Present a concise medical summary within each appeal. Contact appropriate parties as needed for additional information. Determine root cause of each denial and apply company-specific coding. Must meet the following requirements for consideration:
Coordinating medical and long term care services. Completing assessments with members, caregivers, or providers. Qualifications for this position include: Bachelor’s degree, Registered Nurse License, or LPN and 2+ years of care management experience.
A provider of healthcare business and operational services needs applicants for an opening for a Telecommute Medicaid Clinical Review Manager in Tampa. Core Responsibilities of this position include: Applies inpatient InterQual criteria to Medicaid inpatient admissions.
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.
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.
A medical malpractice insurer has a current position open for a Telecommute Medical Claims Specialist in Jacksonville. Individual must be able to fulfill the following responsibilities: Ensure that claims information that impacts decisions in other departments.
A staffing agency is in need of a Telecommuting Medical Chart Abstractor in Jacksonville. Candidates will be responsible for the following: Providing medical abstraction and indexing services. Accommodating changes in business and account needs as they arise. Required Skills:
Skills and Requirements Include: Candidates must reside in Alabama, Georgia, or Florida. Two years of academic facility experience. Three years of outpatient coding experience. Certified Coding Specialist is required. Two years Trauma level 1 or 2 experience.
Candidates will be responsible for the following: Reviewing medical records for the determination of accurate assignment of all documented diagnoses and procedures. Demonstrating ability to achieve accuracy and consistency in the selection of principal and secondary diagnoses.
Explaining company sales, medical underwriting, and enrollment process. Required Skills: An active Health Producer License. FFM Certified. AHip or Gorman Certified. Recent experience being a Health Insurance Agent for at least one season. A patient, caring, personality.