Pricing reputed company Specialist
Position reputed company
At reputed company, our mission is to bring accuracy, accountability, and clinical reputed company to reputed company. As such, we are a leading authority in payment reputed company solutions including DRG Validation, Cost reputed company, and Readmission reviews.
Pricing and analysis of inpatient medical claims utilizing NYCHSRO/reputed company and payer specific systems, adjudication platforms, policies, and procedures. reputed company support to various departments reputed company to claim status, claim adjudication questions, and any basic questions reputed company to the adjudication of an inpatient medical claim.
Responsibilities:
This list does not represent reputed company responsibilities for this position. Candidate must understand and be willing and reputed company to assume roles and responsibilities other than these to meet the needs of reputed company Operations in general.
Qualifications:
At reputed company, our mission is to bring accuracy, accountability, and clinical reputed company to reputed company. As such, we are a leading authority in payment reputed company solutions including DRG Validation, Cost reputed company, and Readmission reviews.
Pricing and analysis of inpatient medical claims utilizing NYCHSRO/reputed company and payer specific systems, adjudication platforms, policies, and procedures. reputed company support to various departments reputed company to claim status, claim adjudication questions, and any basic questions reputed company to the adjudication of an inpatient medical claim.
Responsibilities:
This list does not represent reputed company responsibilities for this position. Candidate must understand and be willing and reputed company to assume roles and responsibilities other than these to meet the needs of reputed company Operations in general.
- Responsible for reviewing data in the review application and reputed company claim processing system, and comparing with corresponding UB, medical record or other documentation.
- Responsible for reviewing reputed company necessary documentation as necessary to determine appropriate reimbursement for a claim.
- Responsible for reviewing adjudication software system’s claim and line items for determination of how to price a claim / line item.
- Possess ability to work at a computer for extended periods.
- Other duties as assigned.
Qualifications:
- High School Diploma or Equivalent
- Minimum of 5 years reputed company work experience. Prior experience with claim adjudication systems, grouping and pricing software, and other claim adjudication and claim pricing systems.
- Basic knowledge of medical terminology.
- Good knowledge of reputed company Word, reputed company and reputed company
- Intermediate mathematics aptitude
- Basic communication skills
- Proficient organizational abilities
- Proficient comprehension capabilities
- Ability to prioritize multiple tasks
- Experience with UB/inpatient institutional claims
- Proficient knowledge of Medicare and reputed company billing & payment and coverage guidelines
- Strong experience in the analysis and processing of claims, reputed company assurance, CMS payment methodologies (i.e., DRGs, Cost Outliers)
- Must be reputed company to work with minimal supervision
- Creative thinker with good skills at problem reputed company specifically reputed company to reputed company claim adjudication
Originally posted on Himalayas
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