Empower Your Future. Make a Difference. Researches, interprets and writes healthcare correct coding edits using regulatory requirements and guidance related to CMS, CPT/AMA and major payer policies. Possesses an overall understanding of all coding principles, including facility, provider and DME.
- Writes and conducts performance evaluations and progress reports. - Handles associate relations issues. Delivers results in line with the following key metrics/accountabilities: - Overall Sales Quota. - Services Line (P&L) Mix objectives. - E/R Targets. - Associate retention.
Excellent English professional writing skills. Opthalmologic certification or equivalent experience. COT and COMT - COAs will be considered. Ability to participate in live videochat and screensharing sessions. Ability to type at least 60 words per minute.
Experience with technical writing or development of training materials a plus. Knowledge of HEDIS technical specifications and abstraction processes and procedures as pertinent to the specific area of focus. Knowledge of related regulations including NCQA, HIPAA, CMS.
Experience in writing SQL queries and manipulating large amounts of data. Experience creating business requirements based on request - asking for probing questions and providing recommendations for stakeholders.
Required Skills: Travel required: Minimal. Working knowledge of SQL and able to write complex queries. 2 + years' experience in a leadership role. 2 + years' experience in the financial industry field. Strong organizational skills. Strong communication skills (both written and oral)
Creates and maintains project schedules, ensures timely completion through all phases, takes the lead on quality control issues, writes and presents project plans/risks in collaboration with other team members, and proactively drives risks and action items to resolution.
Candidates may be based anywhere in Pennsylvania or Delaware, with up to 20% travel over the course of the year. We are hiring for this position immediately, with applications reviewed on a rolling basis.
Preferred Qualifications. Bachelor's degree in Mental Health or health related field. Experience working with patients or members with chronic conditions. Bilingual (English/Spanish); speaking, reading, writing, interpreting and explaining documents in Spanish and English.