Candidates will be responsible for the following: Using a holistic approach consults with clinical colleagues, supervisors, Medical Directors and/or other programs t. Identifying and escalating quality of care issues through established channels.
Must be able to: Analyze medical information from medical records. Accurately code diagnostic and procedural information. Seek out missing information and create complete records. Qualifications for this position include: High school diploma/GED or equivalent.
2-4 years experienced in a fast-paced, high-volume recruiting and/or staffing environment. Prior pharma sales recruiting or Pharma/Biotech/Clinical/Medical recruiting experience. Successful candidates will have excellent organizational, time management, communication, and interpersonal skills.
Knowledge of official guidelines for coding and reporting. Knowledge of MS-DRGs and reimbursement methods for Medicare, CHAMPUS, Medicaid, other payers. Familiar with charge master and use of CDM for reference. Knowledge of medical terminology, anatomy, physiology, and pharmacology.
Minimum 2 years recent experience in medical-oriented scheduling environment. Must be adept at handling large call volumes, preferably with use of VOIP call systems. Working knowledge of the following systems: EPIC/Cerner and/or PHS.