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Certifications: Registered Nurse (RN), Registered Health Information Technologist (RHIT), Registered Health Information Administrator (RHIA), Certified Coding Specialist (CCS), Certified Professional Coder (CPC), Certified Professional Coder-Hospital (CPC-H) orCertified Radiology Cardiovascular Coding (CIRCC.
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Acts as an advisor and consultant in the establishment of operational policies of the practice to include: Purchasing and capital allocations; Managed care plan participation; Budget and practice expenses; Medicare/Medicaid participation; Billing and collection of professional fees; Personnel management and related policies; Risk management and quality assurance; and Coding compliance.
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Collaborates with staff/departments, including, but not limited to: Executive Management, Resource Management, Medical Records, Patient Administration, Group Practice Managers, Health Care Integrators, Coders/Coding Auditors, Population Health Nurse Consultants, Medical Management, Referral Management, TRICARE Operations, patient care teams, Quality Improvement, and the Managed Care Support Contractors.
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Actively seek to obtain certification with American Health Information Management Association (AHIMA) as a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), or Certified Coding Specialist (CCS) and/or Registration with American Association of Professional Coders (AAPC) as a Certified Professional Coder (CPC), Certified Outpatient Coder (COC), Certified Inpatient Coder (CIC) or other equivalent coding certification.
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The Associate Director, Provider Engagement represents the scope of health plan/provider relationship across such areas as financial performance, incentive programs, quality and clinical management, population health, data sharing, connectivity, documentation and coding, HEDIS and STARs performance, operational improvements and other areas as they relate to provider performance, member experience, market growth, provider experience and operational excellence.
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Analysts are responsible for ensuring a successful audit including verifying provider information, medical record retrieval, conducting medical chart reviews on encounters and validating HCC’s which have been submitted via claims data, identifying erroneous data and initiate corrections needed, submitting the final audited record to the coding team, and tracking the entire process.
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Taking personal responsibility for appropriately coding and billing for care rendered. Experience with initial x-ray interpretation prior to over-read from the Radiologist. Nurse Practitioners must be permitted to treat all age groups, from infant to geriatric, as per their board specialty, such as Family Nurse Practitioner.
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Previous experience in family practice, urgent care, emergency medicine or full-service walk in medical clinic. NextCare offers full time employees medical, health savings account, NextCare employee visit program, dental, vision, basic life, voluntary employee/spouse/child life, long term disability, short term disability, employee assistance program, critical illness, accident, legal, identity theft and paid time off benefits.
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Distribute Pfizer RC-approved materials to HCPs/office staff relating to coverage and reimbursement matters, such as Patient Assistance Programs and billing and coding reference guides. Coding and billing knowledge or certification a plus but not required.
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1-2 years of experience in coding and data mining/analysis tools and business intelligence tools with prioritization for candidates with experience using Power BI, SQL, and R or Python. Bachelor’s degree required in fields such as computer programming, statistics, mathematics, analytics, econometrics, data science, information management, or management information systems or relevant related fields of study.
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General Description: Under general direction of the Billing Compliance Director, this position is responsible for the identification, review, investigation and resolution of billing and coding compliance issues and patient complaints.
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In conjunction with the primary account director, implements strategies and tactics to support appropriate formulary placement, reimbursement (coverage, coding, payment, and patient access), pathways across payer customers.
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Title: CoderDepartment: UMCP Central Billing and Coding Specialty: NeurosurgeryDescriptionUMC Physicians is seeking an experienced full-time Neurosurgery Coder to join our team of specialty coders.
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Responsibilities include, but are not limited to, claim denials, underpayments, coding denials, filing of appeals, zero payments and other claim issues that result in incorrect reimbursement towards outstanding claims.
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Requirements: Attend a 30-week paid training program to gain skills and certifications in network security, programming, coding, computer languages, computer systems, communication network operations, and network administrations.
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coding job in Oklahoma City, OK
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