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3-5 years of clinical practice, with at least 2 of these years in auditing, appeals, medical review, and CDI. Case management or Utilization Review experience and CM, coding and/or CDI certification a plus.
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Excellent working knowledge of electronic medical records, medical terminology, ICD-10, CPTII coding, and medical coding and billing processes. We are experts in hospitalist integration, and graduate medical education.
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This role relies on medical background, business acumen, and industry-standard clinical / coding guidance to ensure physician and healthcare provider plans, education, reporting and materials are accurate and consistent across the enterprise to support regional and corporate strategic initiatives.
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Our network of nationally recognized medical billing & coding schools makes it easy for you to find the right program in your area - take the first step towards your new career today. My Medical Career is the #1 portal for individuals seeking a career in the Medical Billing & Coding field.
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Preferred Skills MEdical coding, CPT, RCM, ICD. Job Description Position : Medical Coder Consultant. Position : Medical Coder Consultant. No. of Position Medical Coder – 10.
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Provide medical coding for specific services called out in provider contracts. Work with the Provider Contracting/Network team and the Configuration team to ensure contracts are configured per the provider reimbursement contract and Medicare/Medicaid guidelines.
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You will be accountable for reviewing patient medical records in the clinic setting to capture an accurate representation of the severity of illness, risk adjustment and facilitate proper coding.
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Apply coding knowledge to analyze/correct CCI Edits and Medical Necessity Edits. As a Medical Coder, you will provide coding and coding auditing services directly to providers.
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Understanding of medical coding systems affecting the adjudication of patient accounts in EDI or UB04 form. These include ICD-9, CPT, HCPCS, DRG, APG, APC, and revenue code structures. The Director of Managed Care Analytics is responsible for supporting the Vice President Managed Care as well as the Managed Care Contracting team in contract modeling, strategic planning, budgeting, financial analysis, and evaluating potential acquisitions.
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Provides training, mentoring and direction to medical coding staff in the department. Minimum of 5 years experience working with physician offices or clinics working with diagnostic and procedure coding and/or medical billing.
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Minimum two years of related experience preferred, such as accounts receivable follow-up, insurance follow-up and appeals, insurance posting, professional medical/billing, medical payment posting, and cash application.
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Identify appropriate assignment of CPT and ICD-10 Codes for outpatient Ambulatory Same Day Surgery services while adhering to the official coding guidelines and established client coding guidelines of the assigned facility.
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