TalentBurst.

  • U.S.A.


  • Irreversible.

  • Full-time.
Task Description

Task Title: Billing and Coding Expert

Place: Remote function – Need to operate in Eastern or Central time zone

Period: 3 months might be extended/ Possible extensions in future; Conversion possibility.

Basic Hours: Flexible, 8-4 or 9-5

Task id # 1129 -1

Interview Process:

  • Zoom or Teams Video call.
  • Supervisor will be accompanied by 2 coders on the group.

Task Description:

Must-Have Abilities

  • Medical record evaluation experience
  • Claim auditing
  • Understanding of CMS/State laws and AMA assistance.
  • Billing knowledge in UB04, 1500 and other health care services.
  • Introduction of the group and function: Payment stability group. Try to include dollars internal by examining medical records and ensure the financial resources match the medical codes and make certain the codes are supported and paid properly.

Nice-To-Have Abilities

  • Physician’s workplace experience
  • Experience Hectic environment
  • Worked for any of these business: Centene, Healthcare Business, Customer Cross, Well Care.
  • Management abilities.
  • Interaction abilities.
  • High school diploma or GED needed
  • Qualified Active Coder- CCS or CPC
  • Organized

Duties

  • Handles claims coding guideline procedure. Assesses claims coding guideline modification demand from scientific, monetary, and declares operations point of views. Supplies regulative and appropriate coding research study on modification demands and makes suggestions on appropriate payment policy and modify performance. Specifies requirements and partners with suppliers throughout screening and application. Supports company dispute/appeal group.
  • Handles research study of claims coding guideline efforts consisting of the advancement of information work strategies.
  • Examining medical records and verifying if medical codes support what is being billed.
  • Gets and logs demands of modifications for tracking functions.
  • Keeps a library of all the existing and retired guidelines, the source of the guideline and the implementation/retire date of the guideline (by Group/Plan/Division).
  • Files supporting authority for each claim coding guidelines by Group/Plan/Division (Master Grid).
  • Takes part in cross-functional groups to deal with crucial claims coding guideline concerns dealing with the company.
  • Administers interaction to Network and gathers feedback.
  • Assesses modification proposition from a regulative point of view, monetary viewpoint, and declares functional point of views.
  • Looks for expert feedback from Health Providers, Financing, and Claims on claims coding guideline modifications.
  • Recognizes coding mistake (e.g., upcoding, bundling/unbundling) and advises proper coding of behavioral health claims.
  • Research study state laws and CPT/AMA assistance.
  • Provides modification propositions.
  • Interacts efficiently to network.
  • Establishes relationship with claims coding guideline software application suppliers.
  • Gets, looks into, and identifies proper action steps for intensified supplier conflicts from Dispute/Appeal group, Claims, and Network.
  • Assistance Claims, Setup, and/or Dispute/Appeal groups as required.
  • Handles high presence tasks and offers suggestions and status to Management.
  • Serves as the very first point of contact in handling daily company problems and assistance for issue resolution.
  • Investigates, evaluates, and provides cost savings chances to Management
  • Perform other responsibilities as designated.

Certifications

  • 5 + & plus; years of experience in the medical coding field with a center, supplier, or payer company.
  • Associate degree chosen, however a mix of education and experience will be thought about.
  • Understanding of CMS/State laws and AMA assistance.
  • Advanced user and understanding of claims payment system.
  • Understanding of 3M Encoder
  • Strong understanding of electronic medical records/billing systems and medical terms and abbreviations.
  • Billing knowledge in UB92, 1500 and other health care services.
  • Understanding of several of the following: SQL, Xcelys, CES, iHT
  • Shown composed interaction abilities.
  • Demonstrated management abilities.
  • Shown interpersonal/verbal interaction abilities.
  • Capability to work as part of a group.
  • Shown analytical abilities.
  • High School Diploma or GED needed
  • CCS – Licensed Coding Expert– Business certificate needed

TalentBurst.

  • Apply Now.