COTIVITI
We are currently seeking USRN / PHRN / Medical Coders to support a growing client base while combining their clinical and/or coding expertise with payment accuracy. The RN is responsible for analyzing and interpreting and assign the correct codes for the descriptions available on various medical procedures and diagnosis and other related medical coding as per the medical policy requirements
Job Responsibilities:
Perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical background to ensure appropriateness for reimbursement
Respond to provider appeals
Respond to client logics and record reviews
Monitor acceptance rates for assigned clients and assist management in proactively detecting negative deviations
Contribute to PCI product by providing feedback to Management/Development Teams on changes to enhance editing and efficiency
Reports his/her work performance on a timely basis to the team lead
Works diligently to meet and exceed productivity and quality benchmarks
Takes charge of ongoing learning and development and participates in relevant training and development activities
Training will be during US hours
Willing to work in a 24*7 work environment post training
RELEVANT EXPERIENCE & EDUCATION
2+ yrs of experience in medical coding/ US healthcare claims processing
Registered Nurse (RN) with CPC/COC certification
Experience in US Healthcare, medical coding, medical billing, RCM health plan operations
Possesses knowledge of healthcare claims payment policy and processing - specifically CMS, Medicaid regulations, AAOS, ICD-9, CPT & HCPCS, etc.
Practical clinical experience working in a hospital/office or nursing home
Has general knowledge of medical procedures, conditions, illnesses, and treatment practices
Possesses excellent written and verbal communication skills. Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency
Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.
SKILLS & COMPETENCIES
Strong analytical, critical thinking and problem-solving skills
Excellent verbal and written communication skills
Be a quick learner and proficient in application of learnings
Excel proficiency
Strong organizational skills and adaptive capacity for rapidly changing priorities and workloads
Ability to work well independently and maintain focus on a topic for prolonged periods of time
We are currently seeking USRN / PHRN / Medical Coders to support a growing client base while combining their clinical and/or coding expertise with payment accuracy. The RN is responsible for analyzing and interpreting and assign the correct codes for the descriptions available on various medical procedures and diagnosis and other related medical coding as per the medical policy requirements
Job Responsibilities:
Perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical background to ensure appropriateness for reimbursement
Respond to provider appeals
Respond to client logics and record reviews
Monitor acceptance rates for assigned clients and assist management in proactively detecting negative deviations
Contribute to PCI product by providing feedback to Management/Development Teams on changes to enhance editing and efficiency
Reports his/her work performance on a timely basis to the team lead
Works diligently to meet and exceed productivity and quality benchmarks
Takes charge of ongoing learning and development and participates in relevant training and development activities
Training will be during US hours
Willing to work in a 24*7 work environment post training
RELEVANT EXPERIENCE & EDUCATION
2+ yrs of experience in medical coding/ US healthcare claims processing
Registered Nurse (RN) with CPC/COC certification
Experience in US Healthcare, medical coding, medical billing, RCM health plan operations
Possesses knowledge of healthcare claims payment policy and processing - specifically CMS, Medicaid regulations, AAOS, ICD-9, CPT & HCPCS, etc.
Practical clinical experience working in a hospital/office or nursing home
Has general knowledge of medical procedures, conditions, illnesses, and treatment practices
Possesses excellent written and verbal communication skills. Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency
Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.
SKILLS & COMPETENCIES
Strong analytical, critical thinking and problem-solving skills
Excellent verbal and written communication skills
Be a quick learner and proficient in application of learnings
Excel proficiency
Strong organizational skills and adaptive capacity for rapidly changing priorities and workloads
Ability to work well independently and maintain focus on a topic for prolonged periods of time
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Cotiviti
About the company
Payment Accuracy COB Specialist
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Position clinical Analyst - coding validation recruited by the company Cotiviti at Cebu, Cebu, Joboko automatically collects the salary of , finds more jobs on Clinical Analyst - Coding Validation or Cotiviti company in the links above
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