- USAA (Phoenix, AZ)
- …impactful. The Opportunity USAA Life Company's Claim Team is seeking a talented Medical Specialist Principal to play a crucial role in advising the Medicare ... on the morbidity and claims risk of health policies, including Medicare Supplement contracts and claims. The responsibilities will include providing support… more
- Owens & Minor (Tallahassee, FL)
- …**POSITION SUMMARY:** This representative will be required to request Medical documentation and assure received documentation meets insurance payer guidelines. ... including: + Prepayment audits/development letters + Post payment requests for documentation + Overpayment refund requests + Medical necessity documentation … more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment, you will be an expert in risk adjustment coding and ... documentation , working closely with physicians, IPA coders, and risk...A Certified Professional Coder (CPC) certification or Certified Coding Specialist (CCS) certification, required + A Certified Risk Adjustment… more
- TEKsystems (Houston, TX)
- The Billing Support Specialist is designed to streamline patient orders to avoid any unnecessary delays. + Reviewed records for accuracy. + Obtained needed documents ... for missing information on records. + Request necessary documentation (chartnotes, prescription request, medical records, etc) to bill Medicare . + Ensuring… more
- TEKsystems (Des Moines, IA)
- Description The Billing Support Specialist will be responsible for ensuring orders are tasked appropriately between different systems. A Billing Support ... Specialist determines where orders must be tasked to ensure...needed documents for missing information on records. -Request necessary documentation (chartnotes, prescription request, medical records, etc) to bill… more
- PruittHealth (Norcross, GA)
- …**KNOWLEDGE, SKILLS, ABILITIES:** * In-depth knowledge of various billing documentation requirements, the patient accounting system, and various data entry ... codes to ensure proper service documentation and billing of patient accounts. * Knowledge of insurance and governmental programs, regulations and billing processes,… more
- Community Health Systems (Franklin, TN)
- …balances within required time frame. Obtains confirmation of payment or required documentation . + Documents all actions taken on appropriate systems so that is ... clearly communicated process for resolution. + Makes appropriate number of calls based on assigned payer. + Handles and resolves incoming correspondence within 5 days of receipt and updates system + Effectively analyze assigned accounts using AS400, Meditech,… more
- Chesapeake Regional Healthcare (Chesapeake, VA)
- The Medicare Billing and Follow-up Representative are responsible for the compliant, accurate and timely billing and follow-up of all hospital Medicare and ... limited as other tasks may be assigned. + Submit Medicare / Medicare Advantage plan claims both electronic and...and using approved abbreviations for universal understanding + Keep documentation clear , concise , and to the point… more
- CVS Health (Hartford, CT)
- …manner. Group Retiree Solutions (GRS) is a core component of the Aetna Medicare Organization. Our vision is to develop an industry-leading group retiree health care ... assessing risks and issues, adhering to timelines as well as executing and ensuring documentation is clear and concise. The ideal candidate will be able to work… more
- CaroMont Health (Gastonia, NC)
- …work collaboratively with Health Information Management, Utilization Review and Clinical Documentation Specialist to mitigate coding denials. This position is ... Job Summary: The Clinical Documentation and Denial Specialist will assist...Staff, Physician Advisor, Nursing staff, Commercial Payers, VA, Managed Medicare Organizations, Medicare , and Medicaid (Center for… more
