This position deals with the medical policy group and the scientific group to assist codify requirement standards. Stay present with coding modifications to use defined coding approach for advantage setup and adjudication.
- Accounts for coding and abstracting of scientific standards, consisting of diagnostic and procedural details.
- Investigates and examines information requirements for repayment.
- Audits medical documents and coded information to verify paperwork supports services rendered for repayment and reporting functions.
- Designates codes for repayments, research study and compliance with regulative requirements using standards.
- Act as a contact and resource to workers within other departments of the health insurance for coding problems.
- Functions carefully with Company owner and end users to establish information requirements to satisfy company requirements.
- Carries out analysis on tasks and offers a task strategy that reveals the jobs requiring to be finished and a time quote for each job.
- Offers status reports that provide an in-depth description of the existing task’s development and suggests time dedicated to each job of the job.
- Reacts to advertisement hoc ask for assistance and analysis.
- Assists style prepare for execution, produce user paperwork and training products. Might conduct end user training.
Other Task Requirements
Obligations
- Strong understanding of insurance coverage billing with claims adjudication experience
General Task Details
Title Medical Coding Expert
Grade 20
Work Experience Claims
Education Associates
License and Accreditations – Needed CCS – Qualified Coding Expert – Business, CPC – Qualified Expert Coder – Business
License and Accreditations – Preferred
Magellan Health Providers is happy to be a Level Playing Field Company and a Tobacco-free work environment. EOE/M/F/ Vet/Disabled. Every worker needs to comprehend, comply and vouch for the security duties and security controls distinct to their position.
Magellan Health.
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