Medical Coding Reviewer
Job Responsibilities:
The primary purpose of this of this position is to provide support to the Predictive Modeling Team. The Reviewer will complete audits following industry billing and coding guidelines and client established parameters.
The Reviewer must be motivated, a self-starter and able to work independently. He/she must actively participate with other staff as part of an effective work team.
The position requires the candidate to be detail oriented and able to manage with tight deadlines. Must have the ability to prioritize and organize tasks and shift priorities as needed. Ideal candidates will have strong written and verbal communication skills and will be able to effectively communicate with all levels of the organization. Candidate must also be highly professional, even during high stress situations, and comfortable dealing directly with our clients.
Hold and keep current a certification of Certified Professional Coder (CPC?), Certified Coding Specialist CCS, Certified Inpatient Coder CIC, Certified Outpatient Coder COC (formerly CPC-H), Certified Professional Medical Auditor (CPMA?) from a nationally recognized coding entity. (AAPC, AHIMA)
Responsibilities: Skills Required - Must Have: Is not a remote position
? The ability to perform audit of assigned cases comparing CHAMPS claims submission to the medical record provided.
? Certified Professional Coder (CPC?) or Certified Coding Specialist CCS
? Keeps abreast of regulatory changes affecting coding rules and regulations.
? Identifies any hospital/facility/provider related issues and recommends possible solution and training.
? Maintains workflow and timelines for all client deliverables
? Maintains productivity levels set forth by the Manager while maintaining a 97% accuracy rate.
? Ability to deal with highly sensitive and confidential information and adhere to data security and HIPAA confidentiality procedures.
? Demonstrate tact and understanding in handling problems
? Meet deadlines and completes audit reports promptly and accurately
? Follows up on audits in a timely fashion to ensure that claims are completed
? Provide support and resource for other reviewers/auditors and workflow management
? Working knowledge of medical terminology, patient care services, and medical record chart documentation (inpatient and outpatient).
? Assist department with special projects as needed
? Healthcare claim audit experience
? Knowledge of UB04, HCFA1500, ICD-9CM, ICD-10CM and HCPCS/CPT codes required
? Proficient in Excel and Word
? All other duties as required
Skills - Preferred:
Experience with Medicaid claim processing
Certified Professional Medical Auditor (CPMA?)
Job Snapshot
Employment Type Full-Time
Job Type Health Care, Other
If interested, please submit resume to Nancy.Mayne@cns-inc.com
Job Responsibilities:
The primary purpose of this of this position is to provide support to the Predictive Modeling Team. The Reviewer will complete audits following industry billing and coding guidelines and client established parameters.
The Reviewer must be motivated, a self-starter and able to work independently. He/she must actively participate with other staff as part of an effective work team.
The position requires the candidate to be detail oriented and able to manage with tight deadlines. Must have the ability to prioritize and organize tasks and shift priorities as needed. Ideal candidates will have strong written and verbal communication skills and will be able to effectively communicate with all levels of the organization. Candidate must also be highly professional, even during high stress situations, and comfortable dealing directly with our clients.
Hold and keep current a certification of Certified Professional Coder (CPC?), Certified Coding Specialist CCS, Certified Inpatient Coder CIC, Certified Outpatient Coder COC (formerly CPC-H), Certified Professional Medical Auditor (CPMA?) from a nationally recognized coding entity. (AAPC, AHIMA)
Responsibilities: Skills Required - Must Have: Is not a remote position
? The ability to perform audit of assigned cases comparing CHAMPS claims submission to the medical record provided.
? Certified Professional Coder (CPC?) or Certified Coding Specialist CCS
? Keeps abreast of regulatory changes affecting coding rules and regulations.
? Identifies any hospital/facility/provider related issues and recommends possible solution and training.
? Maintains workflow and timelines for all client deliverables
? Maintains productivity levels set forth by the Manager while maintaining a 97% accuracy rate.
? Ability to deal with highly sensitive and confidential information and adhere to data security and HIPAA confidentiality procedures.
? Demonstrate tact and understanding in handling problems
? Meet deadlines and completes audit reports promptly and accurately
? Follows up on audits in a timely fashion to ensure that claims are completed
? Provide support and resource for other reviewers/auditors and workflow management
? Working knowledge of medical terminology, patient care services, and medical record chart documentation (inpatient and outpatient).
? Assist department with special projects as needed
? Healthcare claim audit experience
? Knowledge of UB04, HCFA1500, ICD-9CM, ICD-10CM and HCPCS/CPT codes required
? Proficient in Excel and Word
? All other duties as required
Skills - Preferred:
Experience with Medicaid claim processing
Certified Professional Medical Auditor (CPMA?)
Job Snapshot
Employment Type Full-Time
Job Type Health Care, Other
If interested, please submit resume to Nancy.Mayne@cns-inc.com