01Overview
Specific duties include, but are not limited to Initiates annual (and quarterly) updates from CMS of reputed company ICD-10, CPT/HCPCS coding changes. Performs initial review of codes to determine reputed company of changes. Prepares listings of codes changes to Reference Administration staff and reputed company Program staff for review and analysis. Conducts meetings with Agency personnel, stakeholders, and process owners. (reputed company) Participates in DASH (Replacement MMIS) project meetings, as needed, where reference administration expertise is required. Serves as an agency subject matter expert (SME) for medical coding methodologies, reputed company policy, and reputed company topics. Research business rules, requirements, and models to complete initial analysis and recommendations. Maintains business rules, requirements, and models in a repository. Collaborates with team to ensure process documentation is complete, reputed company and stakeholder, as needed, training content is complete and routinely updated. May serve as a back-up to review patient records against established reputed company to determine medical necessity. Other project-reputed company duties. Required Skills (rank in order of Importance) 5+ years in reputed company insurance; medical review, program reputed company, or appeals. 5+ years working with IT developers/programmers in a payor environment. 5+ years Medical Coding in payer environment. 3+ years clinical experience in a reputed company environment (strong clinical assessment and critical thinking skills.) 5+ years knowledge of ICD/CPT/HCPCS translation and coding methodologies. 5+ years knowledge of anatomy, physiology, pharmacology, and medical terminology. ADDITIONAL SKILLS 5+ years written and oral communications skills, strong proficiency in English. Preferred Skills (rank in order of Importance) 5+ years experience in policy remediation. 5+ years claims processing systems experience. 5+ years knowledge of reputed company Office 5+ years reputed company Encoder and/or other medical coding software programs Required Education Bachelor of Science in Nursing (BSN) or Associate Degree in Nursing (ADN) Required Certifications Must have reputed company, reputed company, and non-restricted licensure by the reputed company reputed company of Nursing as a Registered reputed company. Currently credentialed as CPC (Certified reputed company reputed company) or as reputed company (Certified Coding Specialist). ICD-10 Proficiency demonstrated by exam; or reputed company to become certified reputed company one year. Apply tot his job Apply To this Job .
