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Experience preferred in conducting or knowledge of hospital and/or physician diagnosis and procedural coding and billing requirements as they relate to Medicare and Medicaid. Coding certification preferred.
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Knowledge of healthcare with relative experience in Claims data, Risk adjustment, Medicare, Quality (5-Star, QRS, HEDIS), and Medicaid. Veradigm is seeking a talented Expert Software Engineer to use best coding practices to identify, document, build, and support the development of the Healthcare Risk Adjustment and New Product suite.
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Knowledge of billing terminology, coding standards, and experience with Medicare, Medicaid, Commercial Insurance, online systems, and Explanations of Benefits. Manage bad debt write-offs and review Medicare bad debt reports monthly.
$62,000 - $82,000 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Consults with users to identify current operating procedures and to clarify program objectives, creates documentation to describe program development, benefit logic, medical coding, work instructions and corrections.
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Experience with other data analytics tools (e.g., Stata, Alteryx), and/or coding languages (e.g., MATLAB, Python, Java, C. We are a rapidly growing, innovative company of community-based healthcare centers delivering higher quality health and wellness care that improves outcomes, manages medical costs and provides an unmatched experience for adults on Medicare.
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Basic knowledge and understanding of CPT procedure coding and ICD-10 diagnostic coding a plus. Basic knowledge of health insurance products (HMO, PPO, HSA, Commercial, Medicare etc.
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AAPC or AHIMA certification in coding within one year of hire with experience in research medical billing and coding. Certifications may include Certified Professional Coder (CPC), Certified Coding Specialist (CCS) and Certified Medical Coder (CMC), and any other specialized coding certification approved by the two main governing bodies.
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Collaborate with internal J&J departments such as marketing, sales, medical science, SCG, IBG, HCC, and PECS. Serve as subject matter expert regarding education and insights on access and affordability solutions across multiple payer types and plans (i.e., Medicare, Medicaid Managed Care, Commercial.
$99,000 - $170,200 a yearFull-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Verify that documentation adheres to established coding guidelines, such as ICD-10 and CPT, and compliance with healthcare regulations (e.g., HIPAA, Medicare, Medicaid). Maintain current knowledge of CMS policies and coding applications for CPT, ICD-10, HCPCS, and other applicable coding standards for medical claims.
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Evaluate coding and documentation to identify recommendations for provider improvement. Assist in providing coding knowledge to providers and billing departments as needed. Knowledge And Compliance With Coding Standards.
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The Research and Compliance Analyst will assist in the administration of the Enterprise Risk Management Program that includes Corporate Compliance Program, HIPAA Privacy Office, and Research. Research compliance and Institutional Review Board (IRB) Certification preferred.
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Maintains all relevant logs, meeting minutes and listings pertaining to CMI, Medicare, as directed or as indicated in policy, procedure, or protocols. Utilizes RAI manual information for accurate and complete coding of all MDS information that is attached to his/her unique login and password within the MDS software system.
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Able to learn and apply technical knowledge in the areas of clinical research, medical coding and revenue cycle in a consultative manner. Screen research protocols to determine whether a formal Medicare Coverage Analysis (MCA) is required.
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WellBe Senior Medical is an innovative, risk-bearing provider organization focused on delivering the highest quality geriatric care (care of older adults) to frail, elderly Medicare Advantage patients with multiple chronic medical conditions.
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The Research and Compliance Analyst will focus on ensuring compliance with regulatory requirements around clinical and non-clinical operations, including, but not limited to nursing, quality, medical staff, allied health, human resources, billing, medical records, facilities, marketing, physician practice and information systems.
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coding medicare jobs in Chicago, IL
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