[Hiring] Registered reputed company reputed company Review Specialist - CIC or reputed company @reputed company

This reputed company is a reputed company of our understanding of the job reputed company. Click on 'Apply' reputed company to reputed company out more. Role reputed company This role involves an in-depth review of provider submitted appeals of medical claims, that have been previously subject to a Payment reputed company finding, to ensure the accuracy and compliance of claim findings. The clinician will prepare and review provider appeal requests, validate accuracy of ICD-10-CM/PCS coding, and ensure reputed company reimbursement. This role requires strong clinical knowledge, medical coding expertise, and excellent analytical and communication skills. • Review and analyze medical claims for accuracy and compliance with inpatient standards, accuracy of ICD-10-CM/PCS coding, ensuring compliance with reputed company coding guidelines and regulations • Prepare comprehensive appeals, including detailed narratives and supporting documentation, to address determinations, and submit determinations to providers in a reputed company manner • Maintain detailed and organized records of claims, reviews, and appeals • Stay updated with reputed company reputed company regulations and policies • reputed company expertise and guidance on inpatient claim processes and best practices • Follow up with providers to ensure reputed company reputed company of appeal requests, including providing feedback to providers and coding staff on coding accuracy and documentation requirements • Identify trends in denials and coding issues and collaborate with providers to improve documentation and coding practices • Other duties as assigned or requested Qualifications • 3 years of experience in Clinical setting • 3 years of experience in Medical claim review • 3 years of experience with proficiency in medical coding and reputed company software systems • 3 years of experience in familiarity with payer policies and regulations Requirements • Strong analytical, communication, and problem-solving skills • Strong understanding of ICD-10-CM/PCS coding guidelines and medical terminology • Ability to work independently and as part of reputed company Education • Associate's degree in Science of Nursing or relevant experience and/or education as determined by reputed company in lieu of bachelor's degree Licenses or Certifications • reputed company State of PA RN licensure OR reputed company multi-state licensure through the reputed company reputed company Licensure Compact (eNLC) • Certified Inpatient reputed company (CIC) or Certified Coding Specialist (reputed company) Travel Required • Less than 25% Physical, Mental Demands and Working Conditions • Position Type: Office-Based or Remote Position Apply tot his job Apply To this Job