Job Summary
Job Status:
Full Time
Location:
-California
Cantact No.:
Email:
Specialty:
all specilties, other
Other Specification:
ICD-10 codes, ICD-9-CM, HIPAA 5010 transaction
Experience Required:
5 Years
Required Medical Billing & Coding Specialist: Nationally Certified, Professional Coder and knowledgeable of International Classification of Diseases and Operation, 9th Revision, Clinical Modification (ICD-9-CM)
Candidate Specification:
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Have experience in One-to-One match between ICD-9-CM and ICD-10; multiple ICD-9-CM codes for a single ICD-10 code and multiple ICD-10 codes for a single ICD-9-CM code as well as CPT-4, DRG and APC and Coding Guidelines
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Can evaluate, train and assist physicians in specifying choices in one to many, one to one and multiple choice destinations in backward and forward cross mapping
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Must be able to Cross map rules and regulations with Federal Government’s Department of Health and Human Services Director of (DHHs) to provide the guidelines for coding and reporting.
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Can analyze the coding accuracy of clinical documentation and mapping codes
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Can amend data according to coding rules, regulatory guidelines and policies plans
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Have experience in Reimbursement Mappings, standard one-to-one reimbursement crosswalk for mapping ICD-10-CM/PCS codes
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Can consult and monitor third party recovery audits
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Provide administrative services for Internal Auditing, Physician billing and auditing experience
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Can interpret medical records and investigating and contributing to the resolution of complex claims
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Clinical documentation and knowledge of Federal and State health care regulations standards policies.
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Implement weekly plans and meetings specifying various milestones of the project with executives, physicians and clients (DHHs) to facilitate moving forward and backward cross mapping in the project.
The successful candidate will have:
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At least 5 years of experience working in a healthcare environment
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At least 5 years instructional design experience creating innovative, blended learning training solutions.
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Strong regulation knowledge of both HIPAA 5010 transaction set and ICD-10 initiatives.
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Lead collaborative projects, processes and facilitate agreement; work effectively as a team member.
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Keep up-to-date and current with technical skills and technologies relevant to the position.
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Take initiative and contribute openly to the project.
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Work towards developing solutions in close partnership with internal and external partners.
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Engage in open feedback forums to elevate the overall standard of performance.
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Assess course materials for revision and continuous improvement purposes.