A healthcare company is seeking a Telecommute Medical Expertise Guide. Must be able to: Assist members with finding cost and quality effective facilities. Assist members with finding quality effective surgeons within their health plan. Ask the health plan members appropriate questions.
Skills and Requirements Include: Medical Transportation Billing and Coding Experience a must. High School Diploma or equivalent. Must be able to type 35 wpm. Must be able to bill a minimum of 60 pre-billed claims per day. Working knowledge of Microsoft Outlook and Word.
A medical center is searching for a person to fill their position for a Telecommute Inpatient Coder III in Fort Meyers. Must be able to: Provide ongoing coding/systems education and training of staff. Ensure compliance with all applicable federal, state and local regulations.
Presenting a concise medical summary within each appeal based on support from the medical record. Composing clinical appeal letters to send to payers. Updating the patient account record to identify actions taken on the account. Must meet the following requirements for consideration:
Review medical charts. Apply coding to appropriate charges. Ensure high quality standards are achieved. Required Skills: RHIA, RHIT, or CCS. 5+ years inpatient facility coding with concentration on cardiology, orthopedic, general surgery, etc. experience.
Entering data into appropriate medical management services. Skills and Requirements Include: Experience in clinical practice with experience in appeals & grievances. Understanding of Utilization Review Guidelines.
Local travel of up to 40% may be required. 1-3 years in case management, disease management, managed care or medical or behavioral health settings. Social Worker, MSW - Master's Degree. Must have valid driver's license with good driving record.
Occasional travel required. 2+ years related work experience to include 1+ years of related experience in health insurance industry. High school diploma or equivalent. Knowledge of ICD-9, ICD-10, CPT, and HCPCS coding. MS Outlook Experience. Knowledge of medical terminology.
Completion of an accredited Licensed Practical Nurse (LPN) Program. 1-3 years experience in case management, home health or medical or behavioral health settings. If licensed, license must be active, unrestricted and in good standing.
Assess, plan, implement, coordinate, monitor and evaluate medical services and Return-To-Work options. Work telephonically and focus on disability and medical management activities that result in a timely and sustained RTW. Participate in roundtables, coordinate services and ongoing treatment.