Must be able to: Analyze and interpret documentation from medical records. Complete accurate coding of hospital-based diagnoses and procedures. Perform professional fee coding of diagnosis and procedures. Qualifications Include: Proficient in three or more types of outpatient coding.
Required Skills: Available to travel 25% of the time. High School Diploma / GED or higher. 2+ years of managed care or medical insurance experience. 1+ years experience in a claims, customer service or provider support role.
A healthcare company has an open position for a Telecommute Medical Device Account Manager. Core Responsibilities of this position include: Approaching strategically targeted new accounts. Penetrating sales territory by marketing all PCS product lines.
A healthcare company needs applicants for an opening for a Telecommute Appeals and Grievances Behavioral Medical Director Psychiatrist. Core Responsibilities Include: Making clinical coverage determinations. Providing clinical oversight to the clinical staff.
Deliver behavioral health services for hospital emergency departments and medical surgery units. Other duties as assigned. Required Skills: Active full medical license in at least one state with willingness to license in additional states as needed.
Perform medical record review for HEDIS and HEDIS-like measures. Perform over-read of medical records. Qualifications for this position include: 1+ year healthcare/health plan experience. 1+ year HEDIS experience and/or knowledge. Home internet is required.
Review medical bills for relatedness to injury. Qualifications Include: 3 + years of related nursing case management experience. Clinical background with exposure to prescription medications. Valid RN or LPN license (LPN’s may be considered if preferred qualifications are met)
3+ years of experience as a patient account representative in a hospital or medical office setting. Knowledge of commercial payers and their billing requirements. Knowledge of MCOs billing requirements. Experience using Emdeon or related clearinghouse software.
HS Diploma, Vocational Training or Equivalent. Minimum 6 years related healthcare experience. Strong medical laboratory knowledge. Ability to prioritize and multi-task to meet various deadlines. ntermediate working knowledge of Microsoft Office, IE, and research tools.
5+ years of experience developing product pricing and utilizing financial modeling. 3+ years of experience developing and managing a medical cost and administrative budget. 7+ years of experience with provider contracting. Undergraduate degree or equivalent experience.