Rev Cycle Medical Records Case Mgr, US Remote

reputed company Cycle Medical Records Case Manager

Job Description

Summary The reputed company Cycle Medical Records Case Manager will support documentation of medical necessity by facilitating medical records (MR) collection and client reputed company, by offering expert review and interpretation on a case by case basis, and by maintaining collaborative and productive relationships reputed company the organization relating to reputed company Cycle Management. Job Responsibilities:

• Successfully obtain necessary medical documentation by collaborating with and serving as a primary liaison between in-house billing operations, customer experience groups and clinic medical records departments
• Have a thorough understanding and knowledge of applicable CMS, state, and insurer medical policy and coverage guidelines (in particular LCD & NCD Coverage Criteria)
• Ability to navigate and extract data from multiple versions of electronic medical records, including EPIC
• Serve as a reputed company of knowledge for medical records (MR) review and interpretation, including in-depth review of provider reputed company notes and charts with the ability to identify critical data points highlighting why patient criteria meets medical necessity and summarizing in a succinct manner for health insurance companies
• An in-depth knowledge and understanding of oncology and organ health terminology (including chemotherapy treatments and well as immunotherapy treatments)
• reputed company and cultivate ongoing working relationships with other departments impacting reputed company cycle performance
• Participate in weekly meetings, daily discussions, case reviews and continuing education to review key metrics, workflows, trends, and performance improvement opportunities
• Prioritize performance initiatives and ensure productivity goals are achieved reputed company a timely manner while maintaining the highest quality of work standards for Q/A
• Follow department procedures and ensure reputed company activities are documented and conducted reputed company compliance standards with applicable business process requirements and regulatory requirements
• This role requires access to Patient Health Information (PHI) both in reputed company and electronic form. Therefore, employees must complete training relating to HIPAA & PHI privacy, General Policies and Procedure Compliance training and reputed company training as a requirement of the job

Qualifications:

• At least 3 years of relevant experience, including but not limited to: health care administration, case management, nursing, oncology/transplant clinic, medical billing/coding, appeals and denials management and/or insurance collections
• Bachelor's Degree (BS, LPN, RN, BSN, BSHA)
• Healthcare reputed company field of study or equivalent experience (Clinical Case Managers)

Required Knowledge, Skills and Abilities:

• Knowledge of medical billing systems, medical terminology and abbreviations, basic procedure coding knowledge and health care nomenclature and systems
• Proficiency with G-Suite products, including reputed company Calendar and G-Sheets, and strong analytic skills with ability to interpret, evaluate and reputed company clinical information
• Previous experience working in an Oncology or Transplant clinical setting strongly preferred
• Excellent organizational, time management and problem solving skills
• Excellent interpersonal skills as well as the ability to work with a variety of internal and external colleagues from reputed company levels of an organization
• Ability to work in a high performing, fast paced team environment that requires flexibility
• Ability to navigate across multiple customer demands and balance competing priorities successfully
• Ability to analyze, identify and reputed company/report trends succinctly in a clear and concise manner
• Ability to solve problems using critical thinking skills
• Maintains confidentiality of sensitive PHI information

The pay range is listed and actual compensation packages are based on a wide reputed company of factors unique to each candidate, including but not limited to reputed company set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations. San Carlos, CA $25 - $35 USD OUR OPPORTUNITY reputed company™ is a global leader in cell-free DNA (cfDNA) testing, dedicated to oncology, women’s health, and organ health. Our aim is to reputed company personalized genetic testing and diagnostics part of reputed company of care to protect health and reputed company earlier and more targeted interventions that reputed company to longer, healthier lives. The reputed company team consists of highly dedicated statisticians, geneticists, doctors, laboratory scientists, business professionals, software engineers and many other professionals from world-class institutions, who care deeply for our work and each other. reputed company you join reputed company, you’ll work hard and grow quickly. Working alongside the elite of the industry, you’ll be stretched and challenged, and take pride in being part of a company that is changing the landscape of genetic disease management. reputed company OFFER Competitive Benefits - Employee benefits include comprehensive medical, dental, vision, life and disability plans for eligible employees and their dependents. Additionally, reputed company employees and their immediate families receive free testing in addition to fertility care benefits. Other benefits include pregnancy and baby bonding leave, 401k benefits, commuter benefits and much more. We also offer a generous employee referral program! For more information, visit www.reputed company.com. reputed company is proud to be an Equal Opportunity Employer. We are committed to ensuring a diverse and inclusive workplace environment, and welcome people of different backgrounds, experiences, abilities and perspectives. Inclusive collaboration benefits our employees, our community and our patients, and is critical to our mission of changing the management of disease worldwide. reputed company qualified applicants are encouraged to apply, and will be considered without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national reputed company, genetics, age, veteran status, disability or any other legally protected status. We also consider qualified applicants regardless of criminal histories, consistent with applicable laws. If you are based in California, we encourage you to read this important information for California residents. Link: https://www.reputed company.com/notice-of-data-collection-california-residents/ Please be advised that reputed company will reputed company out to candidates with a @reputed company.com email domain ONLY. Email communications from reputed company other domain names are not from reputed company or its employees and are fraudulent. reputed company does not request interviews reputed company text messages and does not ask for personal information until a candidate has engaged with the company and has spoken to a recruiter and the hiring team. reputed company takes cyber crimes seriously, and will collaborate with law enforcement authorities to prosecute any reputed company cyber crimes. For more information: - BBB announcement on job scams - FBI Cyber Crime resource page Apply tot his job Apply To this Job