specific clinical charges and denial management and appeals process in a collaborative environment with revenue cycle management and clinical partners at various Houston Methodist facilities.
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Knowledge of CPT/ICD/HCPS coding. Knowledge of CPT/ICD/HCPS coding. Responsible for auditing medical bills to ensure that they are appropriate and adhere to the State Fee Schedules, customer guidelines and PPO discounts.
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Makes sound design/coding decisions keeping customer experience in the forefront. We are looking for a skilled software test engineer to join our QA team. Makes sound design/coding decisions keeping customer experience in the forefront.
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Fraud certification from CFE, AHFI, AAPC or coding certificates preferred. Claim reviews for appropriate coding, data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy claims.
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Experience with WSDOT, ODOT, and/or ITD coding, preferred but not required. 2 years' experience as an Instrument Operator, Party Chief or Survey Technician. Experience with WSDOT, ODOT, and/or ITD coding, preferred but not required.
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Our journey started in 2006 with medical billing and coding services for physicians, then pivoted to HCC coding for payers. Our journey started in 2006 with medical billing and coding services for physicians, then pivoted to HCC coding for payers.
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Preferred QualificationsPreferred experience working in Value Based Care or Population Health including documenting and coding from a MA (Medicare Advantage) risk perspective and conducting Health Risk Assessments on high risk/chronically ill patients.
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Follows proper coding processes and protocols as set forth in the SMTC SDLC. We are looking for a 100% remote Kinaxis Rapid Response technical resource who can participate in the design, development and analysis of their Kinaxis Rapid Response workbooks/applications.
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Job Description:Cucumber & Java (Strong java coding experience)Deliver a robust automation framework built upon established and proven open-source tools and strong experience on Service layer testing)to support Agile/Scrum development, DevOps, and CI/CDDesign and architect modular and reusable automated testing solutions that satisfy client requirements.
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