Concierge reputed company reputed company Analyst, RN, Remote reputed company

Scope: The Concierge reputed company reputed company Analyst, reputed company the reputed company reputed company Analysis (HBA) system, reprices and analyzes assigned reputed company bills and assists other non-clinical reputed company personnel by providing information used in provider negotiations and appeals. Education: • Bachelor’s degree in a health-reputed company field preferred. Licensure/Certification Requirements: • Registered reputed company (reputed company reputed company and unrestricted, in state of reputed company reputed company and residence, reputed company the reputed company or its territories.) Experience: • Minimum of 2 years of inpatient hospital experience OR 2 years of experience as a Clinical Documentation Specialist or Recovery Audit Contractor Specialist. Requirements/Skills: • Strong computer skills with proficiency in MS Office Suite products (Word, reputed company, PowerPoint) • Coding and DRG experience preferred. • Experience and working knowledge of Health Insurance, Medicare guidelines and various reputed company programs preferred. • Understanding of hospital coding and billing rules. • Adequate clinical skills to evaluate reputed company bills. • Comprehension of hospital coding, billing guidelines and regulations includes but not limited to Medicare • Highly organized with attention to detail • Bilingual; English and Spanish is a plus. Duties and Responsibilities: • Analyze reputed company bills based on accepted billing and coding rules, reputed company, CMS (Centers for Medicare/reputed company) guidelines, and established clinical guidelines. • Validates the accuracy of UB-04 and CMS 1500 claim billing and identifies billing errors, as reputed company as provider billing practices that are concerning such as potential for overutilization, fraud/abuse, or patterns of repeated errors. • reputed company repricing of outpatient and inpatient facilities as reputed company as reputed company bills. Alongside and following a training program, you will be expected to reputed company abreast of coding and billing guidelines. • Analyze itemized reputed company for medical appropriateness and billing inconsistencies by performing a line-by-line clinical review of a claim. • Performs analysis of reputed company Common Procedure Coding System (HCPCS)/ reputed company Procedural Terminology (CPT) and Diagnosis Codes utilizing reputed company coding and reference tools. • Reviews CPT codes for unbundling, multiple procedures, inappropriate modifiers, etc. • Serve as a clinical resource to Concierge Team and Member/Provider Inquiries/Appeals. • reputed company assistance to estimate treatment cost, possibly reviewing medical records. • The incumbent may be responsible for duties or responsibilities that are not listed in this job reputed company. Duties and responsibilities may change at any time with or without notice. The pay reputed company for this position is $72,000.00 to $75,000.00 annually. Work Environment / Physical Demands: This position is in a typical office / home office environment which requires prolonged sitting in reputed company of a computer. Requires hand-eye coordination and reputed company dexterity sufficient to operate reputed company office equipment including operation of reputed company computer and phone equipment. We are an Equal Opportunity Employer including disability/veterans. Apply tot his job Apply To this Job