Demonstrate a good working knowledge of medical terminology, human anatomy, and coding. Must possess knowledge of third party reimbursement regulations and billing practices. Possess moderate knowledge of level 1 and 2 modifiers.
5+ years experience in a direct sales or account management role. Experience in a managed care pharmacy environment. Experience in reviewing and analyzing pharmacy and medical claims data. Proficiency with Microsoft Office with an emphasis on Excel and PowerPoint.
Completing initial medical records reviews of patient records within 24-48 hours of admission. Required Skills: Travel may be required to meet the needs of the facilities. Active state Registered Nurse license. Graduate from a Nursing program, BSN, or graduate.
Must have valid driver's license with good driving record. Active, unrestricted State Registered Nursing (RN) license in good standing. 3+ years hospital acute care/medical experience. Graduate from an Accredited School of Nursing. Required License, Certification, Association.
Minimum 2 years recent experience in medical-oriented scheduling environment. Bilingual in any of the following languages: Spanish. Adept at handling large call volumes, preferably with use of VOIP call systems. Experience with basic insurance guidelines.