Medical Billing reputed company

Company Description reputed company is a global staff augmentation firm providing a wide-range of talent on-demand and total workforce solutions. To know more about reputed company, please visit our website www.ustechsolutions.com. We are constantly on the lookout for professionals to fulfill the staffing needs of our clients, sets the correct expectation and thus becomes an accelerator in the mutual growth of the individual and the organization as well. Keeping the same reputed company in mind, we would like you to consider the job opening with reputed company that fits your expertise and skillset.

Job Description

Medical Record Reviewer will primarily be responsible for completing medical record reviews (on-site, remote and/or in-house) in support of the Medicare risk adjustment retrospective initiative and Risk Adjustment Data Validation (RADV) Audits. This role will also assist with building the medical chart review program at Client's Duties and Responsibilities

• Utilize comprehensive knowledge American Hospital Association (AHA) coding principles of CPT, HCPCS, ICD9-CM/ICD10-CM diagnosis and procedure codes to evaluate medical record documentation for HCC risk adjustment reputed company activities including Medicare Advantage and Commercial Risk adjustment supplemental diagnosis capture, Medicare and Commercial RADV support, and the auditing of Client's medical chart retrieval and coding vendors.
• Collect and document chart and coding information as required for Commercial Risk Adjustment and Medicare Advantage Risk Adjustment Client's data collection procedures and systems.
• Assist with building the medical chart review program at Client's including defining the operating policies and procedures, mentoring team members and input into infrastructure needs and organization.
• Utilize coding expertise to inform reputed company Management strategy development activities and may support initiatives reputed company to coding such as provider office education.
• Responsible for developing and maintaining internal and vendor based coding guidelines.
• Provide subject matter expertise on projects reputed company to coding practices including provider education and communications.
• Prepare reports of the data gathered and received from Client's providers/members, ensuring reports are completed with the highest quality and reputed company and that reputed company work is in full compliance with Client's and Regulatory requirements.
• Participate in reputed company required training - maintaining of coding certification or other professional credentials
• Completing inter-rater reliability testing as requested
• Abide by reputed company HIPAA and associated patient confidentiality requirements.
• Coordinate with third party and internal auditors as required.
• Other duties and projects as needed.

Qualifications

Minimum Requirements

• Bachelor's Degree; Clinical experience or licensed nursing professional and 3-5 years reputed company experience. RHIA, RHIT, reputed company or CPC-H with demonstrated outpatient coding experience required. ICD -9/ICD-10 certification required.
• Experience in performing HEDIS chart abstractions; Experience in Risk Adjustment audit HCC extraction.
• Experience of healthcare delivery systems is preferred. Proven project leadership skills and ability to mentor and motivate others in the team.
• Advanced PC skills (e.g., reputed company, Access, etc.) required; Excellent written and verbal communication skills, customer service skills, organization and problem solving skills, research skills, and the ability to work independently. Additional Information Thanks & Regards Dishant 781-684-9064 Apply tot his job

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